Factors associated with prenatal stress and anxiety in pregnant women during COVID-19 in Spain

Abstract

Aim of the study To describe prenatal stress and state anxiety levels in pregnant women living in Spain during the lockdown of the first wave of COVID-19 and its relation with obstetric factors, perception of health care, and concerns about the socio-sanitary situation. Methods The present study is an observational, correlational, and cross-sectional quantitative study. The participants in the study were pregnant women recruited through non-probabilistic convenience and snowball sampling during the lockdown. A web link was provided to an online questionnaire designed for this research, which collected socio-demographic and obstetric variables, perceptions of health care received during the pandemic and preoccupations associated with COVID-19. It also included the Prenatal Stress Questionnaire (PDQ) and the State Anxiety Inventory (STAI-S). Results Based on the responses of 695 pregnant women, the results showed a mean of 16.98 (SD = 25.20) of prenatal stress and elevated levels of anxiety (M = 25.20/SD = 11.07) in the first wave of the pandemic. Risk factors for prenatal stress and anxiety were the level of preoccupation associated with COVID-19 and previous mental health issues. A specific risk factor for anxiety was having more than one child and a protective factor were perceiving accessibility and availability of health care, with clear and consistent pregnancy care and follow-up protocols. Conclusions The lockdown period for COVID-19 was a stressful experience for pregnant women, highlighting the need to address their psychological well-being through clear and coherent protocols in terms of maternal-foetal health control and follow-up.

The Study on Stress and Related Factors Among Pregnant Women During the COVID-19 Pandemic in Tertiary Teaching Hospital

“…Furthermore, the result of the study showed that nearly a third of pregnant women experienced elevated stress levels related to feeling unprepared for birth or being worried about perinatal infection. The result is similar to a previous study (Sirhan et al, 2022) which recorded that the COVID-19 pandemic was associated with high-stress levels and mental health problems. Biresaw et al (2022) wrote that a recent study during the COVID-19 pandemic period indicated that there is increased anxiety and poor quality of sleep levels.…”

Trajectories of distress from pregnancy to 15-months post-partum during the COVID-19 pandemic

“…Findings indicate that greater negative COVID impact, lower education, and lower social support were positively associated with higher levels of distress levels during pregnancy. These findings are in line with prior research indicating that social support is a protective factor (e.g., Lebel et al, 2020;Zhou et al, 2021;Khoury et al, 2021b;Fernandes et al, 2022) and COVID-related stress is a risk factor (e.g., Khoury et al, 2021b;Awad-Sirhan et al, 2022;Giesbrecht et al, 2022) for mental health and distress in prenatal and postpartum samples during the pandemic. In particular, prior work by Fernandes et al (2022) showed that higher social support was associated with lower levels of depression from pregnancy 6-months postpartum.…”

Pregnancy-Specific Stress during the First Lockdown of the COVID-19 Pandemic: Assessing Face-to-Face versus Online Recruitment

“…Significant higher levels of PDQ were observed in Group 1: pregnant women recruited face-to-face in health centres during Spain´s severest restrictions on individual mobility and highest psychological uncertainty. There is evidence that the pandemic has impacted the general population’ s level of anxiety, specifically among pregnant women, who reported anxiety levels about two-thirds higher than normal [ 14 , 15 , 25 , 43 ]. We observe that visiting the health centre at a time of greatest threat and uncertainty may trigger high stress levels and concerns about being exposed to the Coronavirus in the hospital environment, as evidenced in Group 1 results.…”

“…Moreover, the analysis of prenatal stress and associated risk factors is more dramatic in an exceptional situation such as a pandemic. There is evidence that the pandemic has amplified the general population’s levels of anxiety and depression, and other psychiatric conditions, specifically among pregnant women [ 14 , 15 , 16 ].…”