The Relationship between the Fear of Covid-19, Depression, and Spiritual Well-Being in Pregnant Women

The impact of COVID-19-related anxiety on obstetric complications and mental health in quarantined pregnant women

INTRODUCTION

The COVID-19 pandemic heightened anxiety among pregnant women, raising concerns about its impact on maternal and fetal health. Although prenatal anxiety is linked to adverse outcomes, the specific relationship between COVID-19-related fear and obstetric complications in quarantined populations remains understudied. This study investigated the association between COVID-19-related fear, obstetric complications, and mental health disorders among quarantined pregnant women in Tehran, Iran.

METHODS

This cross-sectional study (June-December 2020) 52 quarantined pregnant women were recruited via convenience sampling from a Tehran health center. Data were collected through structured telephone interviews using a validated researcher-made questionnaire. The tool assessed demographics, obstetric history, mental health symptoms (e.g., night-time anxiety, sleep disturbances), and COVID-19-related fear via a 0-10 Auditory Analog Scale (AAS). Obstetric complications (e.g., severe vaginal bleeding, chorioamnionitis) were self-reported and clinically verified. Spearman's rank correlation (non-parametric variables) and Pearson's correlation (continuous variables) were used, with significance set at p < 0.05.

RESULTS

Participants (mean age: 29.9 ± 6.47 years; gestational age: 30 ± 11.57 weeks) exhibited high COVID-19 fear (54.5% severe fear). Fear correlated significantly with obstetric complications (r = 0.22, p = 0.007), particularly delayed care-related outcomes such as severe vaginal bleeding (18.8%), chorioamnionitis (8.9%), and reluctance to seek hospitalization (12.5%). Fear also linked to mental health challenges (r = 0.23, p = 0.005), including night-time anxiety (28.9%) and sleep disturbances (32.2%). Weak correlations emerged with occupation (r = 0.23, p = 0.01) and education (r = 0.24, p = 0.02), though effect sizes were modest (R² ≈ 0.05).

CONCLUSION

COVID-19-related fear in quarantined pregnant women was associated with obstetric complications (e.g., care avoidance) and mental health disorders (e.g., sleep disturbances). Despite modest correlations, findings underscore the need for antenatal care integrating mental health screening, telehealth support, and culturally sensitive interventions to mitigate pandemic-driven risks to maternal-fetal health.

Prenatal Attachment, Personality, and Depression in High-Risk Pregnancies During Pandemic Emergencies

Background: The observational study investigates how personality factors influence depression, prenatal attachment, and fear of COVID-19 in women with high-risk pregnancies. Methods: Women experiencing a high-risk pregnancy between the 20th and 24th weeks of gestation (N = 84) were selected. The Personality Inventory (PI), Beck Depression Inventory (BDI), Prenatal Attachment Inventory (PAI), and Fear of COVID (FCV-19S) were used for data collection. Results: Agreeableness was significantly negatively correlated with fear of COVID-19 (r = -0.33, p = 0.002) and positively correlated with prenatal attachment (r = 0.28, p = 0.008). Conscientiousness was negatively correlated with prenatal attachment (r = 0.34, p = 0.001). Depression was positively correlated with fear of COVID-19 (r = 0.27, p = 0.013). Linear regressions showed that agreeableness negatively predicted fear of COVID-19 (β = -0.34, p = 0.002) and positively predicted prenatal attachment (β = 0.27, p = 0.008). Conscientiousness negatively influenced prenatal attachment (β = -0.35, p = 0.001). Conclusions: This study explores personality traits in high-risk pregnancies, a variable underexplored in this clinical population. High-risk pregnancies may lead to adverse outcomes for both mother and child.

Perinatal depression and its associated risk factors during the COVID-19 pandemic in low- and middle-income countries: a systematic review and meta-analysis

PURPOSE

Perinatal depression significantly impacts maternal and child health, with further complexities arising during the COVID-19 pandemic. This review is the first to comprehensively synthesize evidence on the prevalence of perinatal depression and its associated risk factors in Low- and Middle-Income Countries (LMICs) during the pandemic period.

METHODS

The study protocol was registered in PROSPERO (CRD42022326991). This review followed the Joanna Briggs Institute (JBI) guideline for prevalence studies. A comprehensive literature search was conducted in six databases: PubMed, Scopus, Web of Science, PsycInfo, CINAHL, and ProQuest. Pooled prevalence estimates were computed for both prenatal and postnatal depression. Identified risk factors were summarized narratively.

RESULTS

A total of 5169 studies were screened, out of which 58 were included in the narrative review and 48 [prenatal (n = 36) and postnatal (n = 17)] were included in the meta-analysis. The pooled depression prevalence for prenatal women was 23% (95% CI: 19-27%), and for the postnatal women was 23% (95% CI: 18-30%). Maternal age, education, perceived fear of COVID-19 infection, week of pregnancy, pregnancy complications, and social and family support were identified as associated risk factors for depression.

CONCLUSIONS

Our review demonstrates an increased prevalence of perinatal depression during the COVID-19 pandemic in LMICs. It sheds light on the significant burden faced by pregnant and postnatal women and emphasizes the necessity for targeted interventions during the ongoing and potential future crisis.

Investigation of the Relationship Between Spiritual Well-Being, Prenatal Stress and Attachment Level of Turkish Women Conceiving Spontaneously or with Assisted Reproductive Techniques

The aim of the study is to examine the relationship between spiritual well-being, prenatal stress and attachment level of Turkish women conceiving spontaneously or with assisted reproductive techniques (ART). The comparative descriptive study type was conducted between November 2021 and June 2022 with 202 pregnant women, including 87 women conceiving with ART and 115 women conceiving spontaneously, who applied for routine prenatal care checkup in a state hospital in the west of Turkey. Both groups have a high level of spiritual well-being. Pregnant women in the ART group experience higher prenatal distress (9.6% for spontaneous, 12.6% for ART, p = 0.487) and low level of attachment (69.72 ± 7.98 for spontaneous, 66.24 ± 8.88 for ART, p = 0.006) compared to the other group. Additionally, as insufficient partner involvement in the prenatal process increases in pregnant women in both groups, prenatal attachment decreases. It is extremely important that midwives and nurses evaluate the spiritual well-being of pregnant women and provide holistic care in line with their spiritual needs.

Predictive Power of Self-Efficacy on the Fear of Childbirth in Pregnant Women: Underlying Mechanisms of Social Support as a Mediator and the COVID-19 Fear as a Moderator

BACKGROUND

Fear of childbirth (FOC) is a common problem associated with psycho-social factors in pregnant women.

OBJECTIVES

This study aimed to determine the mediator of social support and the moderator role of fear of coronavirus disease 2019 (COVID-19) in the relationship between self-efficacy and FOC in pregnant women.

MATERIALS AND METHODS

This descriptive and cross-sectional study was conducted with 422 pregnant women registered in 18 family health centers. Data were collected with the introductory information form, the Wijma Delivery Expectancy/Experience Questionnaire-A, the Childbirth Self-Efficacy Inventory, the Multidimensional Scale of Perceived Social Support, and the Fear of COVID19 Scale. The SPSS 22 package program and Hayes's process macro 3.2 were used in the analysis of the data.

RESULTS

Findings showed that 19.9% of the pregnant women experienced severe FOC. Self-efficacy and social support negatively predicted FOC, while fear of COVID-19 predicted it positively. Perceived social support moderately mediated the relationship between FOC and self-efficacy. Fear of COVID-19 was found to be a marginally effective moderator in the relationship between self-efficacy and FOC. This indicates that as self-efficacy increases in pregnant women with low fear of COVID-19, the FOC is experienced less.

CONCLUSION

In the relationship between self-efficacy and FOC, social support is a key factor in reducing FOC. To reduce the FOC, the social support of pregnant women should be strengthened, and the fear associated with acute crisis periods such as pandemics should be reduced with some preventive measures.

Turning to religion as a mediator of the relationship between hopelessness and job satisfaction during the COVID-19 pandemic among individuals representing the uniformed services or working in professions of public trust in Poland

INTRODUCTION

During the COVID-19 pandemic individuals performing uniformed service or working in a profession of public trust were particularly exposed to chronic stress. The exposure to stress contributes to a decrease in quality of life across various domains, including professional performance. The perceived mental difficulties can lead to a feeling of hopelessness which, in turn can generate a decrease in job satisfaction. Religiosity is a factor which, in stress-inducing conditions, not only stops the spiral of perceived resource losses but also triggers gains in the resources possessed.

AIM

The aim of the study was to assess the preference for positive religious coping strategies, namely turning to religion as a mediator for the relationship between perceived hopelessness and job satisfaction in the individuals declaring religiosity during the COVID-19 pandemic. The analysis has been performed based on the Conservation of Resources theory (COR).

METHODS

The study encompassed 238 individuals representing the uniformed services or working in professions of public trust in Poland. The Inventory for Measuring Coping with Stress (MINI-COPE) and the Beck Hopelessness Scale (BHS) were used in the research.

RESULTS

The mediating role of turning to religion in relationship between perceived hopelessness and job satisfaction was confirmed only in the group of women. The relationship found in this group indicates that perceived hopelessness is alleviated by turning to religion, which simultaneously leads to an increase in job satisfaction.

CONCLUSION

The obtained results prove that counselling should be standard practice after potentially traumatic events in the workplace; moreover, emotional and/or instrumental support should be offered along with spiritual one.

Impact of the COVID-19 pandemic on depression during pregnancy: a cross-sectional study

PURPOSE

Uncertainty and restrictions on daily life have increased fear, stress, and depression during the coronavirus disease 2019 (COVID-19) pandemic. Depression is the most common mental health problem in pregnant women. The purpose of this study was to evaluate the levels of fear and stress related to COVID-19 experienced by pregnant women, as well as their levels of depression, and to examine the factors associated with depression during pregnancy.

METHODS

This was a cross-sectional, correlational study conducted among 153 pregnant women who visited a maternity hospital in Busan, South Korea. A self-reported questionnaire was used for data collection from December 18, 2021 to March 8, 2022. Data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, Pearson correlation coefficients, and multiple regression.

RESULTS

Pregnant women experienced a moderate level of fear related to COVID-19, with an average score of 21.55±4.90. The average score for depression during pregnancy was 14.86±11.10, with 50.3% of the participants experiencing depression (≥13). The factors associated with depression during pregnancy were fear of COVID-19, contact with a confirmed case of COVID-19, being in the third trimester of pregnancy, high stress levels due to difficulties experienced from social distancing measures, and unintended pregnancy. These five statistically significant factors explained 35.0% of variance in depression during pregnancy.

CONCLUSION

Considering the prevalence of depression in pregnant women during the COVID-19 pandemic, it is necessary to develop interventions to reduce anxiety by providing correct information and alleviating the stress of social distancing.

Hope Buffers the Effect of Fear of COVID-19 on Depression among College Students: Insomnia as a Mediator

BACKGROUND

In the period of the global pandemic, psychophysical problems induced by the fear of COVID-19 among college students deserve attention since the dormitory environment in college greatly increases the possibility of COVID-19 infection.

METHODS

A hypothesized mediated moderation model was to be verified using a cross-sectional study among 2453 college students. Fear of COVID-19, insomnia, hope, and depression were assessed by using the relevant scales.

RESULTS

(1) The fear of COVID-19 was positively correlated to depression (β = 0.365, t = 5.553, 95% CI = [0.236, 0.494]); (2) hope moderated the influence of the fear of COVID-19 on depression (β = -0.093, t = -4.066, 95% CI = [-0.137, -0.048]), as well as on insomnia (β = -0.095, t = -4.841, 95% CI = [-0.133, -0.056]); and (3) the mediated moderation model with hope as the moderator and insomnia as the full mediating variable between fear of COVID-19 and depression was verified (β = -0.060, 95% CI = [-0.093, -0.028]).

CONCLUSIONS

The findings suggest that hope is a vital mechanism to explain the relationship between the fear of COVID-19 and depression in early adulthood. In practical application, mental health practitioners should focus on boosting hope and alleviating insomnia when addressing COVID-19-related depression issues among college students.

A propensity score matching study: The prevalence of mental health problems among pregnant women at first antenatal care increased in Chongqing during the first wave of the COVID-19 pandemic

Background

The 2019 coronavirus disease (COVID-19) pandemic increased the risks of mental health challenges, especially anxiety and depression. However, the impact of COVID-19 on mental health during pregnancy has not been fully established. Therefore, we investigated the impact of the COVID-19 pandemic on maternal mental health.

Methods

Two cohorts of pregnant women at their first antenatal care in the First Affiliated Hospital of Chongqing Medical University were enrolled in this study. One cohort was enrolled before the COVID-19 outbreak, from 1 June to 31 December 2019 (n = 5,728, pre-COVID-19 group), while the other was enrolled during the COVID-19 pandemic, from 24 January to 23 March 2020 (n = 739, COVID-19 pandemic group). Symptoms of depression, anxiety, and somatization disorders were assessed by the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-15 (PHQ-15), with a cutoff point of 10 for moderate-to-severe depression, anxiety, and somatoform symptoms. The propensity score matching method (1:1) was used to balance differences in demographic characteristics between groups. A chi-square analysis was performed to compare differences in demographic characteristics between the groups.

Results

Prevalence of moderate-to-severe depression, anxiety, and somatoform symptoms among pregnant women at their first antenatal care visit during the COVID-19 pandemic (9.5, 2.2, and 20.8%, respectively) was significantly lower than those before the pandemic (16.3, 4.4, and 25.7%, respectively) (p < 0.05). Compared with the same period before the pandemic, during the pandemic, the number of women newly registered for antenatal care decreased by nearly 50%. There were significant differences in the distributions of demographic characteristics between the groups (p < 0.05). After matching the demographic characteristics, differences in the prevalence of maternal mental health disorders between the groups reversed dramatically. Prevalence of moderate-to-severe depression, anxiety, and somatoform symptoms during the COVID-19 pandemic in this population (2.3, 9.6, and 20.8%, respectively) was significantly higher than those before the pandemic (0.3, 3.9, and 10%, respectively) (p < 0.05).

Conclusion

The COVID-19 pandemic increased mental health risks among pregnant women. As a large proportion of pregnant women with mental health challenges delay their prenatal care or change healthcare facilities after the outbreak of public health emergencies, there is a need to establish a balanced healthcare system in medical institutions at all levels.

Health Promotion Behaviors of Pregnant Couples in the COVID-19 Pandemic: Actor-Partner Interdependence Model

Pregnancy during the pandemic may be a stressful life event. This cross-sectional study aimed to identify the actor and partner effects of the fear of COVID-19, depression, posttraumatic growth, and marital adjustment on the health promotion behaviors of pregnant couples during the COVID-19 pandemic in Korea. Data were collected from 123 pregnant couples using a structured questionnaire. The data were analyzed using the Actor-Partner Interdependence Model (APIM). The actor effects of the fear of COVID-19, depression, and posttraumatic growth on the health promotion behaviors of pregnant women and their spouses were significant. Furthermore, both actor and partner effects of husbands' marital adjustment on health promotion behaviors were significant. When carrying out nursing intervention for the health promotion of pregnant couples, programs aimed at reducing depression and improving posttraumatic growth in pregnant couples should be included. In addition, improving marital adjustment will positively affect the health promotion behaviors of pregnant couples. The findings highlight the important role of healthcare providers in assessing depressive symptoms and fear of COVID-19 in pregnant couples and providing support to promote health behaviors as part of prenatal care.

The Relationship Among Spirituality, Self-Efficacy, COVID-19 Anxiety, and Hopelessness During the COVID-19 Process in Turkey: A Path Analysis

This study explores the relationship among spirituality, self-efficacy, COVID-19 anxiety, and hopelessness. The participants are comprised of 418 individuals (282 females and 136 males) in Turkey whose ages range between 18 and 61 years old. The participants completed the following surveys: The Coronavirus Anxiety Scale, the General Self-Efficacy Scale, the Beck Hopelessness Scale, and the Spiritual Orientation Inventory. The relationships among the variables have been examined using path analysis. According to the results, spirituality, self-efficacy, and COVID-19 anxiety have direct effects on hopelessness. The analysis also shows self-efficacy to mediate the relationship between spirituality and hopelessness. The proposed model has good fit indices. The findings are discussed in the context of the literature on COVID-19, spirituality, self-efficacy, and hopelessness, with practical implications for mental health professionals being provided.