INTRODUCTION: Our study (part of multicentric "MindCOVID") investigates risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic in the Czech Republic. MATERIAL AND METHODS: The study used a prospective cross-sectional design. Data was collected using an online self-administered questionnaire. Standardized scales, general anxiety disorder (GAD)-7 and patient health questionnaire (PHQ)-9 were administered online. Multivariate regression analysis was employed to evaluate the relationship between sociodemographic, medical and psychological variables. RESULTS: The Czech sample included 1830 pregnant women. An increase of depressive and anxiety symptoms measured by PHQ-9 and GAD-7 in pregnant women during the COVID-19 pandemic was associated with unfavorable financial situation, low social and family support, psychological and medical problems before and during pregnancy and infertility treatment. Fear of being infected and adverse effect of COVID-19, feeling of burden related to restrictions during delivery and organization of delivery and feeling of burden related to finances were associated with worse anxiety and depressive symptoms. CONCLUSIONS: Social and emotional support and lack of financial worries are protective factors against mood disorders in pregnant women in relation to COVID-19 pandemic. In addition, adequate information about organization of delivery and additional support from healthcare professionals during the delivery are needed. Our findings can be used for preventive interventions, given that repeated pandemics in the future are anticipated.

Department of Clinical Psychology Na Homolce Hospital Prague Czech Republic

Department of Neurology Na Homolce Hospital Prague Czech Republic

Department of Obstetrics and Gynecology Prince of Wales Hospital The Chinese University of Hong Kong Hong Kong SAR

Department of Reproductive Health Center of Postgraduate Medical Education Warsaw Poland

Fetal Medicine Center 1st Medical Faculty of the Charles University and General Teaching Hospital Prague Czech Republic

Kúpele pre dušu s r o Bardejov Spa Bardejov Slovak Republic

See more in PubMed

Effati‐Daryani F, Zarei S, Mohammadi A, Hemmati E, Ghasemi Yngyknd S, Mirghafourvand M. Depression, stress, anxiety and their predictors in Iranian pregnant women during the outbreak of COVID‐19. BMC Psychol. 2020;8:99. PubMed PMC

Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus disease 2019 (COVID‐19) and pregnancy: what obstetricians need to know. Am J Obstet Gynecol. 2020;222:415‐426. PubMed PMC

Li S, Wang Y, Xue J, Zhao N, Zhu T. The impact of COVID‐19 epidemic declaration on psychological consequences: a study on active Weibo users. Int J Environ Res Public Health. 2020;17:2032. PubMed PMC

Berthelot N, Lemieux R, Garon‐Bissonnette J, Drouin‐Maziade C, Martel É, Maziade M. Uptrend in distress and psychiatric symptomatology in pregnant women during the coronavirus disease 2019 pandemic. Acta Obstet Gynecol Scand. 2020;99:848‐855. PubMed

Wu Y, Lu YC, Jacobs M, et al. Association of prenatal maternal psychological distress with fetal brain growth, metabolism, and cortical maturation. JAMA Netw Open. 2020;29(3):e1919940. PubMed PMC

Dean DC, Planalp EM, Wooten W, et al. Association of prenatal maternal depression and anxiety symptoms with infant white matter microstructure. JAMA Pediatr. 2018;172:973‐981. PubMed PMC

Cardwell MS. Stress: pregnancy considerations. Obstet Gynecol Surv. 2013;68:119‐129. PubMed

Snapper LA, Hart KL, Venkatesh KK, Kaimal AJ, Perlis RH. Cohort study of the relationship between individual psychotherapy and pregnancy outcomes. J Affect Disord. 2018;239:253‐257. PubMed PMC

Yang S, Yang R, Liang S, et al. Symptoms of anxiety and depression during pregnancy and their association with low birth weight in Chinese women: a nested case control study. Arch Womens Ment Health. 2017;20:283‐290. PubMed

Ravid E, Salzer L, Arnon L, et al. Is there an association between maternal anxiety propensity and pregnancy outcomes? BMC Pregnancy Childbirth. 2018;18:287. PubMed PMC

Lebel C, MacKinnon A, Bagshawe M, Tomfohr‐Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among pregnant individuals during the COVID‐19 pandemic. J Affect Disord. 2020;277:5‐13. PubMed PMC

Ahmad M, Vismara L. The psychological impact of COVID‐19 pandemic on women's mental health during pregnancy: a rapid evidence review. Int J Environ Res Public Health. 2021;18:7112. PubMed PMC

Yan H, Ding Y, Guo W. Mental health of pregnant and postpartum women during the coronavirus disease 2019 pandemic: a systematic review and meta‐analysis. Front Psychol. 2020;11:617001. PubMed PMC

Thapa SB, Mainali A, Schwank SE, Acharya G. Maternal mental health in the time of the COVID‐19 pandemic. Acta Obstet Gynecol Scand. 2020;99:817‐818. PubMed PMC

López‐Morales H, del Valle MV, Canet‐Juric L, et al. Mental health of pregnant women during the COVID‐19 pandemic: a longitudinal study. Psychiatry Res. 2021;295:113567. PubMed PMC

Khoury JE, Atkinson L, Bennett T, Jack SM, Gonzalez A. COVID‐19 and mental health during pregnancy: the importance of cognitive appraisal and social support. J Affect Disord. 2021;282:1161‐1169. PubMed PMC

Salehi L, Rahimzadeh M, Molaei E, Zaheri H, Esmaelzadeh‐Saeieh S. The relationship among fear and anxiety of COVID‐19, pregnancy experience, and mental health disorder in pregnant women: a structural equation model. Brain Behav. 2020;10:e01835. PubMed PMC

Durankuş F, Aksu E. Effects of the COVID‐19 pandemic on anxiety and depressive symptoms in pregnant women: a preliminary study. J Matern Fetal Neonatal Med. 2022;35:205‐211. PubMed

Kocalevent RD, Hinz A, Brähler E. Standardization of the depression screener patient health questionnaire (PHQ‐9) in the general population. Gen Hosp Psychiatry. 2013;35:551‐555. PubMed

Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD‐7. Arch Intern Med. 2006;166(10):1092–1097. PubMed

Kajdy A, Feduniw S, Ajdacka U, et al. Risk factors for anxiety and depression among pregnant women during the COVID‐19 pandemic: a web‐based cross‐sectional survey. Medicine (Baltimore). 2020;99:e21279. PubMed PMC

Kajdy A, Sys D, Pokropek A, et al. Risk factors for anxiety and depression among pregnant women during the COVID‐19 pandemic: results of a web‐based multinational cross‐sectional study. Int J Gynaecol Obstet. 2023;160:167‐186. PubMed PMC

Shahid A, Javed A, Rehman S, Tariq R, Ikram M, Suhail M. Evaluation of psychological impact, depression, and anxiety among pregnant women during the COVID‐19 pandemic in Lahore. Pakistan Int J Gynecol Obstet. 2020;151:462‐465. PubMed PMC

Kahyaoglu Sut H, Kucukkaya B. Anxiety, depression, and related factors in pregnant women during the COVID‐19 pandemic in Turkey: a web‐based cross‐sectional study. Perspect Psychiatr Care. 2021;57:860‐868. PubMed PMC

Sade S, Sheiner E, Wainstock T, et al. Risk for depressive symptoms among hospitalized women in high‐risk pregnancy units during the COVID‐19 pandemic. J Clin Med. 2020;9:2449. PubMed PMC

Mappa I, Distefano FA, Rizzo G. Effects of coronavirus 19 pandemic on maternal anxiety during pregnancy: a prospectic observational study. J Perinat Med. 2020;48:545‐550. PubMed

Yue C, Liu C, Wang J, et al. Association between social support and anxiety among pregnant women in the third trimester during the coronavirus disease 2019 (COVID‐19) epidemic in Qingdao, China: the mediating effect of risk perception. Int J Soc Psychiatry. 2021;67:120‐127. PubMed PMC

Patabendige M, Gamage MM, Weerasinghe M, Jayawardane A. Psychological impact of the COVID‐19 pandemic among pregnant women in Sri Lanka. Int J Gynecol Obstet. 2020;151:150‐153. PubMed PMC

Hessami K, Romanelli C, Chiurazzi M, Cozzolino M. COVID‐19 pandemic and maternal mental health: a systematic review and meta‐analysis. J Matern Fetal Neonatal Med. 2022;35:4014‐4021. PubMed

Moyer CA, Compton SD, Kaselitz E, Muzik M. Pregnancy‐related anxiety during COVID‐19: a nationwide survey of 2740 pregnant women. Arch Womens Ment Health. 2020;23:757‐765. PubMed PMC

Ceulemans M, Hompes T, Foulon V. Mental health status of pregnant and breastfeeding women during the COVID‐19 pandemic: a call for action. Int J Gynecol Obstet. 2020;151:146‐147. PubMed

Vieira LG, Camargo ELJS, Schneider G, et al. Effects of the COVID‐19 pandemic on the mental health of pregnant and puerperal women: a systematic review. Open Nurs J. 2021;15:388‐398.

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;249:96‐97. PubMed PMC

Wu Y, Zhang C, Liu H, et al. Perinatal depressive and anxiety symptoms of pregnant women during the coronavirus disease 2019 outbreak in China. Am J Obstet Gynecol. 2020;223:240.e1‐240.e9. PubMed PMC

Ayaz R, Hocaoğlu M, Günay T, et al. Anxiety and depression symptoms in the same pregnant women before and during the COVID‐19 pandemic. J Perinat Med. 2020;48:965‐970. PubMed

Jelly P, Chadha L, Kaur N, et al. Impact of COVID‐19 pandemic on the psychological status of pregnant women. Cureus. 2021;13:e12875. PubMed PMC

Lega I, Bramante A, Lauria L, et al. The psychological impact of COVID‐19 among women accessing family care centers during pregnancy and the postnatal period in Italy. Int J Environ Res Public Health. 2022;19:1983. PubMed PMC

Luo Y, Zhang K, Huang M, Qiu C. Risk factors for depression and anxiety in pregnant women during the COVID‐19 pandemic: evidence from meta‐analysis. PLoS ONE. 2022;17:e0265021. PubMed PMC

MacKinnon AL, Madsen JW, Giesbrecht GF, et al. Effects of mindfulness‐based cognitive therapy in pregnancy on psychological distress and gestational age: outcomes of a randomized controlled trial. Mind. 2021;12:1173‐1184.