Background Anxiety and depression symptoms in pregnancy typically affect between 10 and 25% of pregnant individuals. Elevated symptoms of depression and anxiety are associated with increased risk of preterm birth, postpartum depression, and behavioural difficulties in children. The current COVID-19 pandemic is a unique stressor with potentially wide-ranging consequences for pregnancy and beyond. Methods We assessed symptoms of anxiety and depression among pregnant individuals during the current COVID-19 pandemic and determined factors that were associated with psychological distress. 1987 pregnant participants in Canada were surveyed in April 2020. The assessment included questions about COVID-19-related stress and standardized measures of depression, anxiety, pregnancy-related anxiety, and social support. Results We found substantially elevated anxiety and depression symptoms compared to similar pre-pandemic pregnancy cohorts, with 37% reporting clinically relevant symptoms of depression and 57% reporting clinically relevant symptoms of anxiety. Higher symptoms of depression and anxiety were associated with more concern about threats of COVID-19 to the life of the mother and baby, as well as concerns about not getting the necessary prenatal care, relationship strain, and social isolation due to the COVID-19 pandemic. Higher levels of perceived social support and support effectiveness, as well as more physical activity, were associated with lower psychological symptoms. Conclusion This study shows concerningly elevated symptoms of anxiety and depression among pregnant individuals during the COVID-19 pandemic, that may have long-term impacts on their children. Potential protective factors include increased social support and exercise, as these were associated with lower symptoms and thus may help mitigate long-term negative outcomes.

Mental health problems are common in pregnancy, typically affecting between 10-25% of pregnant individuals. Elevated symptoms of depression and anxiety can negatively impact both the pregnant individual and developing fetus. The current COVID-19 pandemic is a unique stressor with potentially wide-ranging consequences for pregnancy and beyond. We assessed symptoms of anxiety and depression among pregnant individuals during the current COVID-19 pandemic and determined factors that were associated with psychological distress. 1987 pregnant participants were surveyed across Canada in April 2020. The assessment included questions about COVID-19-related stress and standardized measures of depression, anxiety, pregnancy-related anxiety, sleep and social support. We found substantially elevated psychological distress compared to similar pre-pandemic pregnancy cohorts, with 37% reporting clinically relevant symptoms of depression, 57% reporting clinically relevant symptoms of anxiety, and 68% reporting elevated pregnancy-related anxiety. Higher levels of social support and longer sleep duration were associated with lower psychological symptoms across domains. This study shows concerningly elevated levels of psychological distress among pregnant individuals during the COVID-19 pandemic, that may have long-term impacts on their children. Potential intervention targets are needed in addition to improving protective factors related to increased social support and sleep -- these should be urgently considered to mitigate long-term negative outcomes.

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