Behavioral coping phenotypes and psychosocial outcomes in a national U.S. sample of pregnant and postpartum women during the COVID-19 pandemic

Abstract
Maternal stress exposure during the COVID-19 pandemic may have transgenerational effects, adversely affecting both the pregnant woman and her offspring. Therefore, there is an urgent need to characterize the coping styles and psychosocial distress of pregnant and postpartum women during the COVID-19 pandemic to help mitigate lasting sequalae on both mothers and infants. Here we use latent profile analysis to examine patterns of behavioral coping strategies associated with risk and resiliency to adverse mental and physical health outcomes. Leveraging a large U.S. sample of perinatal women (N = 2,876 pregnant women, N = 1,536 postpartum women), we identified four behavioral phenotypes of coping strategies: (1) passive-coping, characterized by primarily engaging in high levels of screen time, social media use, and eating comfort foods; (2) active-coping, characterized by primarily engaging in high levels of self-care, social support, and limiting media exposure; (3) low-coping, characterized by low levels of all coping strategies; (4) high-coping, characterized by high levels of both active and passive coping strategies. Critically, we found that passive-coping phenotypes were associated with higher levels of depression and anxiety and worsening stress and energy levels in both pregnant and postpartum women. Supplementing passive coping strategies with high levels of active coping strategies (the high-coping profile) lessened adverse outcomes in postpartum women. These behavioral coping phenotypes highlight potential risk and protective factors for perinatal women, which is critical in helping to identify and treat perinatal women most at risk for experiencing mood and affective disorders resulting from the COVID-19 pandemic.