Download PDF
CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(10): 765-774
DOI: 10.1055/s-0041-1736174
Original Article
COVID-19

The Impact of the COVID-19 Pandemic on Depression and Sexual Function: Are Pregnant Women Affected More Adversely?

O impacto da pandemia de COVID-19 na depressão e na função sexual: as mulheres grávidas são afetadas de forma mais adversa?
Ramazan Denizli 
1   Department of Gynecology, Arhavi State Hospital, Artvin, Turkey
,
Önder Sakin 
2   Department of Gynecology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
,
Kazibe Koyuncu 
2   Department of Gynecology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
,
Nayif Çiçekli 
3   Department of Gynecology, Mus State Hospital, Mus, Turkey
,
Nihat Farisoğulları 
4   Department of Gynecology, Viransehir State Hospital, Sanliurfa, Turkey
,
Mikail Özdemir 
5   Department of Public Health, Marmara University School of Medicine, Istanbul, Turkey
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Objective To investigate depression and sexual function among pregnant and non-pregnant women throughout the COVID-19 pandemic.

Methods A total of 188 women, 96 pregnant and 92 non-pregnant were included. The Beck Depression Inventory (BDI) and the Arizona Sexual Experience Scale (ASEX) were applied to the participants after obtaining sociodemographic data.

Results The depression scores of pregnant and non-pregnant women were similar (p = 0.846). We found that the depression scores were significantly higher among the group of participants who have lower economic status (p = 0.046). Moreover, the depression score was significantly higher among women who lost their income during the pandemic (p = 0.027). The score on the ASEX was significantly higher, and sexual dysfunction was more prevalent among women who have lower levels of schooling and income (p < 0.05). Likewise, the ASEX scores were significantly higher (p = 0.019) among the group who experienced greater income loss throughout the pandemic. Upon comparing the pregnant and non-pregnant groups, we detected that sexual dysfunction had a significantly higher rate among pregnant women (p < 0.001).

Conclusion In times of global crisis, such as the current pandemic, low-income families have an increased risk of experiencing depression and sexual dysfunction. When we compared pregnant women with non-pregnant women, depression scores were similar, but pregnant women were at a 6.2 times higher risk of developing sexual dysfunction.

Resumo

Objetivo Investigar a depressão e as funções sexuais de mulheres grávidas e não grávidas durante a pandemia de Covid-19.

Métodos Um total de 188 mulheres, 96 grávidas e 92 não grávidas, foram incluídas. O Inventário de Depressão de Beck (Beck Depression Inventory, BDI, em inglês) e a Escala de Experiências Sexuais do Arizona (Arizona Sexual Experience Scale, ASEX, em inglês) foram aplicados aos participantes após a obtenção dos dados sociodemográficos.

Resultados As pontuações de depressão de mulheres grávidas e não grávidas foram semelhantes (p = 0,846). Verificou-se que as pontuações de depressão foram significativamente maiores no grupo de participantes de menor nível econômico (p = 0,046). Além disso, a pontuação de depressão foi significativamente maior em mulheres que perderam sua renda durante a pandemia (p = 0,027). A pontuação na ASEX foi significativamente maior, e a disfunção sexual foi mais prevalente em pessoas com menores escolaridade e nível de renda (p < 0,05). Da mesma forma, as pontuações na ASEX foram significativamente mais altas (p = 0,019) no grupo que experimentou maior perda de renda durante a pandemia. Ao comparar os grupos de gestantes e não gestantes, detectou-se que a disfunção sexual apresentava índice significativamente maior entre as gestantes (p <0,001).

Conclusão Em tempos de crise global, como a atual pandemia, famílias de baixa renda têm um risco maior de sofrer depressão e disfunção sexual. Quando comparamos mulheres grávidas e mulheres não grávidas, as pontuações de depressão foram semelhantes, mas as mulheres grávidas apresentaram um risco 6,2 vezes maior de desenvolver disfunção sexual.

Keywords

COVID-19 - pandemic - pregnant - depression - sexual function

Palavras-chave

Covid-19 - pandemia - grávida - depressão - função sexual

Contributions

All authors participated in the concept and design of the present study; in the analysis and interpretation of data; in the draft or revision of the manuscript; and they have approved the manuscript as submitted. All authors are responsible for the reported research.


Ethical considerations

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.




Publication History

Received: 03 November 2020

Accepted: 08 August 2021

Article published online:
16 November 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Budak F, Korkmaz Ş. [An overview of the COVID-19 pandemic process: the case of Turkey]. J Soc. Res Manage 2020; (01) 62-79 Turkish.
    CrossrefPubMedSearch in Google Scholar
  • 2 Ankarali H, Ankarali S, Erarslan N. COVID-19, SARS-CoV2, infectıon: current epidemiological analysis and modeling of Disease. Anatol Clin J Med Sci. 2020; 25 (Suppl. 01) 1-22
    CrossrefPubMedSearch in Google Scholar
  • 3 Açikgöz Ö, Günay A. The early impact of the Covid-19 pandemic on the global and Turkish economy. Turk J Med Sci 2020; 50 (SI-1) 520-526
    CrossrefPubMedSearch in Google Scholar
  • 4 Freeman A, Tyrovolas S, Koyanagi A, Chatterji S, Leonardi M, Ayuso-Mateos JL. et al. The role of socio-economic status in depression: results from the COURAGE (aging survey in Europe). BMC Public Health 2016; 16 (01) 1098
    CrossrefPubMedSearch in Google Scholar
  • 5 Kuehner C. Why is depression more common among women than among men?. Lancet Psychiatry 2017; 4 (02) 146-158
    CrossrefPubMedSearch in Google Scholar
  • 6 Richards D, Sanabria AS. Point-prevalence of depression and associated risk factors. J Psychol 2014; 148 (03) 305-326
    CrossrefPubMedSearch in Google Scholar
  • 7 Thapa SB, Mainali A, Schwank SE, Acharya G. Maternal mental health in the time of the COVID-19 pandemic. Acta Obstet Gynecol Scand 2020; 99 (07) 817-818
    CrossrefPubMedSearch in Google Scholar
  • 8 Kim DR, Sockol LE, Sammel MD, Kelly C, Moseley M, Epperson CN. Elevated risk of adverse obstetric outcomes in pregnant women with depression. Arch Women Ment Health 2013; 16 (06) 475-482
    CrossrefPubMedSearch in Google Scholar
  • 9 López-Morales H, Del Valle MV, Canet-Juric L, Andrés ML, Galli JI, Poó F. et al. Mental health of pregnant women during the COVID-19 pandemic: A longitudinal study. Psychiatry Res 2021; 295: 113567
    CrossrefPubMedSearch in Google Scholar
  • 10 Figueiredo B, Conde A. Anxiety and depression in women and men from early pregnancy to 3-months postpartum. Arch Women Ment Health 2011; 14 (03) 247-255
    CrossrefPubMedSearch in Google Scholar
  • 11 Garcia S, Moreno S, Aponte H. Prevalence of sexual dysfunction in female outpatients and personnel at a Colombian hospital: correlation with hormonal profile. J Sex Med 2008; 5 (05) 1208-1213
    CrossrefPubMedSearch in Google Scholar
  • 12 Orji EO, Ogunlola IO, Fasubaa OB. Sexuality among pregnant women in South West Nigeria. J Obstet Gynaecol 2002; 22 (02) 166-168
    CrossrefPubMedSearch in Google Scholar
  • 13 Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561-571
    CrossrefPubMedSearch in Google Scholar
  • 14 Beck AT, Steer RA, Brown GK. BDI-II: Beck Depression Inventory manual. 2nd ed.. San Antonio: Psychological Corporation; 1996
    Search in Google Scholar
  • 15 Hisli N. [A reliability and validity study of Beck Depression Inventory in a university student sample]. Turk. J Psychol 1989; 7 (23) 3-13 Turkish.
    PubMedSearch in Google Scholar
  • 16 McGahuey CA, Gelenberg AJ, Laukes CA, Moreno FA, Delgado PL, McKnight KM. et al. The Arizona sexual experience scale (Asex): reliability and validity. J Sex Marital Ther 2000; 26 (01) 25-40
    CrossrefPubMedSearch in Google Scholar
  • 17 Soykan A. The reliability and validity of Arizona sexual experiences scale in Turkish ESRD patients undergoing hemodialysis. Int J Impot Res 2004; 16 (06) 531-534
    CrossrefPubMedSearch in Google Scholar
  • 18 Kinsella MT, Monk C. Impact of maternal stress, depression and anxiety on fetal neurobehavioral development. Clin Obstet Gynecol 2009; 52 (03) 425-440
    CrossrefPubMedSearch in Google Scholar
  • 19 Sandman CA, Wadhwa PD, Chicz-DeMet A, Dunkel-Schetter C, Porto M. Maternal stress, HPA activity, and fetal/infant outcome. Ann N Y Acad Sci 1997; 814: 266-275
    CrossrefPubMedSearch in Google Scholar
  • 20 Çalik KY, Aktaş S. [Depression in pregnancy: prevalence, risk factors and treatment]. Curr Approaches Psychiatry. 2011; 3 (01) 142-162 Turkish.
    PubMedSearch in Google Scholar
  • 21 Burger PHM, Neumann C, Ropohl A, Paulsen F, Scholz M. Development of depression and deterioration in quality of life in German dental medical students in preclinical semesters. Ann Anat 2016; 208: 183-186
    CrossrefPubMedSearch in Google Scholar
  • 22 Açikgöz A, Dayi A, Binbay T. [Prevalence of depression among female university students and associated factors]. Cukurova Med J. 2018; 43 (01) 131-140 Turkish.
    CrossrefPubMedSearch in Google Scholar
  • 23 Durankuş F, Aksu E. Effects of the COVID-19 pandemic on anxiety and depressive symptoms in pregnant women: a preliminary study. J Matern Fetal Neonatal Med 2020; •••: 1-7 [ahead of print]
    CrossrefPubMedSearch in Google Scholar
  • 24 Wu Y, Zhang C, Liu H, Duan C, Li C, Fan J. et al. Perinatal depressive and anxiety symptoms of pregnant women along with COVID-19 outbreak in China. Am J Obstet Gynecol 2020; 223 (02) 240.e1-e9
    CrossrefPubMedSearch in Google Scholar
  • 25 Almeida-Filho N, Lessa I, Magalhães L, Araújo MJ, Aquino E, James SA. et al. Social inequality and depressive disorders in Bahia, Brazil: interactions of gender, ethnicity, and social class. Soc Sci Med 2004; 59 (07) 1339-1353
    CrossrefPubMedSearch in Google Scholar
  • 26 Kaya B. [Depression: a socio-economic and cultural perspective]. Turk J Clin Psychiatr. 2007; 10 (06) 11-20 Turkish.
    PubMedSearch in Google Scholar
  • 27 Salonia A, Munarriz RM, Naspro R, Nappi RE, Briganti A, Chionna R. et al. Women's sexual dysfunction: a pathophysiological review. BJU Int 2004; 93 (08) 1156-1164
    CrossrefPubMedSearch in Google Scholar
  • 28 Basson R, Althof S, Davis S, Fugl-Meyer K, Goldstein I, Leiblum S. et al. Summary of the recommendations on sexual dysfunctions in women. J Sex Med 2004; 1 (01) 24-34
    CrossrefPubMedSearch in Google Scholar
  • 29 Anğın AD, Özkaya E, Çetin M, Gün I, Sakin O, Ertekin LT. et al. Comparison of female sexual function and sexual function of their partners between groups of pregnant and non-pregnant women. Ginekol Pol 2020; 91 (05) 235-239
    CrossrefPubMedSearch in Google Scholar
  • 30 Aydin M, Cayonu N, Kadihasanoglu M, Irkilata L, Atilla MK, Kendirci M. Comparison of sexual functions in pregnant and non-pregnant women. Urol J 2015; 12 (05) 2339-2344
    PubMedSearch in Google Scholar
  • 31 Anees M, Batool S, Imtiaz M, Ibrahim M. Socio-economic factors affecting quality of life of Hemodialysis patients and its effects on mortality. Pak J Med Sci 2018; 34 (04) 811-816
    CrossrefPubMedSearch in Google Scholar
  • 32 Alp Yilmaz F, Avci D, Arzu Aba Y, Ozdilek R, Dutucu N. Sexual dysfunction in postpartum Turkish women: it's relationship with depression and some risk factors. Afr J Reprod Health 2018; 22 (04) 54-63
    CrossrefPubMedSearch in Google Scholar
  • 33 Astepe BS, Köleli I. A cross-sectional study of female sexual dysfunction among Turkish pregnant and nonpregnant women: correlation with hormone profile. Eur Respir J 2018; 5 (02) 258-267
    CrossrefPubMedSearch in Google Scholar
  • 34 Acele EÖ, Karaçam Z. Sexual problems in women during the first postpartum year and related conditions. J Clin Nurs 2012; 21 (7-8): 929-937
    CrossrefPubMedSearch in Google Scholar
  • 35 Banaei M, Moridi A, Dashti S. Sexual dysfunction and its associated factors after delivery: longitudinal study in Iranian women. Mater Sociomed 2018; 30 (03) 198-203
    CrossrefPubMedSearch in Google Scholar
  • 36 Makkii M, Yazdi NA. Sexual dysfunction during primiparous and multiparous women following vaginal delivery. Tanzan J Health Res 2012; 14 (04) 263-268
    CrossrefPubMedSearch in Google Scholar
  • 37 Kahramanoglu I, Baktiroglu M, Hamzaoglu K, Kahramanoglu O, Verit FF, Yucel O. The impact of mode of delivery on the sexual function of primiparous women: a prospective study. Arch Gynecol Obstet 2017; 295 (04) 907-916
    CrossrefPubMedSearch in Google Scholar
  • 38 Mollaioli D, Sansone A, Ciocca G, Limoncin E, Colonnello E, Di Lorenzo G. et al. Benefits of sexual activity on psychological, relational, and sexual health during the COVID-19 breakout. J Sex Med 2021; 18 (01) 35-49
    CrossrefPubMedSearch in Google Scholar
  • 39 Caruso S, Rapisarda AMC, Minona P. Sexual activity and contraceptive use during social distancing and self-isolation in the COVID-19 pandemic. Eur J Contracept Reprod Health Care 2020; 25 (06) 445-448
    CrossrefPubMedSearch in Google Scholar