Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

The Impact of COVID-19 Pandemic on Stress and Anxiety of Non-infected Pregnant Mothers

Authors
Abolfazl Mehdizadehkashi 1
Shahla Chaichian 2
Ladan Haghighi 1
Nooshin Eshraghi 3
Arash Bordbar 4
Neda Hashemi 1
Roya Derakhshan 1
Shahla Mirgalobayat 1
Samaneh Rokhgireh 1
Kobra Tahermanesh 1
1 Endometriosis Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
2 Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
3 Department of Perinatology, Shahid Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, Iran
4 Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
10.18502/jri.v22i2.5801
Abstract
Background: The newly emerging COVID-19 has caused severe anxiety around the world and it is infecting more people each day since there is no preventive measure or definite therapy for the diseases. The present study aimed to evaluate its effect on anxiety and stress of pregnant mothers during perinatal care. Methods: Three–hundred pregnant mothers without COVID–19 infection who were referred to the hospitals affiliated to Iran University of Medical Sciences for delivery during April 2020, based on negative clinical symptoms and the results of polymerase chain reaction (rt-PCR) for COVID–19, were recruited by census method and asked to complete the Persian version of the perceived stress scale (PSS); participants views about their anxiety level and the role of COVID–19 as the source of their stress and worries were recorded. Women who refused to continue the study were excluded. The frequency of variables and mean scores were calculated using SPSS v. 21. Results: Mean age of mothers was 30.20±16.19 years; 31.3% were primigravida and mean gestational age was 38.00±4.14 weeks. Moreover, 16.3% asked for earlier pregnancy termination and 39% requested Cesarean section (C/S). Assessing the mothers’ anxiety revealed a high/very high level of anxiety in 51.3%. The majority felt worried and frustrated because of COVID–19 (86.4%). Social media had a great impact on the level of stress among these mothers (60.3%). Conclusion: COVID-19 pandemic is an important source for the increased anxiety and stress among healthy pregnant mothers.
Keywords
Anxiety
Coronavirus
COVID-19
Pregnant women
Term birth
  1. Thoits PA. Stress and health: Major findings and policy implications. J Health Soc Behav. 2010;51 Suppl:S41-S53.
  2. Keller A, Litzelman K, Wisk LE, Maddox T, Cheng ER, Creswell PD, et al. Does the perception that stress affects health matter? the association with health and mortality. Health Psychol. 2012;31(5):677-84.
  3. Schneiderman N, Ironson G, Siegel SD. Stress and health: psychological, behavioral, and biological determinants. Annu Rev Clin Psychol. 2005;1:607-28.
  4. Goodman JH, Chenausky KL, Freeman MP. Anxiety disorders during pregnancy: a systematic review. J Clin Psychiatry. 2014;75(10):e1153-84.
  5. Schetter CD, Tanner L. Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Curr Opin Psychiatry. 2012;25(2):141-8.
  6. Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry. 2010;67(10):1012-24.
  7. Lima SAM, El Dib RP, Rodrigues MRK, Ferraz GAR, Molina AC, Neto CAP, et al. Is the risk of low birth weight or preterm labor greater when maternal stress is experienced during pregnancy? a systematic review and meta-analysis of cohort studies. PloS One. 2018;13(7):e0200594.
  8. Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord. 2016;191:62-77.
  9. Satyanarayana VA, Lukose A, Srinivasan K. Maternal mental health in pregnancy and child behavior. Indian J Psychiatry. 2011;53(4):351-61.
  10. Singhal T. A review of coronavirus disease-2019 (COVID-19). Indian J Pediatr. 2020;87(4):281-6.
  11. Hu Y, Sun J, Dai Z, Deng H, Li X, Huang Q, et al. Prevalence and severity of corona virus disease 2019 (COVID-19): a systematic review and meta-analysis. J Clin Virol. 2020;127:104371.
  12. Hellewell J, Abbott S, Gimma A, Bosse NI, Jarvis CI, Russell TW, et al. Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts. Lancet Glob Health. 2020;8(4):e488-e96.
  13. World Health Organization. Coronavirus disease 2019 (COVID-19). Geneva: World Health Organization; 2020 Mar. 10 p. Report No. 70.
  14. Gao J, Zheng P, Jia Y, Chen H, Mao Y, Chen S, et al. Mental health problems and social media exposure during COVID-19 outbreak. PloS One. 2020;15(4):e0231924.
  15. Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: an overview. J Chin Med Assoc. 2020;83(3):217-20.
  16. Rajkumar RP. COVID-19 and mental health: a review of the existing literature. Asian J Psychiatr. 2020;52:102066.
  17. Lancet T. COVID-19: protecting health-care workers. Lancet. 2020;395(10228):922.
  18. Akkerman D, Cleland L, Croft G, Eskuchen K, Heim C, Levine A, et al. Routine prenatal care. 5th ed. Bloomington (MN): Institute for clinical systems improvement (ICSI); 2012. 116 p.
  19. Alzamora MC, Paredes T, Caceres D, Webb CM, Valdez LM, La Rosa M. Severe COVID-19 during pregnancy and possible vertical transmission. Am J Perinatol. 2020;37(8):861-5.
  20. Corbett GA, Milne SJ, Hehir MP, Lindow SW, O’connell MP. Health anxiety and behavioural changes of pregnant women during the COVID-19 pandemic. Eur J Obstet Gynecol Reprod Biol. 2020;249:96-7.
  21. Loomans EM, Van Dijk AE, Vrijkotte TG, Van Eijsden M, Stronks K, Gemke RJ, et al. Psychosocial stress during pregnancy is related to adverse birth outcomes: results from a large multi-ethnic community-based birth cohort. Eur J Public Health. 2013;23(3):485-91.
  22. Dashraath P, Jeslyn WJL, Karen LMX, Min LL, Sarah L, Biswas A, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222(6):521-31.
  23. Cohen S, Kessler RC, Gordon LU. Measuring stress: a guide for health and social scientists. 1st ed. New York: Oxford University Press; 1997. 235 p.
  24. Lee EH. Review of the psychometric evidence of the perceived stress scale. Asian Nurs Res (Korean Soc Nurs Sci). 2012;6(4):121-7.
  25. Maroufizadeh S, Zareiyan A, Sigari N. Reliability and validity of Persian version of perceived stress scale (PSS-10) in adults with asthma. Arch Iran Med. 2014;17(5):361-5.
  26. Giardinelli L, Innocenti A, Benni L, Stefanini M, Lino G, Lunardi C, et al. Depression and anxiety in perinatal period: prevalence and risk factors in an Italian sample. Arch Womens Ment Health. 2012;15(1):21-30.
  27. Bayrampour H, McDonald S, Tough S. Risk factors of transient and persistent anxiety during pregnancy. Midwifery. 2015;31(6):582-9.
  28. Zandifar A, Badrfam R. Iranian mental health during the COVID-19 epidemic. Asian J Psychiatr. 2020;51:101990.
  29. Takian A, Raoofi A, Kazempour-Ardebili S. COVID-19 battle during the toughest sanctions against Iran. Lancet. 2020;395(10229):1035-6.
  30. Serafini G, Parmigiani B, Amerio A, Aguglia A, Sher L, Amore M. The psychological impact of COVID-19 on the mental health in the general population. QJM. 2020;113(8):531-7.
  31. Dubey S, Biswas P, Ghosh R, Chatterjee S, Dubey MJ, Chatterjee S, et al. Psychosocial impact of COVID-19. Diabetes Metab Syndr. 2020;14(5):779-88.
  32. Depoux A, Martin S, Karafillakis E, Preet R, Wilder-Smith A, Larson H. The pandemic of social media panic travels faster than the COVID-19 outbreak. J Travel Med. 2020;27(3):taaa031.
  33. Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID-19 scale: development and initial validation. Int J Ment Health Addict. 2020 Mar 27:1-9.
  34. Shanafelt T, Ripp J, Trockel M. Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic. JAMA. 2020;323(21):2133-4.
  35. World Health Organization. Rational use of personal protective equipment for coronavirus disease (‎‎COVID-19)‎‎ and considerations during severe shortages: interim guidance. Geneva: World Health Organization; 2020. 32 p.
  36. Yang CJ, Chen TC, Chen YH. The preventive strategies of community hospital in the battle of fighting pandemic COVID-19 in Taiwan. J Microbiol Immunol Infect. 2020;53(3):381-3.
  37. The Center for Disease Control and Prevention [Internet]. USA: Center for Disease Control and Prevention. Breastfeeding and caring for newborns. 26 Feb 2021 [cited 15 Apr 2021]; [about 7 screens]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html
Journal of Reproduction & Infertility
Volume 22, Issue 2
Spring 2021
Pages 125-132