COVID-19 Pandemic-Related Perceived Loneliness as a Potential Risk Factor for Worse Outcomes Among People Who are Pregnant or Postpartum

Introduction: People in the perinatal period may be especially susceptible to the effects of social isolation and loneliness. We assessed the COVID-19 pandemic-related impact on loneliness and other outcomes in this population. Methods: A cross-sectional anonymous survey was completed during August–November, 2020, and January–April, 2021, by people who were pregnant or postpartum in Pennsylvania and Wisconsin, respectively. Wilcoxon rank sum, Fisher exact, or chi-square tests were used to compare mental health, substance use, pregnancy-related and overall health, pandemic’s life impact, and social status metrics between 2 groups of respondents: those who screened positive (“Lonely”) versus negative (“Not Lonely”) for loneliness. Multivariate logistic regression analysis assessed factors associated with Lonely versus Not Lonely status. Results: Among 613 respondents, 48.8% were categorized as Lonely. Lonely individuals were more likely to be postpartum (P = 0.01); nulliparous (P = 0.04); have more pregnancy complications (P = 0.049); have a diagnosed mood disorder (P < 0.001); receive mental health care (P < 0.001); have elevated depression (P < 0.001), anxiety (P < 0.001), and stress (P < 0.001) scores; rate their social status as lower (P < 0.001); and endorse a worse pandemic-life impact (P < 0.001). A multivariate analysis identified that being postpartum (OR 0.59; 95% CI, 0.40-0.87) and having worse depression (OR 1.24; 95% CI, 1.13-1.36), stress (OR 0.41; 95% CI, 0.28-0.60), perceived social status (OR 0.83; 95% CI, 0.73-0.95), and pandemic-life impact (OR 1.79; 95% CI, 1.11-2.93) were associated with the Lonely status. Conclusions: Early during the COVID-19 pandemic, screening positive for loneliness was associated with a worse biopsychosocial profile and more pregnancy complications among people in the perinatal period. Focusing efforts on preventing loneliness may help improve outcomes critical for maternal-fetal and child health.