Impact of the COVID-19 Pandemic on Maternal Anxiety in Brazil

Roseli Nomura; Isabela Tavares; Ana Carla Ubinha; Maria Laura Costa; Maria Lucia Opperman; Marianna Brock; Alberto Trapani; Lia Damasio; Nadia Reis; Vera Borges; Alberto Zaconeta; Ana Cristina Araujo; Rodrigo Ruano; BrAPS-Covid Brazilian Anxiety During Pregnancy Study Group In Covid-

doi:10.3390/jcm10040620

Impact of the COVID-19 Pandemic on Maternal Anxiety in Brazil

J Clin Med. 2021 Feb 6;10(4):620. doi: 10.3390/jcm10040620.

Affiliations

¹ Department of Obstetrics, Escola Paulista de Medicina, Federal University of São Paulo, Rua Napoleão de Barros, 875, Sao Paulo, SP CEP 04024-002, Brazil.
² Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP CEP 13083-881, Brazil.
³ Gynecology and Obstetrics Unit, Hospital de Clínicas de Porto Alegre, Department of Gynecology and Obstetrics, Faculdade de Medicina, Federal University of Rio Grande do Sul, Porto Alegre, RS CEP 90035-903, Brazil.
⁴ Department Obstetrics and Gynecology, University of Amazonas State, Manaus, AM CEP 69065-001, Brazil.
⁵ Women's Health Care Unit, Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina, Florianópolis, SC CEP 88036-800, Brazil.
⁶ Department Obstetrics and Gynecology, Federal University of Piaui, Teresina, PI CEP 64049-550, Brazil.
⁷ Gynecology and Obstetrics Unit, University Hospital Maria Aparecida Pedrossian of Medical School, Federal University of Mato Grosso do Sul, Campo Grande, MS CEP 79080-190, Brazil.
⁸ Department Obstetrics and Gynecology, Botucatu Medical School- Unesp, Botucatu, SP CEP 18618-687, Brazil.
⁹ Maternal and Child Unit, University Hospital of Brasília, Faculty of Medicine, University of Brasília, Brasília, DF CEP 70910-900, Brazil.
¹⁰ Department of Gynecology and Obstetrics, Maternidade Januário Cicco, Federal University of Rio Grande do Norte, Natal, RN CEP 59078-900, Brazil.
¹¹ Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic may have an effect on maternal anxiety and influence postpartum experience.

Objective: To study the prevalence of maternal anxiety in late pregnancy in the context of the COVID-19 outbreak in Brazil and to analyze its association with maternal knowledge and concerns about the pandemic.

Methods: This was a national multicenter cross-sectional study performed in 10 different public university hospitals, between 1 June and 31 August 2020, in Brazil. The inclusion criteria were: maternal age more than 18 years; gestational age more than 36 weeks at childbirth; single alive newborn without malformations; and absence of mental disorders. We applied a structured questionnaire to explore the knowledge and concerns about COVID-19. Maternal anxiety was assessed using the Beck Anxiety Inventory (BAI).

Results: Of the 1662 women interviewed, the BAI score in late pregnancy indicated that 13.9% presented moderate and 9.6% severe maternal anxiety. Moderate or severe maternal anxiety was independently associated with the fear of being unaccompanied at childbirth (aOR1.12, 95% CI 1.10-1.35), and independent protective factors were confidence in knowing how to protect oneself from COVID-19 (aOR0.89, 95% CI 0.82-0.97) and how to safely breastfeed (aOR0.89, 95% CI 0.83-0.95).

Conclusion: The COVID-19 pandemic has a significant impact on maternal anxiety.

Keywords: breastfeeding; childbirth; coronavirus disease 2019; maternal anxiety; pandemic; postpartum; pregnancy; questionnaires.