Prenatal anxiety and the associated factors among Chinese pregnant women during the COVID-19 pandemic--a smartphone questionnaire survey study

Can Cui; Lingling Zhai; Kristin K Sznajder; Jiana Wang; Xiao Sun; Xiaocai Wang; Weiyu Zhang; Fengzhi Yang; Xiaoshi Yang

doi:10.1186/s12888-021-03624-1

Prenatal anxiety and the associated factors among Chinese pregnant women during the COVID-19 pandemic--a smartphone questionnaire survey study

BMC Psychiatry. 2021 Dec 10;21(1):619. doi: 10.1186/s12888-021-03624-1.

Authors

Can Cui^#¹, Lingling Zhai^#², Kristin K Sznajder³, Jiana Wang¹, Xiao Sun⁴, Xiaocai Wang⁴, Weiyu Zhang¹, Fengzhi Yang¹, Xiaoshi Yang⁵

Affiliations

¹ Department of Social Medicine, College of Health Management, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, P.R. China.
² Department of Maternal and Child Health, School of Public Health, China Medical University, No.77 Puhe Road, Shenbeixin District, Shenyang, Liaoning Province, 110016, P.R. China.
³ Department of Public Health Sciences, College of Medicine, Pennsylvania State University, 90 Hope Drive, Suite 2200, Hershey, PA, 17033, USA.
⁴ Shenyang Women's and Children's Hospital, No.41 Shenzhou Road, Shenhe District, Shenyang, Liaoning Province, 110000, P.R. China.
⁵ Department of Social Medicine, College of Health Management, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, P.R. China. xsyang@cmu.edu.cn.

^# Contributed equally.

Abstract

Backgrounds: The uncertainty of the pandemic of Coronavirus Disease 2019 (COVID-19) brought about tremendous psychological harm for pregnant women, causing their high rates of prenatal anxiety. The impacts of COVID-19 pandemic and symptoms of pregnant status are highly linked with prenatal anxiety. Whereas, self-efficacy and support from family and friends could attenuate the development of prenatal anxiety. Thus, the purpose of the study is to evaluate the prevalence of prenatal anxiety and its influence factors among pregnant women during the pandemic of COVID-19 in Shenyang, China.

Methods: A cross-sectional study with face-to-face interview between April 24, 2020 and May 3, 2020 during the COVID-19 pandemic was applied among pregnant women in Shenyang Women's and Children's Hospital. Chi-square tests were calculated to determine the differences in prenatal anxiety among categorical variables. Multivariable logistic regression was employed to investigate the risk factors of prenatal anxiety.

Results: The percentage of prenatal anxiety (GAD-7 score ≥ 7) among pregnant women during the pandemic of COVID-19 was 34/304 (11.18%). Logistic regression indicated that vomiting (OR 4.454, 95% CI 1.113-17.821) and feeling susceptible to SARS-CoV-2 infection (OR 2.966, 95% CI 1.151-7.642) increased the odds of prenatal anxiety. Satisfaction with medical care (OR 0.303, 95% CI 0.113-0.813) and self-efficacy (OR 0.253, 95% CI 0.100-0.639) decreased the odds of prenatal anxiety. High monthly income (OR 0.246, 95% CI 0.078 ~ 0.780) reduced the chances of suffering from prenatal anxiety.

Conclusion: The pregnant women in China exerted a higher prevalence of prenatal anxiety during the COVID-19 pandemic than that without COVID-19 pandemic. Effective management on symptoms of pregnant status should be delivered to relieve prenatal anxiety for the pregnant women. Furthermore, interventions on self-efficacy enhancement and high-quality medical prenatal care should be provided to prevent from the susceptibility of SARS-CoV-2 infection and reduce prenatal anxiety.

Keywords: COVID-19; Medical care; Prenatal anxiety; Self-efficacy; Vomiting.

MeSH terms

Anxiety / epidemiology
COVID-19*
Child
Cross-Sectional Studies
Female
Humans
Pandemics
Pregnancy
Pregnant Women
SARS-CoV-2
Smartphone
Surveys and Questionnaires