Abstract
Background: Previous systematic review indicated the prevalence of prenatal anxiety as 14–54%. Pregnant women are a high-risk population for COVID-19. However, the prevalence of anxiety symptoms and related factors is unknown in Chinese pregnant women during COVID-19 outbreak.Objective: To investigate the prevalence of anxiety symptoms and the related factors in Chinese pregnant women who were attending crisis intervention during the COVID-19 pandemic.Methods: The data of this cross-sectional study were collected in about 2 months (February 28 to April 26, 2020). Data analysis was performed from April to May 2020. Participants completed a set of questionnaires via the Wechat Mini-program before starting the online self-help crisis intervention for COVID-19 epidemic. A total of 2,120 Chinese pregnant women who were attending a self-help crisis intervention participated in this study. A survey was developed to address possible stress-related factors in pregnant women during the COVID-19 outbreak, including demographic, socioeconomic, and pregnancy-related factors, as well as COVID-19 related factors. Generalized Anxiety Disorder-7 (GAD-7) scale and the 10-item perceived stress scale were, respectively, employed to measure anxiety and stress-related factors.Results: A total of 21.7% (459) of pregnant women reported at least mild anxiety (≥5 on the GAD-7 scale), and only 82 women reported moderate to severe anxiety (≥10 on the GAD-7 scale). Factors associated with at least mild anxiety included living in Hubei province (OR = 1.68, 95% CI = 1.32–2.13), nobody providing everyday life support (OR = 1.81, 95% CI = 1.18–2.77), pelvic pain or vaginal bleeding (OR = 1.67, 95% CI = 1.32–2.09), and higher perceived stress (OR = 6.87, 95% CI = 5.42–9.02). Having relatives or neighbors with a diagnosis of COVID-19 was not associated with anxiety (p > 0.05).Conclusions and Relevance: Our findings indicate that evaluation and intervention for maternal and infant health are necessary in pregnant women with anxiety during COVID-19 epidemic, especially those with higher perceived stress, less everyday life support, or vaginal bleeding. Interactions among these related medical, social and psychological factors need to be investigated in future studies.
Highlights
Prenatal anxiety in pregnant women is a worldwide public health issue due to its high prevalence and heavy burden posed to pregnant women themselves and their family
The main findings are as following: (1) the prevalence of prenatal anxiety symptom was 21.7%, and most of the anxious pregnant women reported mild anxiety; (2) higher perceived stress was a critical predictor of prenatal anxiety symptoms, not indicating specific stressful events; (3) anxiety symptoms were associated with pregnancy-related stressful events, including nobody providing emotional support and experiencing pelvic pain or vaginal bleeding, and the latter was a both pregnancy-related and COVID-19 related stressful event; (4) anxiety symptoms were associated with living in Hubei, but was not associated with the other COVID-19-related factors
We found that during the COVID19 epidemic, the prevalence of anxiety symptom was 21.7% in Chinese pregnant women attending the crisis intervention, and the rate was 27.0% in the pregnant participants living in Hubei
Summary
Prenatal anxiety in pregnant women is a worldwide public health issue due to its high prevalence and heavy burden posed to pregnant women themselves and their family. Prenatal anxiety can result in adverse perinatal outcomes (Mirzadeh and Khedmat, 2020), impaired fetal brain development (Wu et al, 2020), and even long-lasting adverse health outcomes in their offspring’s late lives (Helgertz and Bengtsson, 2019; Rees et al, 2019). The high rate of cesarean section may reflect the anxietyrelated impacts on mothers under the COVID-19 outbreak estimated by researchers (Fakari and Simbar, 2020; Mirzadeh and Khedmat, 2020). Previous systematic review indicated the prevalence of prenatal anxiety as 14–54%. The prevalence of anxiety symptoms and related factors is unknown in Chinese pregnant women during COVID-19 outbreak
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