Depression and anxiety among pregnant mothers in the initial stage of the Coronavirus Disease (COVID-19) pandemic in the southwest of Iran

?BackgroundWomen are at a higher risk for depression progression, especially during pregnancy. The current study purposed to investigate depression, anxiety, and stress levels of pregnant mothers in the initial stage of the COVID-19 infection in the southwest of Iran. MethodsThis cross-sectional study was conducted during March and April, 2020, in Shiraz, Iran. Pregnant mothers registered in maternity clinics affiliated with Shiraz University of Medical Sciences were included. An online self-administered checklist was used. It included socio-demographic, obstetric and medical histories, and the short form of the Depression Anxiety Stress Scales (DASS-21) to evaluate depression, anxiety, and stress. A p-value<0.05 was considered significant.ResultsIn total, 540 pregnant mothers answered the questionnaire. 83.5% had no comorbidity. Abnormal depression scores were significantly higher in those who had no insurance (OR=2.5) and in those with poor self-rated health (SRH) (OR=27.8). Pregnant mothers with lower SRH and two or more comorbidities had a higher chance of having an abnormal level of anxiety subscale (6.9, 3.7 times, retrospectively).ConclusionThe results revealed that an abnormal level of depression was associated with SRH and medical insurance status. Moreover, the number of comorbidities and poor SRH significantly increased the chance of achieving abnormal anxiety levels in pregnant mothers during the COVID-19 pandemic. Plain English summaryChildren of mothers who experience high psychological distress during pregnancy are more susceptible to cognitive and behavioral problems. Few studies have reported the psychological distress of pregnant mothers during the COVID-19 pandemic, and it may be considered as a risk factor for child developmental disorders.In total, 540 out of 920 registered pregnant mothers in maternity clinics affiliated with Shiraz University of Medical Sciences answered the online questionnaire and were included in this study. An online self-administered data gathering tool was used so that the respondents felt more secure. The data gathering tool had three main parts: socio-demographic, obstetric and medical histories, and the short form of the Depression Anxiety Stress Scales (DASS-21) which consisting of 21 questions, 7 in each subscale; depression (DASS-D), anxiety (DASS-A) and stress (DASS-S).Pregnant mothers who had two or more comorbidities or those with lower self-rated health (SRH) had a higher chance of having an abnormal anxiety level. Depression levels were higher in pregnant mothers who had no insurance. Additionally, depression symptoms were more prevalent in pregnant mothers who had low health status than in those with good or intermediated SRH.In conclusion, the COVID-19 pandemic contributes to a significant increase in depression and anxiety symptoms among pregnant mothers. Moreover, lack of insurance, poor SRH, and having comorbidities are significantly associated with increasing depressive and anxiety scores.

Automated summary

This study investigated the levels of depression, anxiety, and stress in pregnant mothers in the initial stage of COVID-19 infection in southwest Iran. The results showed that abnormal depression levels were associated with self-rated health and medical insurance status, while comorbidities and poor self-rated health significantly increased the chance of abnormal anxiety levels among pregnant mothers. The COVID-19 pandemic has led to a significant increase in depression and anxiety symptoms among pregnant mothers, with lack of insurance, poor self-rated health, and comorbidities being risk factors for higher depressive and anxiety scores.