Knowledge,Fear,and Anxiety Levels Among Pregnant Women During the COVID-19 Pandemic: A Cross-Sectional Study

Abstract

This study aimed to evaluate pregnant women’s knowledge, fear, and anxiety levels during the coronavirus outbreak. This cross-sectional study was conducted on 170 pregnant women between May 20 and July 10, 2020. Data collection form for demographics and obstetric details, questionnaire on knowledge, attitudes, and practice toward COVID-19, and State-Trait Anxiety Inventory-I were used. The vast majority of pregnant women were afraid of being infected with the COVID-19 and causing mother-to-baby transmission. A positive correlation was found between fear of coronavirus transmission and the level of anxiety (p < .05). Risk perceptions regarding COVID-19 have affected the anxiety and knowledge levels of pregnant women. Based on the findings, knowledge levels, concerns, and fears about the risk of COVID-19 exposure have implications on the anxiety levels of pregnant women. Pregnant women experienced high stress and anxiety levels due to increased risk of COVID-19 transmission during face-to-face antenatal visits.

Keywords

COVID-19 pregnancy anxiety fear knowledge

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References

Akiki

Avison

W. R.

Speechley

K. N.

Campbell

M. K.

(2016). Determinants of maternal antenatal state-anxiety in mid-pregnancy: Role of maternal feelings about the pregnancy. Journal of Affective Disorders, 196, 260–267. https://doi.org/10.1016/j.jad.2016.02.016

American College of Obstetricians and Gynecologist. (n.d). COVID-19 Vaccination Considerations for Obstetric–Gynecologic Care. Retrieved December 26, 2021, from https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care

American College of Obstetricians and Gynecologist. (2015). Ob-Gyns Screening for Perinatal Depression. Number 757 (Replaces Committee Opinion No. 630). Retrieved October 20, 2020, from https://www.acog.org//media/project/acog/acogorg/clinical/files/committee-opinion/articles/2018/11/screening-for-perinatal-depression.pdf

American College of Obstetricians and Gynecologist. (2020). Novel Coronavirus 2019 (COVID-19), Practice Advisory. Retrieved October 20, 2020 from acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/03/novel-coronavirus-2019

Blakeway

Prasad

Kalafat

Heath

P. T.

Ladhani

S. N.

Le Doare

Magee

L. A.

O’Brien

Rezvani

von Dadelszen

Khalil

(2022). COVID-19 vaccination during pregnancy: Coverage and safety. American Journal of Obstetrics and Gynecology, 226, 236.e1–236.e14. https://doi.org/10.1016/j.ajog.2021.08.007

Chang

S.-F.

Hung

C.-H.

Hsu

Y.-Y.

Liu

Wang

T.-N.

(2017). The effectiveness of health education on maternal anxiety, circumcision knowledge, and nursing hours: A quasi-experimental study. Journal of Nursing Research, 25(4), 296–303. https://doi.org/10.1097/JNR.0000000000000177

Chinchilla-Ochoa

Barriguete-Chávez Peón

Farfán-Labonne

B. E.

Garza-Morales

Leff-Gelman

Flores-Ramos

(2019). Depressive symptoms in pregnant women with high trait and state anxiety during pregnancy and postpartum. International Journal of Women's Health, 11, 257–265. https://doi.org/10.2147/IJWH.S194021

ClinCalc. (2020). Sample size calculator. Retrieved March 1, 2020, from https://clincalc.com/Stats/SampleSize.aspx

Dagklis

Tsakiridis

Mamopoulos

Athanasiadis

Papazisis

(2020). Anxiety during pregnancy in the era of the COVID-19 pandemic. SSRN Electronic Journal. (Preprint) https://doi.org/10.2139/ssrn.3588542

10.

Dawood

F. S.

Hunt

Patel

Kittikraisak

Tinoco

Kurhe

Soto

Hombroek

Garg

Chotpitayasunondh

Gonzales

Bhargav

Thompson

M. G.

Chotpitayasunondh

Florian

Prakash

Arriola

Macareo

Das

Azziz-Baumgartner

(2018). The Pregnancy and Influenza Multinational Epidemiologic (PRIME) study: A prospective cohort study of the impact of influenza during pregnancy among women in middle-income countries. Reproductive Health, 15(1), 1–13. https://doi.org/10.1186/s12978-018-0600-x

11.

Donders

Lonnée-Hoffmann

Tsiakalos

Mendling

Martinez

Oliveira

Judlin

Xue

Donders

G. G. G.

, & Isidog Covid-Guideline Workgroup. (2020). ISIDOG recommendations concerning COVID-19 and pregnancy. Diagnostics, 10(4), 1–23. https://doi.org/10.3390/diagnostics10040243

12.

Durankuş

Aksu

(2020). Effects of the COVID-19 pandemic on anxiety and depressive symptoms in pregnant women: A preliminary study. The Journal of Maternal-Fetal & Neonatal Medicine. Advance online publication. https://doi.org/10.1080/14767058.2020.1763946.

13.

Goncu Ayhan

Oluklu

Atalay

Menekse Beser

Tanacan

Moraloglu Tekin

Sahin

(2021). COVID-19 vaccine acceptance in pregnant women. International Journal of Gynaecology and Obstetrics, 154(2), 291–296. https://doi.org/10.1002/ijgo.13713

14.

GOV.UK. (n.d). COVID-19 vaccination: A guide on pregnancy and breastfeeding. Retrieved February 2, 2022, from https://www.gov.uk/government/publications/covid-19-vaccination-women-of-childbearing-age-currently-pregnant-planning-a-pregnancy-or-breastfeeding/covid-19-vaccination-a-guide-for-women-of-childbearing-age-pregnant-planning-a-pregnancy-or-breastfeeding

15.

Gunnes

Gjessing

H. K.

Bakken

I. J.

Ghaderi

Gran

J. M.

Hungnes

Magnus

Samuelsen

S. O.

Skrondal

Stoltenberg

Trogstad

Wilcox

A. J.

Håberg

S. E.

(2020). Seasonal and pandemic influenza during pregnancy and risk of fetal death: A Norwegian registry-based cohort study. European Journal of Epidemiology, 35(4), 371–379. https://doi.org/10.1007/s10654-020-00600-z

16.

Kahyaoglu Sut

Kucukkaya

(2021). Anxiety, depression, and related factors in pregnant women during the COVID-19 pandemic in Turkey: A web-based cross-sectional study. Perspectives in Psychiatric Care, 57, 860–868. https://doi.org/10.1111/ppc.12627

17.

Magee

L. A.

von Dadelszen

Kalafat

Duncan

E. L.

O’Brien

Morris

Heath

Khalil

(2021). COVID-19 vaccination in pregnancy-number needed to vaccinate to avoid harm. The Lancet Infectious Diseases, 21(12), 1627. https://doi.org/10.1016/S1473-3099(21)00691-5

18.

Mahase

(2020). China coronavirus: WHO declares international emergency as death toll exceeds 200. BMJ, 368, m408. https://doi.org/10.1136/bmj.m408

19.

Masjoudi

Aslani

Seifi

Khazaeian

Fathnezhad-Kazemi

(2021). Association between perceived stress, fear and anxiety of COVID 19 with self-care in pregnant women: A cross-sectional study. Psychology Health & Medicine. 27(2), 289–300. https://doi.org/10.1080/13548506.2021.1894344

20.

Ner

Le Compte

(1993). State and Trait Anxiety Inventory - Manual (Turkish). Bogazici University Press (Original work published in Turkish)

21.

Rasmussen

S. A.

Smulian

J. C.

Lednicky

J. A.

Wen

T. S.

Jamieson

D. J.

(2020). Coronavirus disease 2019 (COVID-19) and pregnancy: What obstetricians need to know. American Journal of Obstetrics and Gynecology, 222, 415–426. https://doi.org/10.1016/j.ajog.2020.02.017

22.

Royal College of Obstetricians and Gynaecologists. (2020). Guidance for provision of midwife-led settings and home birth in the evolving coronavirus (COVID-19) pandemic. Retrieved October 20, 2020, from https://www.rcog.org.uk/globalassets/documents/guidelines/2020-07-10-guidance-for-provision-of-midwife-led.pdf

23.

Sahin

Tanacan

Erol

S. A.

Anuk

A. T.

Eyi

E. G. Y.

Ozgu-Erdinc

A. S.

Yucel

Keskin

H. L.

Tayman

Unlu

Kirca

Dinc

San

Parpucu

Ü. M.

Surel

A. A.

Moraloglu

O. T.

(2020). A pandemic center’s experience of managing pregnant women with COVID-19 infection in Turkey: A prospective cohort study. International Journal of Gynecology & Obstetrics, 151, 74–82.

24.

Samannodi

(2021). COVID-19 vaccine acceptability among women who are pregnant or planning for pregnancy in Saudi Arabia: A cross-sectional study. Patient Preference and Adherence, 15, 2609–2618. https://doi.org/10.2147/PPA.S338932

25.

Schwartz

D. A.

Graham

A. L.

(2020). Potential maternal and infant outcomes from coronavirus 2019-NCOV (SARS-CoV-2) infecting pregnant women: Lessons from SARS, MERS, and other human coronavirus infections. Viruses, 12(2), 1–16. https://doi.org/10.3390/v12020194

26.

Sinaci

Ozden Tokalioglu

Ocal

Atalay

Yilmaz

Keskin

H. L.

Erdinc

S. O.

Sahin

Moraloglu Tekin

(2020). Does having a high-risk pregnancy influence anxiety level during the COVID-19 pandemic? European Journal of Obstetrics, Gynecology, and Reproductive Biology, 255, 190–196.

27.

Society for Maternal Fetal Medicine. (2021). Provider considerations for engaging in COVID-19 vaccine counseling with pregnant and lactating patients. Retrieved December 26, 2021, from https://s3.amazonaws.com/cdn.smfm.org/media/3134/Provider_Considerations_for_Engaging_in_COVID_Vaccination_Considerations_10-1-21_%28final%29.pdf.

28.

Spielberger

C. D.

(1983). Manual for the State-Trait Anxiety Inventory (STAI). Consulting Psychologists Press.

29.

Turkey Ministry of Health. (2021). Turkish Ministry of Health Information Page. Retrieved April, 1, 2021, from https://covid19bilgi.saglik.gov.tr/tr/ (Original work published in Turkish).

30.

United Nations. (n.d.). Policy Brief : COVID-19 and the Need for Action on Mental Health Executive Summary. https://unsdg.un.org/resources/policy-brief-covid-19-and-need-action-mental-health

31.

Villar

Ariff

Gunier

R. B.

, et al. (2021). Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatrics, 175(8), 817–826. https://doi.org/10.1001/jamapediatrics.2021.1050

32.

World Health Organization. (2020a). Coronavirus Disease (COVID-19) Dashboard. Retrieved October 20, 2020, from https://covid19.who.int/?gclid=CjwKCAiAl4WABhAJEiwATUnEFwyWdLKo8qrQS6_Y4UW3lVgP2ohXQZ0PKNUT2FtleNfl5TXqiWNhCxoCsxMQAvD_BwE. Access Date: 15.01.2021.

33.

World Health Organization. (2020b). Coping with stress during the 2019-nCoV outbreak. Retrieved October 20, 2020, from https://www.who.int/docs/default-source/coronaviruse/coping-with-stress.pdf?sfvrsn=9845bc3a_2&ua=1&ua=1.

34.

Zhang

Liu

Duan

Fan

Chen

Guo

Wang

Zhang

You

Yang

Tao

. . .Huang

H. F.

(2020). Perinatal depressive and anxiety symptoms of pregnant women during the coronavirus disease 2019 outbreak in China. American Journal of Obstetrics and Gynecology, 223, 240.e1–240.e9.

35.

Xie

Wang

Zhang

Wang

(2021). Alteration in the psychologic status and family environment of pregnant women before and during the COVID-19 pandemic. International Journal of Gynecology & Obstetrics, 153, 71–75. https://doi.org/10.1002/ijgo.13575

36.

Yassa

Birol

Yirmibes

Usta

Haydar

Yassa

Sandal

Tekin

A. B.

Tug

(2020). Near-term pregnant women’s attitude toward, concern about and knowledge of the COVID-19 pandemic. The Journal of Maternal-Fetal & Neonatal Medicine, 33, 3827–3834. https://doi.org/10.1080/14767058.2020.1763947

37.

Zhong

B.-L.

Luo

H.-M.

Zhang

Q.-Q.

Liu

X.-G.

W.-T.

(2020). Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: A quick online cross-sectional survey. International Journal of Biological Sciences, 16(10), 1745–1752. https://doi.org/10.7150/ijbs.45221