ANXIETY DURING THE COVID-19 PANDEMIC: PRELIMINARY FINDINGS FROM THE UCSF ASPIRE STUDY

Abstract

To describe the prevalence of anxiety symptoms in early pregnancy and identify predictors of early pregnancy anxiety during the COVID-19 pandemic. We assessed baseline moderate-to-severe anxiety symptoms after enrollment into the UCSF ASPIRE (Assessing the Safety of Pregnancy in the Coronavirus Pandemic) Prospective Cohort from May 2020 through February 2021. Pregnant persons <10 weeks’ gestation completed questions regarding sociodemographic characteristics, obstetric/medical history, and pandemic-related experiences. Chi-square and multivariate hierarchical logistic regression analyses determined predictors of moderate or severe anxiety symptoms (GAD-7 ≥10). All analyses performed with Statistical Analysis Software (SAS®) version 9.4. 4,303 persons completed the GAD-7 questionnaire. The mean age of this nationwide sample was 33 years and 25.7% of participants received care through a fertility clinic. 12.6% of pregnant persons reported moderate-to-severe anxiety symptoms. On univariate analysis, less than a college education (p<0.0001), pre-existing history of anxiety (p<0.0001), and history of prior miscarriage (p=0.0143) were predictors of moderate-to-severe anxiety symptoms; care at a fertility center was protective (26.6% vs 25.7%, p= 0.0009). COVID-19 related stressors were strongly predictive of anxiety in pregnancy (p<0.0001). Race/ethnicity and a prior history of live birth were not predictors of moderate-to-severe anxiety. In the hierarchical logistic regression model, pre-existing history of anxiety remained associated with anxiety during pregnancy. While education was no longer significant, there was a trend towards this being predictive. Hierarchical Logistic regression predicting moderate to severe anxiety symptomsTabled 1Step 1Step 2Step 3aORaORaORDemographicsEducationProfessional degree---Masters1.624*1.2911.237College1.4561.2051.213<College2.584***2.205**1.852Obstetric/Medical historyPre-existing AnxietyNo--Yes3.157***2.485***COVID-19 stressorsHousehold contact deceased from COVID-19No-Yes9.397**Very/Extremely Worried about COVID-19No-Yes2.428***Perceived stressLow-Moderate-High6.860*** Open table in a new tab *p<0.05, **p<0.01, ***p<0.001 Pre-existing history of anxiety and low maternal educational attainment likely exacerbated the contribution of stressors due to the COVID-19 pandemic on early pregnancy anxiety.