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Licensed Unlicensed Requires Authentication Published by De Gruyter April 16, 2021

Pregnant women’s psychological state and influence factors: anxiety, and depression during COVID-19 outbreak

Yuming Cao, Juan Liu, Yuanzhen Zhang, Yating Li, Zhenlie Chen and Jing Lu

Abstract

Objectives

The outbreak of COVID-19 affects both physical and mental health of pregnant women. This study focuses on their psychological status, and analyzes the main factors affecting their emotions of pregnant women so as to provide guidance for psychological counseling and social intervention during epidemics.

Methods

Multiple researchers distributed a questionnaire online via the Internet. Pregnant women volunteered, and the questionnaire was automatically collected in the background.

Results

The 298 valid questionnaires recovered showed that 82 cases of pregnant women were in states of anxiety, accounting for 27.51%, of which 78.05% were mild (82 cases), 19.51% were moderate (16 cases), and 2.44% were severe (2 cases). Moreover, 31.21% of pregnant women were in states of depression (93 cases), of which 52.69% were mild (49 cases), 40.86% were moderate (38 cases), and 6.45% were severe (6 cases). The risk factors for states of anxiety or depression were fear of fetal malformation or genetic disease, history of adverse pregnancy, can’t do routine prenatal examination, and insufficient support and care from husbands and families. Besides, 16 cases had sought psychological help during the epidemic, among whom 62.50% (10 cases) experienced anxiety, 68.75% (11 cases) had depression.

Conclusions

During the outbreak of COVID-19, obstetricians may take use of the Internet, based on the advantages in epidemic prevention, controlling health education, and popularizing science. In addition, husbands and family members should provide greater care for pregnant women, to protect their mental health during public health incidents.


Corresponding author: Jing Lu, Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, P.R. China, Phone: +86 027 67812929, E-mail:

Funding source: The New Pneumonia Emergency Science and Technology Project of Science and Technology Department of Hubei Province

Award Identifier / Grant number: 2020FCA011

Funding source: The Fundamental Research Funds for the Central Universities of China

Award Identifier / Grant number: 2042017kf0083

Funding source: The COVID-19 Emergency Science and Technology Project in Wuhan

Award Identifier / Grant number: 2020020201010011

  1. Research funding: This work was supported by the New Pneumonia Emergency Science and Technology Project of Science and Technology Department of Hubei Province (Grant Number 2020FCA011), the COVID-19 Emergency Science and Technology Project in Wuhan (Grant Number 2020020201010011), and the Fundamental Research Funds for the Central Universities of China (Grant Number 2042017kf0083). The funding organization(s) played no role in study design; in the collection, analysis and interpretation, of data; in the writing of the report; or in the decision to submit the report for publication.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The study was reviewed and approved by the Medical Ethical Committee of Zhongnan Hospital of Wuhan University (Approval Number 2020034).

References

1. Taha, SA, Matheson, K, Anisman, H. H1N1 was not all that scary: uncertainty and stressor appraisals predict anxiety related to a coming viral threat. Stress Health 2014;30:149–57. https://doi.org/10.1002/smi.2505.Search in Google Scholar

2. Lau, JT, Griffiths, S, Choi, KC, Tsui, HY. Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong. BMC Infect Dis 2010;10:139. https://doi.org/10.1186/1471-2334-10-139.Search in Google Scholar

3. Yang, X, Yu, Y, Xu, J, Shu, H, Xia, J, Liu, H, et al.. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020;8:475–81. https://doi.org/10.1016/s2213-2600(20)30079-5.Search in Google Scholar

4. Ko, CH, Yen, CF, Yen, JY, Yang, MJ. Psychosocial impact among the public of the severe acute respiratory syndrome epidemic in Taiwan. Psychiatry Clin Neurosci 2006;60:397–403. https://doi.org/10.1111/j.1440-1819.2006.01522.x.Search in Google Scholar

5. Peng, EY, Lee, MB, Tsai, ST, Yang, CC, Morisky, DE, Tsai, LT, et al.. Population-based post-crisis psychological distress: an example from the SARS outbreak in Taiwan. J Formos Med Assoc 2010;109:524–32. https://doi.org/10.1016/s0929-6646(10)60087-3.Search in Google Scholar

6. Yeung, NCY, Lau, JTF, Choi, KC, Griffiths, S. Population responses during the pandemic phase of the Influenza A (H1N1) pdm09 epidemic, Hong Kong, China. Emerg Infect Dis 2017;23:813–5. https://doi.org/10.3201/eid2305.160768.Search in Google Scholar

7. Sohrabi, C, Alsafi, Z, O’Neill, N, Khan, M, Kerwan, A, Al-Jabir, A, et al.. World Health Organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19). Int J Surg 2020;76:71–6. https://doi.org/10.1016/j.ijsu.2020.02.034.Search in Google Scholar

8. Knight, RG, Waal-Manning, HJ, Spears, GF. Some norms and reliability data for the state--trait anxiety inventory and the Zung self-rating depression scale. Br J Clin Psychol 1983;22:245–9. https://doi.org/10.1111/j.2044-8260.1983.tb00610.x.Search in Google Scholar

9. Jokelainen, J, Timonen, M, Keinanen-Kiukaanniemi, S, Harkonen, P, Jurvelin, H, Suija, K. Validation of the Zung self-rating depression scale (SDS) in older adults. Scand J Prim Health Care 2019;37:353–7. https://doi.org/10.1080/02813432.2019.1639923.Search in Google Scholar

10. Demyttenaere, K, Bruffaerts, R, Posada-Villa, J, Gasquet, I, Kovess, V, Lepine, JP, et al.. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health surveys. JAMA 2004;291:2581–90. https://doi.org/10.1001/jama.291.21.2581.Search in Google Scholar

11. Aryal, KK, Alvik, A, Thapa, N, Mehata, S, Roka, T, Thapa, P, et al.. Anxiety and depression among pregnant women and mothers of children under one year in Sindupalchowk district. J Nepal Health Res Counc 2018;16:195–204. https://doi.org/10.3126/jnhrc.v16i2.20310.Search in Google Scholar

12. Groleau, D, Benady-Chorney, J, Panaitoiu, A, Jimenez, V. Hyperemesis Gravidarum in the context of migration: when the absence of cultural meaning gives rise to "blaming the victim". BMC Pregnancy Childbirth 2019;19:197. https://doi.org/10.1186/s12884-019-2344-1.Search in Google Scholar

13. van de Loo, KFE, Vlenterie, R, Nikkels, SJ, Merkus, PJFM, Roukema, J, Verhaak, CM, et al.. Depression and anxiety during pregnancy: the influence of maternal characteristics. Birth 2018;45:478–89. https://doi.org/10.1111/birt.12343.Search in Google Scholar

14. Hu, HQ, Zhang, J, Zhao, W, Tian, T, Huang, AQ, Wang, LL. The occurrence and determinants of anxiety and depression symptoms in women of six counties/districts in China during pregnancy. Zhonghua Yufang Yixue Zazhi 2017:51:47–52. https://doi.org/10.3760/cma.j.issn.0253-9624.2017.01.010.Search in Google Scholar

15. Sundstrom Poromaa, I, Comasco, E, Georgakis, MK, Skalkidou, A. Sex differences in depression during pregnancy and the postpartum period. J Neurosci Res 2017;95:719–30. https://doi.org/10.1002/jnr.23859.Search in Google Scholar

16. Pearlstein, T. Depression during pregnancy. Best Pract Res Clin Obstet Gynaecol 2015;29:754–64. https://doi.org/10.1016/j.bpobgyn.2015.04.004.Search in Google Scholar

17. Yonkers, KA, Wisner, KL, Stewart, DE, Oberlander, TF, Dell, DL, Stotland, N, et al.. The management of depression during pregnancy: a report from the American psychiatric association and the American college of Obstetricians and gynecologists. Obstet Gynecol 2009;114:703–13.10.1097/AOG.0b013e3181ba0632Search in Google Scholar

18. Bystritsky, A, Kerwin, L, Feusner, JD, Vapnik, T. A pilot controlled trial of bupropion XL versus escitalopram in generalized anxiety disorder. Psychopharmacol Bull 2008;41:46–51.Search in Google Scholar

19. Kang, L, Li, Y, Hu, S, Chen, M, Yang, C, Yang, BX, et al.. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry 2020;7:e14. https://doi.org/10.1016/s2215-0366(20)30047-x.Search in Google Scholar

20. Xiao, H, Zhang, Y, Kong, D, Li, S, Yang, N. The effects of social support on Sleep quality of Medical Staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Med Sci Monit 2020;26:e923549. https://doi.org/10.12659/msm.923549.Search in Google Scholar

21. Hanita, O, Roslina, O, Azlin, MI. Maternal level of pregnancy-associated plasma protein A as a predictor of pregnancy failure in threatened abortion. Malays J Pathol 2012;34:145–51.Search in Google Scholar

22. CCDC. National Health Commission of China Guidelines for psychological assistance hotlines during 2019-nCoV pneumonia epidemic. Cambridge: CCDC; 2020.Search in Google Scholar

23. Verbeek, T, Arjadi, R, Vendrik, JJ, Burger, H, Berger, MY. Anxiety and depression during pregnancy in Central America: a cross-sectional study among pregnant women in the developing country Nicaragua. BMC Psychiatry 2015;15:292. https://doi.org/10.1186/s12888-015-0671-y.Search in Google Scholar

24. Zachariah, R. Social support, life stress, and anxiety as predictors of pregnancy complications in low-income women. Res Nurs Health 2009;32:391–404. https://doi.org/10.1002/nur.20335.Search in Google Scholar

25. Habtamu Belete, A, Alemayehu Assega, M, Alemu Abajobir, A, Abebe Belay, Y, Kassahun Tariku, M. Prevalence of antenatal depression and associated factors among pregnant women in Aneded woreda, North West Ethiopia: a community based cross-sectional study. BMC Res Note 2019;12:713. https://doi.org/10.1186/s13104-019-4717-y.Search in Google Scholar

26. Pereira, PK, Lovisi, GM, Pilowsky, DL, Lima, LA, Legay, LF. Depression during pregnancy: prevalence and risk factors among women attending a public health clinic in Rio de Janeiro, Brazil. Cad Saúde Pública 2009;25:2725–36. https://doi.org/10.1590/s0102-311x2009001200019.Search in Google Scholar

27. Marcinko, VM, Marcinko, D, Dordevic, V, Oreskovic, S. Anxiety and depression in pregnant women with previous history of spontaneous abortion. Coll Antropol 2011;35:225–8.Search in Google Scholar

28. Onishi, H, Uchida, N, Takahashi, T, Furuya, D, Ebihara, Y, Sato, I, et al.. Thiamine deficiency in the bereaved after cancer-related spousal loss. Palliat Support Care 2019;17:738–40. https://doi.org/10.1017/s147895151900018x.Search in Google Scholar

29. Mohammad, KI, Gamble, J, Creedy, DK. Prevalence and factors associated with the development of antenatal and postnatal depression among Jordanian women. Midwifery 2011;27:e238–45. https://doi.org/10.1016/j.midw.2010.10.008.Search in Google Scholar

30. Rauchfuss, M, Maier, B. Biopsychosocial predictors of preterm delivery. J Perinat Med 2011;39:515–21. https://doi.org/10.1515/jpm.2011.067.Search in Google Scholar

31. Moyer, CA, Compton, SD, Kaselitz, E, Muzik, M. Pregnancy-related anxiety during COVID-19: a nationwide survey of 2740 pregnant women. Arch Womens Ment Health 2020;23:757–65. https://doi.org/10.1007/s00737-020-01073-5.Search in Google Scholar

32. Mappa, I, Distefano, FA, Rizzo, G. Effects of coronavirus 19 pandemic on maternal anxiety during pregnancy: a prospectic observational study. J Perinat Med 2020;48:545–50. https://doi.org/10.1515/jpm-2020-0182.Search in Google Scholar

33. Kotabagi, P, Fortune, L, Essien, S, Nauta, M, Yoong, W. Anxiety and depression levels among pregnant women with COVID-19. Acta Obstet Gynecol Scand 2020;99:953–4. https://doi.org/10.1111/aogs.13928.Search in Google Scholar


Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2020-0541).


Received: 2020-11-19
Accepted: 2021-03-31
Published Online: 2021-04-16
Published in Print: 2021-07-27

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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