Fear, anxiety and depression among pregnant women during COVID-19 pandemic: impacts of healthy eating behaviour and health literacy

Figures & data

Figure 1. The study sample in hospitals and health centres across Vietnam.

Table 1. Participants’ characteristics, fear of COVID-19, anxiety and depression.

Variables	Total (n = 518)	FCoV-19S (n = 514)		Anxiety (n = 513)			Depression (n = 513)
		Mean ± SD	p	GAD < 8 (n = 476)	GAD ≥ 8 (n = 42)	p	PHQ < 10 (n = 473)	PHQ ≥ 10 (n = 45)	p
	n (%)			n (%)	n (%)		n (%)	n (%)
Age (mean ± SD)	28.6 ± 4.0			28.6 ± 3.9	29.3 ± 5.1	.344	28.6 ± 3.9	28.9 ± 4.6	.648
Occupation			.001			.936			.204
Employed	385 (74.3)	19.6 ± 5.2		354 (74.4)	31 (73.8)		348 (73.6)	37 (82.2)
Own business and others	133 (25.7)	21.3 ± 5.1		122 (25.6)	11 (26.2)		125 (26.4)	8 (17.8)
Ability to pay for medication			.712			.705			.648
Very or fairly difficult	281 (54.5)	20.0 ± 5.0		257 (54.1)	24 (57.1)		258 (54.7)	23 (51.1)
Very or fairly easy	235 (45.5)	20.2 ± 5.6		218 (45.9)	18 (42.9)		214 (45.3)	22 (48.9)
S-COVID-19-S			.450			.152			.640
No	412(79.5)	19.9 ± 5.4		375 (78.8)	37 (88.1)		375 (79.3)	37 (82.2)
Yes	106 (20.5)	20.4 ± 4.5		101 (21.2)	5 (11.9)		98 (20.7)	8 (17.8)
Comorbidity			.257			.410			.426
None	496 (95.8)	20.1 ± 5.3		457 (96.0)	39 (92.9)		454 (96.0)	42 (93.3)
One or more	22 (4.2)	18.8 ± 4.0		19 (4.0)	3 (7.1)		19 (4.0)	3 (6.7)
Gestational age			.151			.010			.022
1st trimester	171 (33.3)	19.5 ± 4.5		167 (35.2)	5 (12.8)		166 (35.2)	6 (14.3)
2nd trimester	136 (26.5)	19.8 ± 5.5		125 (26.3)	11 (28.2)		121 (25.6)	15 (35.7)
3rd trimester	206 (40.2)	20.6 ± 5.6		183 (38.5)	23 (59.0)		185 (39.2)	21 (50.0)
Gestational weight gain, median (IQR)	6.0 (2.0, 10.0)			6.0 (2.0, 11.0)	8.0 (5.0, 10.0)	.155	6.0 (2.0, 11.0)	9.0 (5.0, 10.0)	.155
Parity			.068			.904			.667
1	226 (43.6)	19.6 ± 5.0		208 (43.7)	18 (42.9)		205 (43.3)	21 (46.7)
≥2	292 (56.4)	20.4 ± 5.5		268 (56.3)	24 (57.1)		268 (56.7)	24 (53.3)
Number of foetuses			.100			.635			.663
1	500 (96.5)	20.1 ± 5.2		460 (96.6)	40 (95.2)		457 (96.6)	43 (95.6)
≥2	18 (3.5)	18.0 ± 5.8		16 (3.4)	2 (4.8)		16 (3.4)	2 (4.4)
Eating behaviour			.481			<.001			<.001
Unchanged or less-healthy diet	267 (51.5)	19.9 ± 4.6		232 (48.7)	35 (83.3)		230 (48.6)	37 (82.2)
Healthier diet	251 (48.5)	20.2 ± 5.9		244 (51.3)	7 (16.7)		243 (51.4)	8 (17.8)
Smoking			.587			<.001			<.001
No	483 (93.2)	20.0 ± 5.1		455 (95.6)	28 (66.7)		453 (95.8)	30 (66.7)
Yes	35 (6.8)	20.7 ± 7.7		21 (4.4)	14 (33.3)		20 (4.2)	15 (33.3)
Drinking alcohol			.942			.004			.001
No	429 (82.8)	20.1 ± 5.0		401 (84.3)	28 (66.7)		400 (84.6)	29 (64.4)
Yes	89 (17.2)	20.1 ± 6.3		75 (15.7)	14 (33.3)		73 (15.4)	16 (35.6)
Physical activity			.023			.005			.054
Never, stopped or exercise less	274 (52.9)	20.5 ± 5.0		243 (51.2)	31 (73.8)		244 (51.7)	30 (66.7)
Unchanged or exercise more	244 (47.1)	19.5 ± 5.5		233 (48.8)	11 (26.2)		229 (48.3)	15 (33.3)
HL index (mean ± SD)	33.6 ± 8.7			33.8 ± 8.5	31.4 ± 9.9	.086	33.8 ± 8.5	31.7 ± 10.2	.126
HES (mean ± SD)	14.3 ± 4.9			14.7 ± 4.6	9.2 ± 4.6	<.001	14.7 ± 4.7	10.0 ± 4.9	<.001
FCoV-19S (mean ± SD)	20.1 ± 5.3

S-COVID-19-S: suspected COVID-19 symptoms; HL index: health literacy index; HES: healthy eating score; FCoV-19S: fear of COVID-19 scale.

Table 2. Associated factors of FCoV-19S in pregnant women.

Variables	FCoV-19S
	Bivariable		Multivariable
	B (95%CI)	p	B (95%CI)	p
Age	0.01 (–0.10 to 0.12)	.854
Occupation
Own business and others	0.00		0.00
Employed	−1.72 (–2.75 to 0.68)	.001	−1.46 (–2.51 to −0.40)	.007
Ability to pay for medication
Very or fairly difficult	0.00
Very or fairly easy	0.17 (–0.74 to 1.09)	.712
S-COVID-19-S
No	0.00
Yes	0.43 (–0.69 to 1.56)	.450
Comorbidity
None	0.00
One or more	−1.31 (–3.57 to 0.95)	.257
Gestational age
1st trimester	0.00		0.00
2nd trimester	0.29 (–0.89 to 1.47)	.624	0.43 (–0.74 to 1.59)	.474
3rd trimester	1.02 (–0.04 to 2.08)	.060	0.73 (–0.32 to 1.79)	.173
Gestational weight gain	0.04 (–0.05 to 0.12)	.392
Parity
1	0.00
≥2	0.85 (–0.06 to 1.77)	.068	0.81 (–0.10 to 1.71)	.081
Eating behaviour
Unchanged or less-healthy diet	0.00
Healthier diet	0.33 (–0.58 to 1.24)	.478
Smoking
No	0.00
Yes	0.72 (–1.09 to 2.54)	.435
Drinking alcohol
No	0.00
Yes	0.052 (–1.16 to 1.26)	.933
Physical activity
Never, stopped or exercise less	0.00
Unchanged or exercise more	−1.05 (–1.96 to −0.14)	.023	−0.741(–1.66 to 0.18)	.116
HL index	−0.003 (–0.05 to o.05)	.919
HES	−0.09 (–0.18 to 0.003)	.058	−0.067 (–0.160 to 0.026)	.160

S-COVID-19-S: suspected COVID-19 symptoms; HL index: health literacy index; HES: healthy eating score; FCoV-19S: fear of COVID-19 scale.

Table 3. Associated factors of anxiety in pregnant women.

Variables	Anxiety (GAD ≥8)
	Bivariable		Multivariable
	OR (95%CI)	p	OR (95%CI)		p
Age	1.05 (0.97–1.13)	.236
Occupation
Own business and others	1.00
Employed	0.97 (0.47–1.99)	.930
Ability to pay for medication
Very or fairly difficult	1.00
Very or fairly easy	0.88 (0.47–1.67)	.705
S-COVID-19-S
No	1.00		1.00
Yes	0.50 (0.19–1.31)	.160	0.62 (0.21–1.85)		.396
Comorbidity
None	1.00
One or more	1.85 (0.53–6.54)	.337
Gestational age
1st trimester	1.00		1.00
2nd trimester	2.94 (0.99–8.67)	.051	4.59 (1.37–15.32)		.013
3rd trimester	4.19 (1.56–11.29)	.004	4.56 (1.50–13.83)		.007
Gestational weight gain	1.02 (0.97–1.09)	.404
Parity
1	1.00
≥2	1.04 (0.55–1.97)	.904
Eating behaviour
Unchanged or less-healthy diet	1.00		1.00
Healthier diet	0.19 (0.08–0.44)	<.001	0.33 (0.12–0.88)		.026
Smoking
No	1.00
Yes	10.86 (4.99–23.60)	<.001	4.29 (1.40–13.14)		.011
Drinking alcohol
No	1.00
Yes	2.68 (1.35–5.33)	.005
Physical activity
Never, stopped or exercise less	1.00		1.00
Unchanged or exercise more	0.37 (0.18–0.76)	.006	0.34 (0.13–0.89)		.029
HL index	0.97 (0.93–1.00)	.086	0.94 (0.90–0.99)		.018
HES	0.79 (0.73–0.85)	<.001	0.79 (0.73–0.87)		<.001

S-COVID-19-S: suspected COVID-19 symptoms; HL index: health literacy index; HES: healthy eating score.

Table 4. Associated factors of depression in pregnant women.

Variables	Depression (PHQ ≥10)
	Bivariable		Multivariable
	OR (95%CI)	p	OR (95%CI)	p
Age	1.02 (0.94–1.09)	.648
Occupation
Own business and others	1.00
Employed	1.66 (0.75–3.65)	.211
Ability to pay for medication
Very or fairly difficult	1.00
Very or fairly easy	1.15 (0.63–2.13)	.648
S-COVID-19-S
No	1.00
Yes	0.83 (0.37–1.84)	.645
Comorbidity
None	1.00
One or more	1.71 (0.49–6.02)	.403
Gestational age
1st trimester	1.00		1.00
2nd trimester	3.43 (1.29–9.09)	.013	5.45 (1.88–15.76)	.002
3rd trimester	3.14 (1.24–7.96)	.016	3.14 (1.13–8.70)	.028
Gestational weight gain, median	1.03 (0.98–1.09)	.246
Parity
1	1.00
≥2	0.88 (0.48–1.62)	.679
Eating behaviour
Unchanged or less-healthy diet	1.00		1.00
Healthier diet	0.21 (0.09–0.45)	<.001	0.33 (0.13–0.82)	.017
Smoking
No	1.00
Yes	11.35 (5.28–24.38)	<.001	4.99 (1.85–13.46)	.002
Drinking alcohol
No	1.00
Yes	3.53 (1.57–5.86)	.001
Physical activity
Never, stopped or exercise less	1.00		1.00
Unchanged or exercise more	0.53 (0.28–1.02)	.057	0.54 (0.24–1.24)	.149
HL index	0.97 (0.94–1.00)	.126	0.96 (0.91–0.99)	.044
HES	0.82 (0.77–0.88)	<.001	0.84 (0.78–0.91)	<.001

S-COVID-19-S: suspected COVID-19 symptoms; HL index: health literacy index; HES: healthy eating score.

Data availability statement

The raw data supporting the conclusions of this article will be made available on reasonable request to the corresponding author.