Perceived Anxiety and Stress among Pregnant Women during COVID-19 Pandemic- A Cross-sectional Study

Introduction: Mental health and well-being is as important as physical health during pregnancy. But the Coronavirus Disease-2019 (COVID-19) pandemic has caused more anxiety and stress among pregnant women. The augmented levels of anxiety and stress may have detrimental effects on antenatal women. Anxiety and depression in pregnancy can lead to adverse pregnancy outcomes like increased risk of abortions, preterm labour and even foetal deaths.

Aim: To assess the anxiety and stress levels among pregnant women attending a tertiary care hospital in Thiruvananthapuram, Kerala during the COVID-19 pandemic and to determine the associated factors.

Materials and Methods: A cross-sectional study was conducted among 348 pregnant women attending a tertiary care teaching hospital in Thiruvananthapuram District in Kerala during the period between October 2020 to November 2020 using a validated tool, Pandemic Anxiety Stress Scale for pregnant women (PASSP). Higher scores indicating higher perceived anxiety stress with a maximum score of 60, categorised as normal, mild, moderate and severe with score between 0-14, 15-29, 30-44, and 45-60, respectively. Qualitative variables were expressed in frequency and percentage. Multivariate logistic regression was done to determine the factors associated with anxiety and stress. The p-value <0.05 was considered significant.

Results: Mild anxiety and stress were seen in 160 (45.98%) pregnant women, 89 (25.57%) had moderate and 7 (2.01%) had severe anxiety and stress, 92 (26.44%) women had no anxiety. A total of 145 (41.67%) pregnant women were scared of vertical transmission to their baby. Multivariate logistic regression revealed that residents in urban area and pregnant women with other co-morbidities associated with pregnancy were the two significant factors (p<0.05) associated with anxiety-stress.

Conclusion: About one-fourth of pregnant women had moderate or severe level of anxiety and stress. Antenatal women with pregnancy related diseases and those living in urban area had more anxiety and stress during pandemic. Measures need to be taken by health system to address the mental health of pregnant women.