1023 The evolution of maternal stressors and coping strategies during the COVID19 pandemic

Abstract

To describe evolving stressors among pregnant women during the COVID19 pandemic and associated coping strategies. Mixed-methods study of pregnant women receiving care at an academic medical center, 3/2020-7/2020. Women were enrolled <28 weeks and completed online surveys regarding effects of the pandemic on stress and multiple aspects of their lives. Free-text answers regarding life stressors and coping methods before and during the pandemic were analyzed using a mixed methods approach. Thematic content analysis was performed on free responses and descriptive statistics were used to compare frequencies of response. Themes reported in pandemic epoch1 (study enrollment 3/2020-4/2020) were compared to those reported in pandemic epoch2 (study enrollment 5/2020–7/2020). Data were analyzed using STATA and Dedoose. 505 women were enrolled: 74% employed; 79% privately insured, 76% self-identified White; 81% married; and 64% have children at home. 41% described individual stressors. Women enrolled during epoch1 were more likely to report stressors than those enrolled in epoch2 (40% vs. 18%, p<0.001). Major stressor themes in epoch1 included: 1. social isolation, 2. balancing work and childcare, 3. COVID19 uncertainty, 4. financial issues, and 5. pregnancy care challenges. There was significant correlation between themes 1 & 2 (32%, p=0.02) and themes 3 & 5 (46%, p=0.01) during epoch1. Themes 1, 2, and 3 persisted in epoch 2 but with additional concerns regarding how social policies impact stress (i.e. the country “opening up”), Table 1. 92% of women reported specific coping strategies; of those, 32% reported no change in coping method during the pandemic. The most commonly identified new strategies included exercise and purposefully calling family and friends, Table 2. Social isolation (1), balancing work and childcare (2), & COVID19 uncertainty (3) are persistent pandemic stressors. These data provides insight into pandemic-related social challenges faced in pregnancy, and identify opportunities for clinicians to provide support.View Large Image Figure ViewerDownload Hi-res image Download (PPT)