Perceived Stress, Resilience, and Anxiety Among Pregnant Chinese Women During the COVID-19 Pandemic: Latent Profile Analysis and Mediation Analysis.

Zheng Luo,Fangfang Shangguan,Yifan Zhao,Yaqing Shen,Zhengkui Liu,Jiajia Yuan

doi:10.3389/fpsyg.2021.696132

Abstract

Objective: The coronavirus disease 2019 (COVID-19) pandemic has posed a major threat to pregnant women's mental health. This study aimed to characterize the patterns of perceived stress in pregnant Chinese women during the COVID-19 pandemic, to examine the profile differences on anxiety and resilience, and to investigate whether the differences in these profiles on anxiety were mediated by resilience.Methods: From February 28, 2020 to April 26, 2020, a sample of 2,116 pregnant Chinese women who participated in online crisis interventions completed an online self-reporting questionnaire assessing their demographic characteristics, perceived stress, resilience, and anxiety.Results: Latent profile analysis (LPA) on two stress dimensions [perceived helplessness (HEL) and perceived self-efficacy (SEL)] indicated four perceived stress profiles: adaptive (33.7% of the sample), resistant (44.6%), insensitive (19.1%), and sensitive (2.6%). The women with both adaptive and insensitive profiles had the lowest levels of anxiety, whereas those with the resistant profile had the lowest levels of resilience. Multicategorical mediation analysis showed that resilience partially mediated the differences in the pregnant women's anxiety between the adaptive/insensitive and resistant profile.Conclusion: This study showed the heterogeneity in the perceived stress patterns of pregnant women during the COVID-19 pandemic, revealing the internal mechanisms of pregnant women's anxiety using a person-centered approach, and provided initial evidence guiding the development of differentiated stress interventions to alleviate pregnant women's anxiety during the pandemic.

Highlights

Since late December 2019, a novel coronavirus disease 2019 (COVID-19) has spread rapidly in China and between countries, with high morbidity and mortality rates
The present study aimed to identify integrative stress profiles consisting of two perceived stress dimensions and to explore the relationship among stress profiles, resilience, and anxiety of pregnant Chinese women using latent profile analysis (LPA) during the COVID-19 pandemic
This study is part of a WeChat psychological crisis intervention program initiated by the Institute of Psychology, Chinese Academy of Sciences, that aimed to help pregnant Chinese women cope with stress during the COVID-19 pandemic

Summary

Introduction

Since late December 2019, a novel coronavirus disease 2019 (COVID-19) has spread rapidly in China and between countries, with high morbidity and mortality rates. It was declared as a global pandemic by the WHO on March 11, 2020. Approximately 20% of pregnant women in China have suffered from anxiety (Ding et al, 2021; Jiang et al, 2021) and 43.3% of pregnant women in the USA experience moderate-to-severe anxiety (Preis et al, 2020a). In Iran, approximately 21% of pregnant women reported pregnancy-related anxiety (Hamzehgardeshi et al, 2021) and the same percentage of women in the third trimester of pregnancy had severe health anxiety (Saadati et al, 2021). Anxiety among pregnant women during the global pandemic should be one of the priorities of public health

Methods

Results

Discussion

Conclusion