When pregnancy and pandemic coincide: changes in stress and anxiety over the course of pregnancy

ABSTRACT

Background

Pregnant women experienced high levels of perceived stress and anxiety at the onset of the COVID-19 pandemic. However, the course of stress and anxiety in individual pregnant women during the pandemic is unknown.

Methods

Participants were 1,087 women ≤20 weeks pregnant in April–May 2020 (T1) at recruitment into the Stony Brook COVID-19 Pregnancy Experiences (SB-COPE) Study, with additional assessments in July–August 2020 (T2) and October 2020 (T3). Growth mixture models conditioned on covariates were used to identify patterns of change over time in pandemic-related stress (originating from feeling unprepared for birth and fearing perinatal infection), pregnancy-specific stress, and anxiety symptoms.

Results

A uniform pattern of change (i.e. one-class solution) in stress perceptions was observed over time. Participants showed the same functional form of decreases in all three types of stress perceptions over the course of their pregnancy and as the pandemic persisted. Initial level of stress did not predict change over time. Anxiety symptoms had a two-class solution in which 25% of participants had high and convex patterns of anxiety, and 75% had low levels with concave patterns.

Discussion

Stress perceptions and anxiety patterns of change over the course of pregnancy during the COVID-19 pandemic were different. Therefore, to evaluate the well-being of pregnant women during a global health crisis, it is important to assess both stress perceptions and emotional stress responses (i.e. anxiety). Screening for anxiety symptoms in early pregnancy would be valuable as symptoms may not spontaneously decrease even when stressful conditions improve.

KEYWORDS:

• Antenatal stress
• anxiety
• pregnancy
• COVID-19 pandemic
• growth mixture modelling

Acknowledgments

We would like to thank Lucero Molina who assisted in preparation of this article.

Disclosure statement

The authors report no conflict of interest.

Supplementary Material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02646838.2022.2117289

Additional information

Funding

Brittain Mahaffey received support from National Institute of Child Health and Human Development of the National Institutes of Health, Grant K23HD092888 during preparation of this article. Jennifer Somers received support from the National Institute of Mental Health of the National Institutes of Health Grant T32MH015750, postdoctoral fellowship on Biobehavioral Issues in Mental and Physical Health During preparation of this article. Heidi Preis and Marci Lobel received support from National Institute on Drug Abuse of the National Institutes of Health, Grant R21DA049827 during preparation of this article. Research reported in this manuscript was supported by the National Institute on Drug Abuse and the IMPROVE Initiative, Office of the Director, under award number R21DA049827. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.