Depression and anxiety in Chinese Pregnant Women in the middle time of COVID-19 mid-phase of the COVID-19 pandemic: a cross-sectional study

Su-Fen QI^1*Wei-Hong Zhang²Li-Yan Du³Jie Hu¹

• ¹Hebei Medical University, Shijiazhuang, China
• ²International Centre for Reproductive Health, Ghent, Belgium
• ³Hebei Center for Women and Children's Health., Shijiazhuang, China

ABSTRACT Background This study aimed to evaluate the prevalence and associated factors of depressive and anxiety symptoms among Chinese pregnant women during the middle period of COVID-19. METHODS From May to August 2021, a cross-sectional online survey was conducted among pregnant women in Shijiazhuang, Hebei Province. The data collected included demographic characteristics (age, occupation, region, parity, number of fetuses, pregnancy-related disorders, education level, awareness of common symptoms, attention to the epidemic, and frequency of temperature measurement). We recruited participants using a convenience sampling approach. Depression and anxiety were assessed using self-depression rating scale (SDS) and a self-rating anxiety scale (SAS). A univariate and multivariable binomial logistic regression model was applied to identify risk factors for depression and anxiety. RESULTS Cronbach's α coefficients for SDS and SAS were 0.837 and 0.826, respectively. Among 1,036 participants, the prevalence of depressive and anxiety symptoms was 59.8% (620 cases) and 6.7% (69 cases), respectively. Factors associated with depression included the number of fetuses (OR=2.98, 95% CI 1.22-7.31), education level (OR=0.58, 95% CI 0.45-0.75), attention to the epidemic (OR=0.65, 95% CI 0.42-0.91), and frequency of temperature measurement (OR=0.62, 95% CI 0.41-0.93). Factors associated with anxiety included parity (OR=0.51, 95% CI 0.31-0.83), attention to the epidemic (OR=2.14, 95% CI 1.18-3.89), and frequency of temperature measurement (OR=2.86, 95% CI 1.08-7.52). Multivariate binomial logistic regression analysis indicated that a higher education level was an associated factor for depression (adjusted OR=0.52, 95% CI 0.38-0.70). However, the parity (adjusted OR=0.46, 95% CI 0.26-0.82) and pregnancy-related disorders (adjusted OR=2.55, 95% CI 1.46-4.45) were independent associated factors for anxiety. Conclusion Pregnant women with lower education levels, primipara status, and pregnancy-related disorders were association with higher levels of depression and anxiety during the middle period of COVID-19. These findings suggest the need for targeted interventions to support the mental health of pregnant women during pandemics.