Development and Validation of a Scale to Measure Anxiety Specific to Pregnancy During the COVID-19 Pandemic: The Antenatal COVID-19 Anxiety Scale.

Abstract

Objective: In the context of the coronavirus disease 2019 (COVID-19) pandemic, anxiety during pregnancy should be assessed from a composite context of anxiety/fear of COVID-19 infection and pregnancy-specific anxiety. The objective of this study was to develop and validate a scale that measures anxiety related to situations specific to pregnancy during the COVID-19 pandemic-the Antenatal COVID-19 Anxiety (AnCAn) Scale.Methods: Items were generated based on a literature review and focused group discussions. Face and content validation was completed. Data were collected from 557 pregnant women attending antenatal clinics of 5 tertiary care general hospitals in India. An exploratory factor analysis was conducted to measure structural validity and to identify latent factors. Screening accuracy was assessed using scores on the 7-item Generalized Anxiety Disorder scale. Data were collected between July and October 2020.Results: The principal component analysis showed that the 12 items of the scale significantly loaded onto 2 latent factors, with Eigen values of 6.575 and 1.213, respectively. Factor solution showed that 6 items correlated with each of the 2 factors. Both sensitivity and specificity of AnCAn total and subscores were > 70%.Conclusions: We conclude that the AnCAn Scale holds good psychometric properties, and it identifies and distinguishes 2 latent factors: (1) anxiety related to acquiring infection and (2) anxiety related to spreading infection and social role obligations, which are compositely related to anxiety specific to COVID-19 and pregnancy.