Recommendations for Clinical Practice, Research, and Policy to Address the Effects of the COVID-19 Pandemic on Anxiety Symptoms in Immigrant and U.S.-Born Latina Mothers

More than one-half of pregnant women experience some level anxiety symptoms (Meades and Ayers, 2011Meades R. Ayers S. Anxiety measures validated in perinatal populations: A systematic review.Journal Affective Disorders. 2011; 133: 1-15Crossref PubMed Scopus (224) Google Scholar), with 20%–35% reporting high or evidence an disorder (Fawcett et al., 2019Fawcett E.J. Fairbrother N. Cox M.L. White I.R. Fawcett J.M. The prevalence disorders during pregnancy the postpartum period: multivariate Bayesian meta-analysis.Journal Clinical Psychiatry. 2019; 80: 18r12527PubMed Scholar; Koelewijn 2017Koelewijn Sluijs A.M. Vrijkotte T.G. Possible relationship between general pregnancy-related first half birth process: prospective cohort study.BMJ Open. 2017; 7: e013413Crossref (68) Nakić Radoš 2018Nakić Tadinac M. Herman postpartum: Course, predictors comorbidity depression.Acta Clinica Croatica. 2018; 57: 39-51Crossref (70) Scholar). Experiencing is associated complications (Kurki 2000Kurki T. 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Coussons-Read C.D. prenatal trajectories infant one-year-old offspring.Infant Behavior Development. 2020; 60: 101468Crossref (16) One largest contributors to experiencing pregnancy, salient (Aris-Meijer 2019Aris-Meijer Bockting Stolk Verbeek Beijers van Pampus Burger What if not seventh heaven? influence specific life events delivery transition antenatal into depression.International Environmental Public Health. 16: 2851Crossref (15) Huizink 2017Huizink A. Menting B. De Moor Verhage Kunseler Schuengel Oosterman From parenting stress: study.Archives Women's Mental 20: 663-672Crossref (86) Postpartum can lead disruption mother–infant bond problems breastfeeding sleep, well long-term child well-being psychopathology (Fallon 2016Fallon Groves Halford J.C. Bennett K.M. Harrold J.A. infant-feeding outcomes.Journal Human Lactation. 32: 740-758Crossref (77) Field, 2018Field Postnatal prevalence, development: narrative review.Infant 51: 24-32Crossref (133) Prenoveau 2017Prenoveau Craske West Giannakakis Zioga Lehtonen Stein depression association emotional negativity behavior at two years.Developmental 53: 50-62Crossref (58) Tietz 2014Tietz Zietlow A.L. Reck bonding mothers disorder: crucial subclinical avoidance behaviour.Archives 2014; 17: 433-442Crossref (123) Living through large-scale stressful such natural disasters (King Laplante, 2005King Laplante D.P. children's cognitive Project Ice Storm.Stress. 2005; 8: 35-45Crossref (206) Tees 2010Tees M.T. Harville E.W. Xiong X. Buekens P. Pridjian Elkind-Hirsch Hurricane Katrina-related stress, mental health, temperament.Maternal Child Health Journal. 14: 511-518Crossref (53) terrorist attacks (Maslow 2016Maslow C.B. Caramanica Li Stellman S.D. Brackbill R.M. Reproductive following exposure September 11, 2001, World Trade Center, New York City.American 106: 1796-1803Crossref health emergencies (Preis 2020aPreis Mahaffey Heiselman Lobel Pandemic-related among coronavirus disease 2019 pandemic.American Obstetrics & Gynecology Maternal-Fetal 2: 100155Abstract Full Text PDF (101) Preis 2020bPreis Vulnerability resilience pandemic-related US start COVID-19 pandemic.Social Science 266: 113348Crossref (147) other catastrophic may increase developing symptoms. novel disease-2019 (COVID-19) pandemic has been shown global scale (Salari 2020Salari Hosseinian-Far Jalali Vaisi-Raygani Rasoulpoor Mohammadi Khaledi-Paveh Prevalence anxiety, population pandemic: meta-analysis.Globalization 1-11PubMed Some populations more others. Latinas report highest levels (20%–36%) (Lara-Cinisomo 2019Lara-Cinisomo Fujimoto E.M. Oksas Jian Y. Gharheeb Pilot study exploring migration experiences immigrant Latinas.Maternal 23: 1627-1647Crossref (14) Scholar) compared (15%–20%) (Fairbrother 2016Fairbrother Janssen Antony M.M. Tucker Young A.H. Perinatal incidence.Journal 200: 148-155Crossref (190) they are one fastest-growing United States—a trend driven by rates rather immigration (Stepler Brown, 2016Stepler Brown Statistical Portrait Hispanics States. Pew Washington, DC2016https://www.pewresearch.org/hispanic/2016/04/19/2014-statistical-information-onhispanics-in-united-states/Date accessed: November 15, 2020Google Additionally, although aforementioned events, also exposed various daily psychosocial sociocultural stressors that predispose them period (i.e., year after childbirth). disproportionately likely have socioeconomic status (Bernstein, 2007Bernstein Minority tops 100 million.www.census.gov/Press-Release/www/releases/archives/population/010048.htmlDate: 2007Date 19, Stepler Williams 2010Williams D.R. Mohammed S.A. Leavell Collins Race, health: Complexities, ongoing challenges research opportunities.Annals Academy Sciences. 1186: 69-101Crossref (869) less access insurance (American College Obstetricians Gynecologists (ACOG), 2017American (ACOG)Guidelines care. Author, Elk Grove Village, IL2017Google Rutledge McLaughlin, 2008Rutledge McLaughlin C.G. coverage: rising disparity.Medical Care. 2008; 46: 1086-1092Crossref (33) barriers care (Osterman Martin, 2011Osterman M.J. Martin Epidural spinal anesthesia use labor: 27-state area, 2008.National Vital Statistics Reports. 59: 1-13Google acculturative process adapting new culture (Berry, 2006Berry Acculturative Stress.in: Wong Handbook Multicultural Perspectives Stress Coping. Trinity Western University, Langley, British Columbia2006: 287-298Crossref perceived discrimination elevated across (Preciado D’Anna-Hernandez, 2017Preciado D’Anna-Hernandez trajectory Mexican-American women.Journal 48: 28-35Crossref (21) This commentary highlights complex factors U.S.-born provides recommendations address those ensure short- well-being. resulted devastating illness death States globe (World Organization, 2020World OrganizationWHO Coronavirus dashboard.https://covid19.who.int/Date: 2020Date February 5, 2021Google By 2021, had reported 449,000 deaths alone, significant racial/ethnic inequities (Centers Disease Control Prevention, 2021aCenters PreventionCDC COVID data tracker: Demographic trends.https://covid.cdc.gov/covid-data-tracker/#demographicsDate: 2021Date CDC indicate Latino Americans represent 20.7% cases (where race/ethnicity available) 38% age-adjusted deaths, but comprise only 19.4% (age-standardized) U.S. 2021bCenters state.https://covid.cdc.gov/covid-data-tracker/#cases_casesinlast7daysDate: Centers 2021cCenters PreventionData pregnancy: severity illness.https://covid.cdc.gov/covid-data-tracker/#pregnant-populationDate: Since pandemic, Latinos experienced greatest COVID-19–related (53.6%), which nearly five times seen non-Latino (11.9%) (Rossen 2020Rossen Branum Ahmad Sutton Anderson Excess COVID-19, age race ethnicity — States, January 26–October 3, 2020. MMWR Morbidity Mortality Weekly Report.www.cdc.gov/mmwr/volumes/69/wr/mm6942e2.htm?s_cid=mm6942e2_wDate: 10% Latina were summer 2020, measured antibody total levels, was rate Philadelphia-based (Flannery 2020Flannery D.D. Gouma Dhudasia M.B. Mukhopadhyay Pfeifer M.R. Woodford E.C. Hensley S.E. SARS-CoV-2 seroprevalence parturient Philadelphia.Science Immunology. 5: eabd5709Crossref In showed number (n = 14,423 [31.5%]) positive non-White racial ethnic groups 2021dCenters PreventionHealth disparities: Race Hispanic origin.www.cdc.gov/nchs/nvss/vsrr/covid19/health_disparities.htmDate: Both Black people face increased risks because structural racism limited housing employment prospects ways make it harder follow physical distancing. live crowded conditions jobs deemed essential, including transportation food service (Shah 2020Shah Sachdeva Dodiuk-Gad R.P. disparities.Journal American Dermatology. 83: e35Abstract (91) often permitted work from home (U.S. Bureau Labor Statistics, 2019U.S. StatisticsEconomic news release. 2019https://www.bls.gov/opub/mlr/2020/article/ability-to-work-from-home.htmDate For particular, racism, discrimination, fear deportation under current sociopolitical climate (Williamson Gelfand, 2019Williamson Gelfand I. Trump racism: do say?.www.brookings.edu/blog/fixgov/2019/08/14/trump-and-racism-what-do-the-data-say/Date: 2019Date These contribute worse (Williams, 2018Williams color: Advancing our understanding race-related stressors.Journal Social Behavior. 466-485Crossref (350) decreased marginalized communities (Martinez 2015Martinez Wu Sandfort Dodge Carballo-Dieguez Pinto Chavez-Baray Evaluating policies undocumented immigrants: Immigrant 2015; 947-970Crossref (295) Recent studies men (Becerra 2020Becerra D. Hernandez Porchas Castillo Nguyen Perez González Immigration Examining enforcement immigrants.Journal Ethnic Cultural Diversity Work. 2 9: 43-59Crossref (31) even fearing (Alvarado, 2020Alvarado “Le temo más la deportación que al coronavirus”: Dice enfermera con TPS trabaja en un asilo California.in: Univision Noticias. Noticias, Doral, FL2020Google previous fears significantly Furthermore, particularly vulnerable job loss 11% remain unemployed October 2020—more double pre-pandemic rate—despite national gains all (Ewing-Nelson, 2020Ewing-Nelson Four dropped out labor force September. National Law Center.https://nwlc.org/wp-content/uploads/2020/10/september-jobs-fs1.pdfDate: All these women. June survey 5,000 participants indicated least behavioral symptom highly prevalent (51.9%), 18.6% suicidal thoughts last 30 days (Czeisler 2020Czeisler M.E. Lane R.I. Petrosky Wiley J.F. Christensen Njai Rajaratnam S.M.W. substance use, ideation 24–30, Reports.www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htmDate: Thus, mothers, combined higher subsequent exacerbate minority-related stressors, leading potentially future. Early detection intervention help needs Latinas, distancing reduce transmission limit opportunities evaluate anxiety. Fears about contagion decrease system contact Although assessing be quick when using effective screeners available English Spanish, State-Trait Inventory (Spielberger 1971Spielberger Gorsuch R.L. Lushene Vagg P.R. Jacobs G.A. Development Spanish edition State–Trait Inventory.Revista Interamericana de Psicologia. 1971; 145-158Google Scholar, Spielberger 1983Spielberger Manual Inventory. Consulting Psychologists Press, Palo Alto, CA1983Google Generalized Disorder 7- 2-item versions (García-Campayo 2010García-Campayo Zamorano Ruiz M.A. Pardo Pérez-Páramo López-Gómez Rejas adaptation generalized disorder-7 (GAD-7) screening tool.Health Quality Life Outcomes. 8Crossref (306) Plummer 2016Plummer Manea Trepel McMillan Screening GAD-7 GAD-2: diagnostic metaanalysis.General Hospital 39: 24-31Crossref (706) professionals time owing medical demands related pandemic. Therefore, we recommend multipronged approach cost effective, reach, promote help-seeking behaviors. instance, reliable credible information, public provide clear concrete information social media presentation symptoms, how detected, where seek help. Indeed, recent suggested (Wiederhold, 2020Wiederhold B.K. Using advantage: Alleviating pandemic.Cyberpsychology, Behavior, Networking. 197-198Crossref (94) However, prior messages must culturally relevant language, originate trusted sources, aim reach patients outlets (Clayman 2010Clayman Manganello Viswanath Hesse B.W. Arora N.K. Providing Hispanics/Latinos: Understanding importance trust use.Journal Communication. 15: 252-263Crossref (119) “less comfortable” speaking lower internet, radio, weekly newspapers comfortable others found (Monforti Marichal, 2014Monforti Marichal digital skills formation African States.Social Computer Review. 3-17Crossref (6) shows surge since non-Latinos (Acevedo, 2020Acevedo rely lifeline, Nielsen finds.www.nbcnews.com/news/latino/latinos-rely-more-social-media-coronavirus-lifeline-nielsen-report-finds-n1235968Date: 25, encourage providers psychoeducation targets English- Spanish-speaking We working directly indirectly patient contacts (e.g., pediatric visits) resources regarding prevention, treatment options. addition providing urge aware efforts heightened profiling Lara-Cinisomo Latinas’ risk. remind confidentiality boundaries protect Insurance Portability Accountability Act) requires further action, woman discloses thoughts. frequent throughout appropriate referral (Gregory 2020Gregory K.D. Chelmow Nelson H.D. Van Niel Conry Garcia Ramos adolescent adult women: recommendation Preventive Services Initiative.Annals Internal 173: 48-56Crossref negative fetus (Field, 2017Field effects: 49: 120-128Crossref (84) inform assess evaluates unique financial strain), cultural stress), deportations), changes needed. Several teams developed (Briggs-Gowan 2020Briggs-Gowan Drury S.S. Carter A.S. Muzik Friedman O’Neill Grasso D.J. Epidemic – Pandemic Impacts Module (EPII-P). University Connecticut School Medicine, Farmington2020Google 2020Drury Johnson Hodnett Gaston-Hawkins Liu brief assessment healthcare equity. Tulane Orleans, LA2020Google researchers collaborate comprehensive affect foster development responsive interventions treatments. To elucidate federal funding necessary develop measures, gather sites, analyze promptly. Institutes agencies emergency timely investigators, origin established records communities, conduct linguistically studies. Because monolithic group, should examine affected subgroup Of 14 subgroups Mexicans proportion 64.9% (Motel Patten, 2012Motel Patten 10 Largest groups: Characteristics, rankings, top counties.www.pewresearch.org/hispanic/2012/06/27/the-10-largest-hispanic-origin-groups-characteristics-rankings-top-counties/Date: 2012Date 24, share language many values, 2020 Presidential election political views voting behaviors homogenous (Sonneland, 2020Sonneland H.K. Chart: How voted election.www.as-coa.org/articles/chart-how-us-latinos-voted-2020-presidential-electionDate: differ key demographic characteristics implications structural, psychosocial, security status. clinicians mindful differences best local, state, can, indirectly, First, additional allocated support growing need health. Local, directed bilingual diversity-trained who prepared requiring states matching funds interpreters, required Medicaid recipients, government earmark services state depleted meeting needs. Also, Resources Administration existing grant accessible small large providers. Second, enable community workers serve numbers essential reside so services, added telehealth services. example, Telehealth Network Grant Program expanded urban rural regions country. important, given Latinas' high-risk competing family demands. Third, officials safe workplace standards employers limiting workers’ virus exposure, consider adopting occupational standards, like California, Michigan, Oregon, Virginia done (Michaels Wagner, 2020Michaels Wagner G.R. Occupational Safety (OSHA) worker safety pandemic.JAMA. 324: 1389-1390Crossref (60) Federal tools Fourth, legislation stimulus packages eligible, regardless whether mixed families, members citizens not. Aid, Relief, Economic Security Act (CARES excluded families (Migration Policy Institute, 2020Migration InstituteMixed-status ineligible CARES checks.www.migrationpolicy.org/content/mixed-status-families-ineligible-pandemic-stimulus-checksDate: Forum I., 2020National Forum, I.Fact sheet: Mixed economic relief.https://immigrationforum.org/article/mixed-status-families-and-covid-19-economic-relief/Date: exposing 16.2 million hardship estimated 37% unauthorized immigrants parents children (Passell Taylor, 2010Passell J.S. Taylor III. Household structure; families.www.pewresearch.org/hispanic/2010/08/11/iii-household-structure-mixed-families/Date: 2010Date 21, example solution, payment introduced Republican senators known Assistance Families (CAAF) (S.4381) would allow relief payments individuals homes (Cassidy 2020Cassidy Daines Romney Rubio Act.www.daines.senate.gov/imo/media/doc/Coronavirus%20Assistance%20for%20American%20Families%20Act_Bill%20Text.pdfDate: If passed, could 26.6 17.3 living households (Asad, 2020Asad Latinos’ citizenship legal status, 2007 2018.Proceedings 117: 8836-8844Crossref (49) Immediate policy critical specifically. much-needed relief, elected halt deportations reunite separated U.S.–Mexico border. Our threats persist years Deportations threaten already poorly managed detention centers (Keller 2020Keller B.D. USA: Time act.Lancet e245-e246Abstract (29) Like women, encounter (Durankuş Aksu, 2020Durankuş Aksu Effects preliminary study.The Neonatal : 1-7Crossref (219) 2020Liu Chen Wang Sun Zhang Shi Baker P.N. obstetric decisions Wuhan Chongqing outbreak: cross-sectional study.British Gynaecology. 127: 1229-1240Crossref (105) Salehi 2020Salehi Rahimzadeh Molaei Zaheri Esmaelzadeh-Saeieh experience, equation model.Brain 10: e01835Crossref (81) endure racist encouraged administration, separations border, threats, coronavirus, unequal laws Act. As Biden–Harris administration begins implementing its priorities, understand fighting keep themselves fronts.