Pregnant under the pressure of a pandemic: a large-scale longitudinal survey before and during the COVID-19 outbreak

Abstract

Background One of the groups that is most vulnerable to the COVID-19 pandemic is pregnant women. They cannot choose to refrain from care; they and their children are at risk of severe complications related to the virus; and they lose comfort and support as clinics prohibit their partners and as societal restrictions demand isolation from friends and relatives. It is urgent to study how this group is faring during the pandemic and we focus here on their health-related worries. Methods A longitudinal survey at a Swedish hospital starting six months before (16 September 2019) and continuing during the COVID-19 outbreak (until 25 August 2020). 6,941 pregnant women and partners of diverse social backgrounds were recruited. 96 percent of birth-giving women in the city take early ultrasounds where recruitment took place. 62 percent of the women with an appointment and 51 percent of their partners gave consent to participate. Results Pregnant women experienced dramatically increased worries for their own health, as well as for their partner’s and their child’s health in the beginning of the pandemic. The worries remained at higher than usual levels throughout the pandemic. Similar, but less dramatic changes, were seen among partners. Conclusions There is a need for heightened awareness of pregnant women’s and partners’ health-related worries as a consequence of the COVID-19 pandemic. Related feelings such as anxiety have been linked to adverse pregnancy outcome and might have long-term effects. The health care system needs to prepare for follow-up visits with these families.

Mental health among pregnant women during the pandemic in Sweden– a mixed methods approach using data from the Mom2B mobile application for research

“…Among the limitations of the present study, we should first acknowledge that selection bias should be considered: only 1% of the background eligible population contributed data; the application cannot be used by women not able to communicate in Swedish, or those not owning a mobile smartphone (8%). Nonetheless, the present results are in line with another recent Swedish study with better representation (37). We cannot exclude a potential bias in the results due to the self-reported nature of the information gathered.…”

“…However, not all women provided comments and thus, we cannot conclude whether the expressed emotions were representative of all women; however, the present results are in line with recent studies. Specifically, consistent with our results, a previous Swedish study including a regional population-based cohort showed increased levels of health-related worry in pregnant women during the months of the pandemic (February-August 2020) (37), whereas other studies have also reported increased levels of anxiety and depression due to loss of supportive perinatal services and uncertainty about the novel coronavirus disease (38).…”

Effects of the COVID pandemic on pregnancy outcomes

“…A large-scale longitudinal survey carried out in Sweden revealed that, at the beginning of the pandemic, pregnant women experienced a considerable increase in worries regarding their own health and that of their child. These worries persisted at higher levels than usual throughout the pandemic [ 70 ]. Such feelings may have contributed to the increase in terminations seen during the COVID-19 pandemic.…”

Giving birth and becoming a parent during the COVID-19 pandemic: a qualitative analysis of 827 women’s responses to an online survey in Norway

“…Two other studies found a rise in psychosocial problems in postnatal women associated with social distancing and restrictions in the UK and Italy (11,12). A Swedish longitudinal study of 6,941 pregnant women and their partners showed that pregnant women experienced a dramatic increase in health-related worries during the pandemic (13).…”