Maternal stress to preterm delivery: COVID19 exacerbates pregnancy complications in Kashmir

Srinagar: Journey to motherhood was no less than an ordeal for 35-year-old Yasmeen (name changed) as she got exposed to COVID  19 in February.  Within no time, she began gasping for air and was immediately put on oxygen at SMHS Hospital, Srinagar.

“She was seven-month pregnant and tested positive for COVID  19. Her oxygen saturation level was less than 83 percent and was put on a ventilator. To save the mother’s life, we had to terminate the pregnancy, and she was operated upon immediately. With the result, the baby was preterm,” Dr. Nowsheen Khan, a gynecologist at Lal Ded Hospital, Srinagar said.

Dr. Nousheen, however, noted that they have not observed any significant neonatal effects in babies from COVID -exposed mothers so far.

“At the same time, the fear and anxiety regarding COVID  19 can lead to increased maternal stresses that may cause an increased risk of preterm delivery and low birth weight,” she said.

Sample this: 30-year-old pregnant female reported recurrent bouts of insomnia last week. “The fear of the second COVID  wave had affected her. She was constantly thinking about the baby’s well-being and feared catching the virus. This contributed to her sleeplessness and anxiety levels,” Dr. Rumisa Mir, Medical officer at Sub-district hospital Char-Sharif said.

A study entitled “Perinatal mental health in Kashmir, India during the COVID  19 pandemic,” published in Maternal and Child Health Journal last year, revealed that the percentage of institutional deliveries in Srinagar are high at 7.4% with 2.6% home deliveries.

“COVID  19 influenced the management of perinatal psychiatric conditions in Kashmir. Anxiety and depression during pregnancy are major public health issues, however, they often remain unrecognized. Increased stress in pregnant women could interfere with the neurodevelopment of the fetus which could pose a risk of psychiatric illness. Further, stress could cause puerperal complications such as postpartum depression and poor parental bonding,” the study said.

The study pointed out there is a major challenge in detecting maternal mental health issues; maternal mental health services are largely deficient in Kashmir and health care workers lack mental health training.

“There is a great shortage of mental health professionals, especially in periphery health care,” it said.

Dr. Rumisa said the anxiety in pregnant females can be managed, and counseling should be preferred over medicines.

“We do administer anti-anxiety medicines where the need arises; however, they should be given in the second trimester. But preferably the meds should be avoided as they can have some adverse effects on the baby’s health. The best way is to go for couple counseling, and encourage a good support system around the expecting mother,” she said