Fear and Anxiety in Pregnant Women During the COVID-19 Pandemic: A Systematic Review

Muñoz-Vela, Francisco Javier; Rodríguez-Díaz, Luciano; Gómez‐Salgado, Juan; Fernández-Carrasco, Francisco Javier; Allande‐Cussó, Regina; Vázquez-Lara, Juana María; Fagundo-Rivera, Javier

doi:10.3389/ijph.2023.1605587

Cited by 7 publications

(5 citation statements)

References 62 publications

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“…Therefore, health care facilities need to strengthen training in medical and nursing communication skills to give pregnant women a better health care experience. We also found that anxiety was a risk factor for FOC, which was consistent with previous literature [ 64 , 68 ]. Since FOC is considered a form of anxiety disorder or a phobic fear [ 12 ], it was not surprising that anxiety disorders are associated with higher levels of FOC.…”

Section: Discussionsupporting

confidence: 93%

Fear of childbirth and its determinants in pregnant women in the third trimester: a cross-sectional study

Zhang,

Liu,

Min

et al. 2023

BMC Psychiatry

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Background Fear of childbirth (FOC) is a prevalent issue among pregnant women and significantly relates to adverse outcomes for the mother and child. However, it is not clear the prevalence and risk factors of FOC among pregnant women in a region with a moderate level of economic development in China. The aim of this study was to investigate the prevalence and risk factors of FOC among pregnant women in the third trimester of pregnancy in Lianyungang city, Eastern China. Methods A cross-sectional survey was conducted from December 2022 to February 2023 among pregnant women in the third trimester who met the inclusion criteria and visited Lianyungang Maternal and Child Health Hospital in Jiangsu Province, Eastern China. A structured questionnaire including sociodemographic characteristics, clinical characteristics, FOC, family function, doctor-patient communication, social support, general self-efficacy, anxiety, depression, insomnia symptoms, and quality of life was used to collect data. A multiple linear regression model was used to identify predictors of FOC. Results This study included 535 pregnant women in the third trimester. The mean score of FOC was 30.67 ± 10.18, and the median score was 29.00. The prevalence of FOC was 56.64%. Multiple linear regression analysis revealed that pregnant women with electronic screen exposure time more than 5 h per day (β = 2.02, 95%CI: 0.50–3.53, P < 0.05), no history of cesarean section (β = 2.66, 95%CI: 0.61–4.71, P < 0.05), likes sour food or hates greasy food (β = 1.75, 95%CI: 0.00-3.50, P < 0.05), anxiety (β = 0.50, 95%CI: 0.21–0.80, P < 0.05) and depression (β = 0.30, 95%CI: 0.04–0.57, P < 0.05) were more likely to have a greater level of FOC than their counterparts. However, a significantly lower level of FOC was observed in pregnant women who were multipara (β=-1.64, 95%CI: -3.27–0.01, P < 0.05), not worrying about delivery without family members (β=-3.75, 95%CI: -5.26–2.25, P < 0.001), had good family function (β=-0.32, 95%CI: -0.64–0.00, P < 0.05) and doctor-patient communication (β=-0.33, 95%CI: -0.64–0.02, P < 0.05). Conclusions The prevalence of FOC was high in Lianyungang city, Eastern China. FOC is influenced by multiple factors. There is an urgent need to develop interventions to reduce the prevalence of FOC in the third trimester of pregnancy, and to pay attention to pregnant women with risk factors for FOC.

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Section: Discussionsupporting

confidence: 93%

Fear of childbirth and its determinants in pregnant women in the third trimester: a cross-sectional study

Zhang,

Liu,

Min

et al. 2023

BMC Psychiatry

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“…Another multinational crosssectional study in Europe reported that moderate to severe anxiety symptoms (GAD-7 score ≥10) were shown among 11% and 10% of pregnant and breastfeeding women [33], which was all greater than the fgure in our results evaluated by using the same widely used assessment tools and cutof values (i.e., a PHQ-9 score ≥10 and a GAD-7 score ≥10, respectively) [34]. A meta-analysis also reported a higher prevalence of anxiety levels in pregnant women during the pandemic, ranging from 45.9% to 62% [35]. Te discrepancies regarding the prevalence of anxiety and depression symptoms among pregnant and postpartum women during the COVID-19 pandemic among the existing studies could be partially explained by studies that performed evaluations at diferent stages of the pandemic and the various control and prevention measures in each region [35].…”

Section: Discussioncontrasting

confidence: 50%

“…A meta-analysis also reported a higher prevalence of anxiety levels in pregnant women during the pandemic, ranging from 45.9% to 62% [35]. Te discrepancies regarding the prevalence of anxiety and depression symptoms among pregnant and postpartum women during the COVID-19 pandemic among the existing studies could be partially explained by studies that performed evaluations at diferent stages of the pandemic and the various control and prevention measures in each region [35]. However, one study with pilot data suggested that maternal levels of anxiety and depression appeared low at the tail end of the COVID-19 pandemic [34], which was verifed by our fndings.…”

Section: Discussionmentioning

confidence: 92%

Mental and Physical Symptoms and Perceived Health Risks of Pregnant and Postpartum Women following the Significant Shift in COVID-19 Management in China: A Cross-Sectional Survey

Lai,

Lu,

Wang

et al. 2024

Perspectives in Psychiatric Care

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Background. There was a remarkable downgrade in China’s COVID-19 response strategies in January 2023. The COVID-19 infection rate grew rapidly in the early stages following the management policy shift. This study attempted to explore the associations between SARS-CoV-2 infection and mental or physical health status in pregnant and postpartum women and the role of perceived health risks and family members’ SARS-CoV-2 infection status on these associations by capturing the impact of policy shifts in a short period of time. Methods. This cross-sectional study with a random sample from a convenience sample of hospitals was conducted in pregnant and postpartum women in January 2023. Standardized assessment tools were employed to assess anxiety, depressive and physical symptoms, and feelings of hopelessness. Hierarchical multiple logistic regressions were conducted to examine the mechanisms of associations of interests by including a range of sociodemographic factors, self-perceived health, SARS-CoV-2 infection status, and perceived health risks as covariates. Results. Of the 1,013 pregnant and postpartum women aged 32.0 ± 0.3 years, 58.2% (n = 590) were diagnosed with COVID-19, and 49.4% (n = 500) had family members who were infected with SARS-CoV-2. Nearly 98% of the included participants took measures to prevent SARS-CoV-2 infection. A COVID-19 diagnosis was positively associated with feelings of hopelessness (OR = 1.68, 95% CI: 1.20–2.35), probable anxiety (OR = 6.42, 95% CI: 2.18–24.61), possible depression (OR = 2.56, 95% CI: 1.07–6.70), and physical symptoms (OR = 6.28, 95% CI: 1.63–42.03) after adjusting for sociodemographic and health characteristics, while the associations presented no statistical significance when family members’ SARS-CoV-2 infection status and perceived health risks were introduced into the models. Conclusions. Our results suggested that pregnant and postpartum women may experience physical and mental health challenges when they or their family members contracted COVID-19 in the context of a considerable shift in COVID-19 management. Early detection of poor health status and its risk factors for vulnerable groups during shifts in health policy and administrative practice is very necessary, and health services, including easy access to psychosocial support and obstetric counselling, should be prioritized.

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“…Given that levels of fear and anxiety are determined both by the characteristics of the pandemic context and by the presence of an intrauterine foetus ( 16 ), a very large and diversified sample of pregnant women across the country was chosen. This was done with the aim of covering different periods of the pandemic and to obtain more information on the effect size.…”

Section: Discussionmentioning

confidence: 99%

“…It is in this context that there has been a historic increase in negative emotions such as fear or anxiety as a psychological response to cope with the illness ( 14 ) or to deal with depressive and anxious symptomatology ( 15 , 16 ).…”

Section: Introductionmentioning

confidence: 99%

Adaptation and psychometric study of the scale for the measurement of fear and anxiety of COVID-19 disease in pregnant women (AMICO_Pregnant)

Muñoz-Vela,

Rodríguez-Díaz,

Fernández-Carrasco

et al. 2023

Front. Public Health

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ObjectiveThe aim of this research was to adapt and explore the psychometric properties of a specific scale to assess the levels of fear and anxiety of COVID-19 disease in pregnant women.MethodsAn adaptation phase, by a panel of experts, and a psychometric descriptive cross-sectional study were carried out on the final version of the 16-item, self-administered AMICO_Pregnant scale. Univariate and bivariate analyses were carried out, followed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The consistency of the scale was assessed using the Omega coefficient and Cronbach’s Alpha.ResultsWith a sample of 1,013 pregnant women living in Spain and over 18 years of age, the mean age was 33 years. The scale showed a bifactor structure (anxiety and fear) that was confirmed with good fit parameters. Reliability was assessed in terms of internal consistency by calculating Cronbach’s Alpha coefficient (0.95) and McDonald’s Omega coefficient (0.94) as indicators of robustness of the scale’s reliability.ConclusionThe AMICO_Pregnant scale of 16 items with scores ranging from 1 to 10 is a valid and reliable tool to assess levels of anxiety and fear of COVID_19 in Spanish pregnant women. Pregnant women have shown moderate levels of anxiety and fear regarding the COVID_19 disease in the final phase of the pandemic.

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Fear and Anxiety in Pregnant Women During the COVID-19 Pandemic: A Systematic Review

Cited by 7 publications

References 62 publications

Fear of childbirth and its determinants in pregnant women in the third trimester: a cross-sectional study

Fear of childbirth and its determinants in pregnant women in the third trimester: a cross-sectional study

Mental and Physical Symptoms and Perceived Health Risks of Pregnant and Postpartum Women following the Significant Shift in COVID-19 Management in China: A Cross-Sectional Survey

Adaptation and psychometric study of the scale for the measurement of fear and anxiety of COVID-19 disease in pregnant women (AMICO_Pregnant)

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