Fear of COVID-19, mental health, and pregnancy outcomes in the pregnancy during the COVID-19 pandemic study: Fear of COVID-19 and pregnancy outcomes

G F Giesbrecht; L Rojas; S Patel; V Kuret; A L MacKinnon; L Tomfohr-Madsen; C Lebel

doi:10.1016/j.jad.2021.12.057

Fear of COVID-19, mental health, and pregnancy outcomes in the pregnancy during the COVID-19 pandemic study: Fear of COVID-19 and pregnancy outcomes

J Affect Disord. 2022 Feb 15:299:483-491. doi: 10.1016/j.jad.2021.12.057. Epub 2021 Dec 21.

Authors

G F Giesbrecht¹, L Rojas², S Patel³, V Kuret⁴, A L MacKinnon⁵, L Tomfohr-Madsen⁶, C Lebel⁷

Affiliations

¹ Department of Paediatrics, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada; Department of Psychology, University of Calgary, Calgary, AB, Canada. Electronic address: ggiesbre@ucalgary.ca.
² Department of Paediatrics, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada.
³ Department of Psychology, University of Calgary, Calgary, AB, Canada.
⁴ Department of Obstetrics & Gynecology, University of Calgary, AB, Canada.
⁵ Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada; Department of Psychology, University of Calgary, Calgary, AB, Canada.
⁶ Department of Paediatrics, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada; Department of Psychology, University of Calgary, Calgary, AB, Canada.
⁷ Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada.

Abstract

Background: Sustained fear during pregnancy has the potential to increase psychological distress and obstetric risk. This study aimed to (1) identify factors and characteristics associated with fear of COVID-19, (2) investigate the relationship between fear of COVID-19 and maternal anxiety and depression, and (3) determine the relationship between fear of COVID-19 and pregnancy outcomes.

Methods: 9251 pregnant Canadians were recruited between April - December 2020. Participants self-reported (scale of 0-100) the degree of threat they perceived from the SARS-CoV-2 virus in relation to themselves and their unborn baby.

Results: Mean fear scores indicated moderate to elevated concern. In multivariable linear regression, fear of COVID-19 was associated with food insecurity, ethnicity, geographic location, history of anxiety prior to pregnancy, having a chronic health condition, pre-pregnancy BMI, parity, and stage of pregnancy at study enrollment. Higher COVID-19 fear was associated with increased odds of depression, adjusted odds ratio (aOR) = 1.75, p < 0.001, 95% CI 1.66-1.85, and anxiety, aOR=2.04, p < 0.001, 95% CI 1.94-2.15). Furthermore, fear of COVID-19 was associated with a 192-gram reduction in infant birthweight, and a 6.1-day reduction in gestational age at birth.

Limitations: The sample has higher education compared to the Canadian population and cannot test causal effects.

Conclusion: This study suggests that sociodemographic, health, and obstetric factors may contribute to increased fear of COVID-19 and associated adverse psychological and pregnancy outcomes.

Keywords: Anxiety; Birthweight; COVID-19; Depression; Fear; Pregnancy during the pandemic (PdP); Pregnancy outcomes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anxiety / epidemiology
COVID-19*
Canada / epidemiology
Depression
Fear
Female
Humans
Mental Health
Pandemics
Pregnancy
Pregnancy Outcome / epidemiology
SARS-CoV-2
Stress, Psychological