Association of Stress-Related Factors With Anxiety Among Chinese Pregnant Participants in an Online Crisis Intervention During COVID-19 Epidemic

Background: Previous systematic review indicated the prevalence of prenatal anxiety as 14-54%. Pregnant women are a high-risk population for COVID-19. However, the prevalence of anxiety symptoms and related factors is unknown in Chinese pregnant women during COVID-19 outbreak. Objective: To investigate the prevalence of anxiety symptoms and the related factors in Chinese pregnant women who were attending crisis intervention during the COVID-19 pandemic. Methods: The data of this cross-sectional study were collected in about 2 months (February 28 to April 26, 2020). Data analysis was performed from April to May 2020. Participants completed a set of questionnaires via the Wechat Mini-program before starting the online self-help crisis intervention for COVID-19 epidemic. A total of 2,120 Chinese pregnant women who were attending a self-help crisis intervention participated in this study. A survey was developed to address possible stress-related factors in pregnant women during the COVID-19 outbreak, including demographic, socioeconomic, and pregnancy-related factors, as well as COVID-19 related factors. Generalized Anxiety Disorder-7 (GAD-7) scale and the 10-item perceived stress scale were, respectively, employed to measure anxiety and stress-related factors. Results: A total of 21.7% (459) of pregnant women reported at least mild anxiety (>= 5 on the GAD-7 scale), and only 82 women reported moderate to severe anxiety (>= 10 on the GAD-7 scale). Factors associated with at least mild anxiety included living in Hubei province (OR = 1.68, 95% CI = 1.32-2.13), nobody providing everyday life support (OR = 1.81, 95% CI = 1.18-2.77), pelvic pain or vaginal bleeding (OR = 1.67, 95% CI = 1.32-2.09), and higher perceived stress (OR = 6.87, 95% CI = 5.42-9.02). Having relatives or neighbors with a diagnosis of COVID-19 was not associated with anxiety (p > 0.05). Conclusions and Relevance: Our findings indicate that evaluation and intervention for maternal and infant health are necessary in pregnant women with anxiety during COVID-19 epidemic, especially those with higher perceived stress, less everyday life support, or vaginal bleeding. Interactions among these related medical, social and psychological factors need to be investigated in future studies.

Automated summary

During the COVID-19 pandemic, approximately 21.7% of Chinese pregnant women reported at least mild anxiety symptoms, with factors such as location of residence, everyday life support, pelvic pain or vaginal bleeding, and perceived stress level being associated with anxiety levels.