Does having a high-risk pregnancy influence anxiety level during the COVID-19 pandemic?

Abstract

Objective We aimed to analyze the changing level of anxiety during COVID-19 pandemic in pregnant women, with and without high-risk indicators separately, in a tertiary care center serving also for COVID-19 patients, in the capital of Turkey. Study Design We designed a case-control and cross-sectional study using surveys. The Spielberger State-Trait Anxiety Scale questionnaire (STAI-T) and Beck Anxiety Inventory (BAI) which were validated in Turkish were given to outpatient women with high-risk pregnancies as study group and normal pregnancies as control group. A total of 446 women were recruited. Results There was a statistically significant difference between those with and without high-risk pregnancy in terms of Trait-State Anxiety scores with COVID-19 pandemic (p < 0.05). We found an increased prevalence of anxiety during COVID-19 pandemic in high-risk pregnant women comparing to pregnancies with no risk factors (p < 0.05). There was a statistically significant difference between the education level in high-risk pregnant women in terms of anxiety scores (p < 0.05), Beck Anxiety score was highest in high school graduates (42.75). While the level of Trait Anxiety was the highest with pandemic in those with high-risk pregnancy with threatened preterm labor and preterm ruptures of membranes (58.0), those with thrombophilia were the lowest (50.88). The State Anxiety level and Beck Anxiety Score of those with maternal systemic disease were the highest (53.32 and 45.53), while those with thrombophilia were the lowest (46.96 and 40.08). The scores of Trait Anxiety (56.38), State Anxiety (52.14), Beck Anxiety (43.94) were statistically higher during the pandemic in those hospitalized at least once (p < 0.05). Conclusion High-risk pregnant women require routine anxiety and depression screening and psychosocial support during the COVID-19 pandemic. High-risk pregnancy patients have comorbid conditions most of the time, hence they not only at more risk for getting infected, but also have higher anxiety scores because of the stress caused by COVID-19 pandemic.

One Year Into the Pandemic: A Systematic Review of Perinatal Mental Health Outcomes During COVID-19

“…Nineteen of the 81 studies compared mental health outcomes in pregnant or postpartum women before and during the pandemic ( Table 2 ). Eleven of these studies reported elevated levels of clinically significant mental health symptoms such as depression and anxiety in pregnant or postpartum women during the COVID-19 pandemic ( 72 – 77 , 81 , 86 , 88 – 90 ). Three studies specifically asked pregnant and postpartum women to report their symptoms during the pandemic as well as to retrospectively report their symptoms before the pandemic.…”

“…Three studies specifically asked pregnant and postpartum women to report their symptoms during the pandemic as well as to retrospectively report their symptoms before the pandemic. These studies generally report higher levels of depression and anxiety during the pandemic ( 75 ), with one study showing that changes in pre- to post-COVID-19 pregnancy-related anxiety were associated with an increase in the number of COVID-19-related stressors ( 81 ) and another study documenting higher rates of trait anxiety specifically in the case of high-risk pregnancies ( 86 ).…”

COVID-19 Pandemic-Related Anxiety in Pregnant Women

“…Considering all the above-mentioned reports, we have decided to exclude pathological pregnancies from the study. One of the latest studies examined influence of high-risk pregnancy during the COVID-19 pandemic on the anxiety level finding higher anxiety scores in this group comparing to physiological pregnancies [ 41 ].…”

Did the SARS-CoV-2 effect pregnancy complications?

“…With the COVID-19 pandemic, depression and anxiety significantly increase in the pregnant population, and researchers recommend that all pregnant women should receive psychosocial support during this period [28,29]. Miscarriage was associated with increased cortisol and decreased immunity as a result of increased acute and chronic stress [30][31][32].…”