Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic

Abstract

Background: Anxiety and depression symptoms in pregnancy typically affect between 10 and 25% of pregnant individuals. Elevated symptoms of depression and anxiety are associated with increased risk of preterm birth, postpartum depression, and behavioural difficulties in children. The current COVID-19 pandemic is a unique stressor with potentially wide-ranging consequences for pregnancy and beyond.

Methods: We assessed symptoms of anxiety and depression among pregnant individuals during the current COVID-19 pandemic and determined factors that were associated with psychological distress. 1987 pregnant participants in Canada were surveyed in April 2020. The assessment included questions about COVID-19-related stress and standardized measures of depression, anxiety, pregnancy-related anxiety, and social support.

Results: We found substantially elevated anxiety and depression symptoms compared to similar pre-pandemic pregnancy cohorts, with 37% reporting clinically relevant symptoms of depression and 57% reporting clinically relevant symptoms of anxiety. Higher symptoms of depression and anxiety were associated with more concern about threats of COVID-19 to the life of the mother and baby, as well as concerns about not getting the necessary prenatal care, relationship strain, and social isolation due to the COVID-19 pandemic. Higher levels of perceived social support and support effectiveness, as well as more physical activity, were associated with lower psychological symptoms.

Conclusion: This study shows concerningly elevated symptoms of anxiety and depression among pregnant individuals during the COVID-19 pandemic, that may have long-term impacts on their children. Potential protective factors include increased social support and exercise, as these were associated with lower symptoms and thus may help mitigate long-term negative outcomes.

Keywords: Anxiety; COVID-19; Depression; Physical Activity; Pregnancy; Stress.

Fig. 1

To understand depression and anxiety symptoms in context, we compared results to published meta-analyses and normative scores on our measures of depression and anxiety. The prevalence of clinically elevated anxiety (blue) and depression (red) symptoms in the current study was substantially higher compared to meta-analyses (green boxes indicate full range of estimates) and the US population norms (green circles). References 1: (Dennis et al., 2017); 2: (Cella et al., 2019) 3: (Gavin et al., 2005) 4: (Brody et al., 2018).