Lack of COVID-19 info ups depression, anxiety, stress levels in pregnant women

Levels of depression, anxiety, and stress among antenatal women increase due to a lack of timely and reliable information on the impact of the novel coronavirus disease (COVID-19) on pregnancy and its outcomes, according to a Singapore study.

“In a global health crisis, healthcare professionals need to address these issues urgently by giving evidence-based information promptly, using resources tailored to the needs of antenatal women,” the researchers said. “Assessment of mental health being should occur concurrently and early intervention in the form of psychological support should be provided to those who need it to limit any long-term impact on mental well-being.”

This cross-sectional survey was conducted from 31 March to 25 April 2020 in the antenatal clinics of KK Women’s and Children’s Hospital to evaluate pregnant women’s knowledge of COVID-19, their perceptions of its impact upon pregnancy, and psychological impact using the validated Depression, Anxiety, and Stress Scales (DASS-21).

A total of 324 women (mean age, 31.8 years; range, 20–45) participated in this study, of whom 53.7 percent were multiparous with mean gestational age of 23.4 weeks. Their most common source of information was internet-based social media platforms. [Ann Acad Med Singapore 2020;50:543-552]

A significant proportion of these women were either unaware of risk of acquiring COVID-19 during pregnancy or believed that the disease would cause foetal distress (82.1 percent), intrauterine death (71.3 percent), foetal anomalies (69.8 percent), miscarriages (64.8 percent), preterm labour (67.9 percent), and rupture of membranes (61.4 percent).

In addition, 216 women (66.7 percent) were either unsure of their options regarding the mode of delivery or would request for a caesarean section if infected with COVID-19. Meanwhile, 242 women (74.7 percent) thought that breastfeeding was associated with an increased risk of transmission of infection to their newborns.

Of the participants, 116 (35.8 percent) screened positive for anxiety, 59 (18.2 percent) for depression, and 36 (11.1 percent) for stress. A significant association was found between household size and stress scores (B, 0.0454, 95 percent confidence interval [CI], 0.0035–0.873). Anxiety scores were also higher among women who associated COVID-19 infection with foetal anomalies (B, –0.395, 95 percent CI, –0.660 to –0.130) and intrauterine foetal death (B, –0.291, 95 percent CI, –0.562 to –0.021).

“In light of these findings and with the widespread usage of mobile phones and internet-based platforms, we recommend utilization of hospital-based social media resources, such as hospital Facebook page and website, and app-based resources for providing timely evidence-based information to alleviate stress and anxiety amongst antenatal women, and as a more efficient means of communication,” the researchers said.

“Healthcare providers should also consider providing links to this information by text messages for ease of use and accessibility. This strategy would help tailor information to be better suited to the needs of the stakeholders,” they added.