Depression among Jordanian women during pregnancy in COVID-19: Role of social support
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Department of Maternal and Child Health, Jordan University of Science and Technology, Irbid, JORDAN
Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, JORDAN
Faculty of Nursing, Al-Ahliyya Amman University, Amman, JORDAN
Faculty of Nursing, Applied Science Private University, Amman, JORDAN
Zarqa Private University, Zarqa, JORDAN
Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
Online publication date: 2023-03-17
Publication date: 2023-07-01
Electron J Gen Med 2023;20(4):em487
To describe the level of depression and social support experienced by pregnant Jordanian women and assess the role of support and other factors on depression level among a sample of Jordanian women during pregnancy during the COVID-19 pandemic.

The study invitation and link to an online survey were shared during November 2021 via social media and through word of mouth. A convenience sample of 434 pregnant women completed the study questionnaire, which included questions on their COVID-19 status, demographics, depression, and social. Depression was assessed using the Center for Epidemiologic Studies Depressive Scale (CES-D).

The prevalence of depression among women during pregnancy was 28.3%. The mean of depression score among women during pregnancy was 24.3±4.4. The prevalence of social support among women during pregnancy were (63%). The mean social support score among the participants was 39.3±9.1. Factors associated with a higher depression score included not get influenza vaccination, not having insurance, described life as poor, having pressure, and not having social support.

This is a national study among women during pregnancy in Jordan. The study found that people who took influenza vaccination, having insurance, described life as poor, and having pressure, they experience more depression than other people. Moreover, our study found as social support increased, the depression decreased.

Abuhammad, S. Attitude of pregnant and lactating women toward COVID-19 vaccination in Jordan: A cross-sectional study. J Perinat Med. 2022;50(7):896-903. https://doi.org/10.1515/jpm-20... PMid:35503514.
Hatamleh R, Abujilban S, AbuAbed ASA, Abuhammad S. The effects of a childbirth preparation course on birth outcomes among nulliparous Jordanian women. Midwifery. 2019;72:23-9. https://doi.org/10.1016/j.midw... PMid:30771607.
Pomer A, Buffa G, Ayoub M-B, et al. Psychosocial distress among women following a natural disaster in a low- to middle-income country: “Healthy mothers, healthy communities” study in Vanuatu. Arch Womens Ment Health. 2019;22(6):825-9. https://doi.org/10.1007/s00737... PMid:31165924.
Berthelot N, Lemieux R, Garon-Bissonnette J, Drouin-Maziade C, Martel É, Maziade M. Uptrend in distress and psychiatric symptomatology in women during pregnancy during the coronavirus disease 2019 pandemic. Acta Obstet Gynecol Scand. 2020;99(7):848-55. https://doi.org/10.1111/aogs.1... PMid:32449178.
Wu Y, Zhang C, Liu H, et al. Perinatal depressive and anxiety symptoms of women during pregnancy during the coronavirus disease 2019 outbreak in China. Am J Obstet Gynecol. 2020;223(2):240.e1-9. https://doi.org/10.1016/j.ajog... PMid:32437665 PMCid:PMC7211756.
Zanardo V, Manghina V, Giliberti L, Vettore M, Severino L, Straface G. Psychological impact of COVID-19 quarantine measures in northeastern Italy on mothers in the immediate postpartum period. Int J Gynecol Obstet. 2020;150(2):184-8. https://doi.org/10.1002/ijgo.1... PMid:32474910 PMCid:PMC9087548.
Racine N, Hetherington E, McArthur BA, et al. Maternal depressive and anxiety symptoms before and during the COVID-19 pandemic in Canada: A longitudinal analysis. Lancet Psychiat. 2021;8(5):405-15. https://doi.org/10.1016/S2215-... PMid:33773109.
Zhou Y, Shi H, Liu Z, et al. The prevalence of psychiatric symptoms of pregnant and non-women during pregnancy during the COVID-19 epidemic. Transl Psychiat. 2020;10:319. https://doi.org/10.1038/s41398... PMid:32950999 PMCid:PMC7501755.
Hompson KA, Bardone-Cone AM. 2019-nCOV distress and depressive, anxiety and OCD-type, and eating disorder symptoms among postpartum and control women. Arch Womens Ment Health. 2021;24(4):671-80. https://doi.org/10.1007/s00737... PMid:33738572 PMCid:PMC7972814.
Nelson B. The positive effects of COVID-19. BMJ. 2020;369:m1785. https://doi.org/10.1136/bmj.m1... PMid:32366620.
Denckla CA, Mancini AD, Consedine NS, et al. Distinguishing postpartum and antepartum depressive trajectories in a large population-based cohort: The impact of exposure to adversity and offspring gender. Psychol Med. 2018;48(7):1139-47. https://doi.org/10.1017/S00332... PMid:28889814 PMCid:PMC5845817.
Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. J Affect Disord. 2020;277:5-13. https://doi.org/10.1016/j.jad.... PMid:32777604 PMCid:PMC7395614.
Payne JL. Depression: Is pregnancy protective? J Womens Health (Larchmt). 2012;21(8):809-10. https://doi.org/10.1089/jwh.20... PMid:22860768.
Christian LM. Physiological reactivity to psychological stress in human pregnancy: Current knowledge and future directions. Prog Neurobiol. 2012;99(2):106-16. https://doi.org/10.1016/j.pneu... PMid:22800930 PMCid:PMC3479316.
Herrera AY, Hodis HN, Mack WJ, Mather M. Estradiol therapy after menopause mitigates effects of stress on cortisol and working memory. J Clin Endocrinol Metab. 2017;102(12):4457-66. https://doi.org/10.1210/jc.201... PMid:29106594 PMCid:PMC5718702.
Ng QX, Venkatanarayanan N, Loke W, et al. A meta-analysis of the effectiveness of yoga-based interventions for maternal depression during pregnancy. Complement Ther Clin Pract. 2019;34:8-12. https://doi.org/10.1016/j.ctcp... PMid:30712750.
Yu M, Gong W, Taylor B, Cai Y, Xu DR. Coping styles in pregnancy, their demographic and psychological influences, and their association with postpartum depression: A longitudinal study of women in China. Int J Environ Res Public Health. 2020;17(10):3654. https://doi.org/10.3390/ijerph... PMid:32455997 PMCid:PMC7277551.
López DML, Hinojo CAB, Bernal JEA, et al. Resilience and psychological distress in women during pregnancy during quarantine due to the COVID-19 outbreak in Spain: A multicentre cross-sectional online survey. J Psychosom Obstet Gynecol. 2021;42(2):115-22. https://doi.org/10.1080/016748... PMid:33730970.
Farewell CV, Jewell J, Walls J, Leiferman JA. A mixed-methods pilot study of perinatal risk and resilience during COVID-19. J Prim Care Community Health. 2020;11:2150132720944074. https://doi.org/10.1177/215013... PMid:32674654 PMCid:PMC7370556.
Preis H, Mahaffey B, Heiselman C, Lobel M. Pandemic-related pregnancy stress and anxiety among women pregnant during the COVID-19 pandemic. Am J Obstet Gynecol. 2020;2(3):100155. https://doi.org/10.1016/j.ajog... PMid:32838261 PMCid:PMC7295479.
Jarde A, Morais M, Kingston D, et al. Neonatal outcomes in women with untreated antenatal depression compared with women without depression. JAMA Psychiatry. 2016;73(8):826-37. https://doi.org/10.1001/jamaps... PMid:27276520.
Gentile S. Untreated depression during pregnancy: Short- and long-term effects in offspring. A systematic review. Neuroscience. 2017;342:154-66. https://doi.org/10.1016/j.neur... PMid:26343292.
Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385-401. https://doi.org/10.1177/014662....
Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: Evaluation of a short form of the CES-D. Am J Prev Med. 1994;10(2):77-84. https://doi.org/10.1016/S0749-... PMid:8037935.
Zhang W, O’Brien N, Forrest JI, et al. Validating a shortened depression scale (10 item CES-D) among HIV-positive pple in British Columbia, Canada. PLoS One. 2012;7(7):e40793. https://doi.org/10.1371/journa... PMid:22829885 PMCid:PMC3400644.
Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med. 1991;;32(6):705-14. https://doi.org/10.1016/0277-9... PMid:2035047.
Dafaalla M, Farah A, Bashir S, et al. Validity, and reliability of Arabic MOS social support survey. Springerplus. 2016;5(1):1306. https://doi.org/10.1186/s40064... PMCid:PMC4978659.
Durankus F, Aksu E. Effects of the COVID-19 pandemic on anxiety in women during pregnancy: A preliminary study. J Matern Fetal Neonatal Med. 2020;35(2):205-11. https://doi.org/10.1080/147670... PMid:32419558.
Szkody E, Stearns M, Stanhope L, McKinney C. Stress‐buffering role of social support during COVID‐19. Fam Process. 2021;60(3):1002-15. https://doi.org/10.1111/famp.1... PMid:33220082 PMCid:PMC7753728.
Xie RH, He G, Koszycki D, Walker M, Wen SW. Prenatal social support, postnatal social support, and postpartum depression. Ann Epidemiol. 2009;19(9):637-43. https://doi.org/10.1016/j.anne... PMid:19443240.
Zamani P, Ziaie T, Lakeh NM, Leili EK. The correlation between perceived social support and childbirth experience in women during pregnancy. Midwifery. 2019;75:146-51. https://doi.org/10.1016/j.midw... PMid:31125906.
Zhong QY, Gelaye B, VanderWeele TJ, Sanchez SE, Williams MA. Causal model of the association of social support with antepartum depression: A marginal structural modeling approach. Am J Epidemiol. 2018;187(9):1871-9. https://doi.org/10.1093/aje/kw... PMid:29617921 PMCid:PMC6118064.
Ahorsu DK, Imani V, Lin CY, et al. Associations between fear of COVID-19, mental health, and preventive behaviours across women during pregnancy and husbands: An actor-partner interdependence modelling. Int J Ment Health Addict. 2020;20(1):68-82. https://doi.org/10.1007/s11469... PMid:32837427 PMCid:PMC7289236.
Nwafor JI, Okedo-Alex IN, Ikeotuonye AC. Prevalence and predictors of depression, anxiety, and stress symptoms among women during pregnancy during COVID-19-related lockdown in Abakaliki, Nigeria. Malawi Med J. 2021;33(1):54-8. https://doi.org/10.1101/2020.0....
Chuma BT, Sagaro GG, Astawesegn FH. Magnitude and predictors of antenatal depression among women during pregnancy attending antenatal care in Sodo Town, Southern Ethiopia: Facility-based cross-sectional study. Depress Res Treat. 2020;2020:6718342. https://doi.org/10.1155/2020/6... PMid:32308994 PMCid:PMC7152952.
Zhao Y, Kane I, Mao L, et al. The prevalence of antenatal depression and its related factors in Chinese women during pregnancy who present with obstetrical complications. Arch Psychiatr Nurs. 2016;30(3):316-21. https://doi.org/10.1016/j.apnu... PMid:27256935.
Alhawatmeh H, Albataineh R, Abuhammad S. Differential effects of guided imagery and progressive muscle relaxation on physical and emotional symptoms in nursing students taking initial clinical training: A randomized clinical trial. Heliyon. 2022;8(10):e11147. https://doi.org/10.1016/j.heli... PMid:36311359 PMCid:PMC9614822.
AlAzzam M, Abuhammad S, Abdalrahim A, Hamdan-Mansour AM. Predictors of depression and anxiety among senior high school students during COVID-19 pandemic: The context of home quarantine and online education. J Sch Nurs. 2021;37(4):241-8. https://doi.org/10.1177/105984... PMid:33563066.
AlAzzam M, Abuhammad S, Tawalbeh L, Dalky H. Prevalence and correlates of depression, anxiety, and suicidality among high school students: A national study. J Psychosoc Nurs Ment Health Serv. 2021;59(8):43-51. https://doi.org/10.3928/027936... PMid:34110946.
Abuhammad S, Khabour OF, Alomari MA, Alzoubi KH. Depression, stress, anxiety among jordanian people during COVID-19 pandemic: A survey-based study. Inform Med Unlocked. 2022;30:100936. https://doi.org/10.1016/j.imu.... PMid:35399332 PMCid:PMC8977212.
AlAzzam M, Abuhammad S. Knowledge and attitude toward mental health and mental health problems among secondary school students in Jordan. J Child Adolesc Psychiatr Nurs. 2021;34(1):57-67. https://doi.org/10.1111/jcap.1... PMid:33305863.
Abuhammad S. Preparing for future pandemics: Challenges for healthcare leadership. J Healthc Leadersh. 2022;14:131-6. https://doi.org/10.2147/JHL.S3... PMid:36118653 PMCid:PMC9480602.