Stress from the threat of COVID-19 led to increased levels of anxiety and depressive symptoms in pregnant women, according to findings from the International COVID-19 Pregnancy Experiences (I-COPE) Study.
The study assessed anxiety, stress and depressive symptoms in pregnant women during the first major wave of the pandemic from April 17 to May 31, 2020.
Nearly 8,150 women, who were an average 27 weeks pregnant, were involved from seven Western countries: the United States, Germany, Switzerland, Spain, Poland, Italy and Israel. Due to pandemic restrictions, women were recruited online through social media, like Facebook, Instagram and Reddit, to fill out questionnaires about their experiences during their pregnancy.
The study was led by Marci Lobel, the director of I-COPE and a professor in the Department of Psychology and the Department of Obstetrics, Gynecology and Reproductive Medicine at the Renaissance School of Medicine at Stony Brook University. She has been studying the impacts of stress on pregnancy and reproductive health for over 30 years.
“Our findings show that the stress experienced by pregnant women predicted more frequent anxiety and depressive symptoms, including symptom levels above clinically defined thresholds for poor mental health,” Lobel said.
Stress during pregnancy can cause health issues, such as low birth weight or premature birth, as well as long-term health and developmental problems. It can physically and mentally affect the mother, as well.
“We know that women who have high stress during pregnancy are more likely to have mood disorders after the birth of the child. We know that even their physical health can be affected. And part of that is because they may have a vulnerable child that they’ve just given birth to,” Lobel said.
While the countries varied in magnitude of pandemic-related pregnancy stress — likely because of cultural differences and the specific impacts of the pandemic in each country — anxiety and depressive symptoms were strongly predicted by pandemic-related and pregnancy-specific stress.
Lobel said she found that pregnant American women were more likely stressed in particular, due to limited access to healthcare, paid maternity leave and child care.
“Being pregnant in the U.S. is always stressful. But being pregnant in the U.S. at the time of a major global health crisis is especially stressful, and therefore to some extent, it’s not surprising to see that it affects women’s mental health,” she said.
Several pre-pandemic studies also found evidence that pregnancy stress is a risk factor for adverse maternal, fetal, infant, and child outcomes. But comparisons of these effects across multiple countries are rare. Lobel said the I-COPE study is the first major research project to compare stress and mental health in pregnant women across those seven Western countries.
She said she hopes the results can be used to inform research and clinical interventions to protect against the consequences of prenatal stress, anxiety, and depression, as these mental health impacts pose longer-term threats to the health and well-being of the parent and their children.