Stress, Anxiety and Depression among Pregnant Women during the first wave of the COVID-19 Pandemic in Israel

Background: The new COVID-19 pandemic resulted in tremendous challenges to mankind in health, emotions and economy. A specifically vulnerable group are pregnant and postpartum women. We conducted a study that aimed to shed light on the effects of this pandemic on emotional state of pregnant and postpartum women.

Objective and Study Design: A cross-sectional study in northern Israel based on web questionnaire for the assessment of general stress, anxiety and depression during the quarantine period of COVID-19 pandemics from April 20 until May 7, 2020. Participants were pregnant women and women up to a year after childbirth. Overall, 356 women of whom 251 pregnant and 101 post-partum filled the questionnaire.

Results: Among 251 pregnant women, 199 (79.3 %) reported moderate-high stress, 145 (57.8 %) high anxiety. A hundred and three (41.0%) reported high level of depression (PH2>3). Among pregnant women, the following were the most prevalent stressors: fear that someone in their family will acquire the virus (80.1%), concern for the health of the baby (77.7%), fear that someone close will die from COVID-19 (72.9%) and worry of being infected within the hospital (71.7%). A univariate analysis of stress revealed that age (χ2=10.93, p<0.004) and income level (χ2=13.35, p<0.001) were associated with the level of stress. Stepwise logistic regression revealed that both age and income level below the mean were predictors of stress. Among the 165 multiparous pregnant women, age (25-34 vs. 35-44) was a predictor of stress (p<0.04).

Conclusion: Our study clearly showed an enormous negative effect of the COVID-19 pandemic on emotional condition including stress, anxiety and depression on both pregnant and postpartum women. This provides an insight on the relation between economy and emotional state during uncertainty period. This effect adds a huge challenge to healthcare system and social support providers as well as the governments in providing means and solutions during pandemics and worldwide disaster.

Keywords: COVID-19, Pregnant, Postpartum, Depression, Anxiety, Stress