Maternal mental health during the COVID-19 lockdown in China, Italy, and the Netherlands: a cross-validation study

Psychol Med. 2021 Jan 13;1-11. doi: 10.1017/S0033291720005504. Online ahead of print.


Background: The coronavirus disease 2019 (COVID-19) pandemic had brought negative consequences and new stressors to mothers. The current study aims to compare factors predicting maternal mental health during the COVID-19 lockdown in China, Italy, and the Netherlands.

Methods: The sample consisted of 900 Dutch, 641 Italian, and 922 Chinese mothers (age M = 36.74, s.d. = 5.58) who completed an online questionnaire during the lockdown. Ten-fold cross-validation models were applied to explore the predictive performance of related factors for maternal mental health, and also to test similarities and differences between the countries.

Results: COVID-19-related stress and family conflict are risk factors and resilience is a protective factor in association with maternal mental health in each country. Despite these shared factors, unique best models were identified for each of the three countries. In Italy, maternal age and poor physical health were related to more mental health symptoms, while in the Netherlands maternal high education and unemployment were associated with mental health symptoms. In China, having more than one child, being married, and grandparental support for mothers were important protective factors lowering the risk for mental health symptoms. Moreover, high SES (mother's high education, high family income) and poor physical health were found to relate to high levels of mental health symptoms among Chinese mothers.

Conclusions: These findings are important for the identification of at-risk mothers and the development of mental health promotion programs during COVID-19 and future pandemics.

Keywords: COVID-19 pandemic; cross-validation model; grandparent support; maternal mental health.