Document Type : Original Article

Authors

1 Department of Psychiatry, GMC, Institute of Mental Health and Neurosciences‑Kashmir, Srinagar, Jammu and Kashmir, India

2 Department of Psychiatry, Clinical Psychologist, Institute of Mental Health and Neurosciences‑Kashmir, Srinagar, Jammu and Kashmir, India

Abstract

BACKGROUND: It is evident that the novel coronavirus disease pandemic inevitably resulted in
increased stress and anxiety in the general population. Pregnancy is a challenging period, and
COVID‑19 has added risk to women pregnant during the pandemic.
AIM: The present study was aimed to assess the emotional difficulties in pregnant females who
tested positive for COVID‑19. The current study estimated the prevalence of depression, anxiety,
and stress among 63 pregnant ladies who tested positive for COVID‑19.
MATERIALS AND METHODS: The study was conducted in Child and Maternity Hospital of GMC
Anantnag, Kashmir, India, from April to December 2020. A total of 63 pregnant females who tested
positive for COVID‑19 participated in the study. The COVID‑positive pregnant ladies were interviewed
in the outpatient department of the child and maternity clinic 2 weeks after the infection. The interview
scale used was Depression, Anxiety, and Stress Scale‑21. The data were analyzed using Chi‑square
test and Fisher’s exact test.
RESULTS: We found that the mean age of participants was 33.5 ± 7.4. We found that 38.1% of the
females had positive bad obstetric history. The prevalence of depression, anxiety, and stress was
33.32%, 50.83%, and 60.3%, respectively. In correlation analysis, notably bad obstetric history and
working females were significant independent factors for higher levels of depression, anxiety, and
stress. The depression was also found more in literate females and the third trimester.
CONCLUSION: The study indicates high levels of depression, anxiety, and stress in pregnant females
who tested positive for COVID‑19. The emotional difficulties were found to be higher in educated and
working females. The bad obstetric history was found to be an independent factor for higher levels of
emotional difficulties in COVID‑positive pregnant females. This calls for extra measures to promote
the mental health and resilience of pregnant females, especially during a crisis.

Keywords

1. Sharma R, Vishwas AS, Jelly P. Impact of COVID‑ 19: Nursing
perspective and concern. Int J Community Med Public Heal
2020;7:4648‑52.
2. Ahmed MZ, Ahmed O, Zhou A, Sang H, Liu S, Ahmad A.
Epidemic of COVID‑19 in China and associated psychological
problems. Asian J Psychiatr 2020;51:102092.
3. Goel N, Workman JL, Lee TF, Innala L, Viau V. Sex differences
in the HPA axis. Compr Physiol 2014;4:1121‑55.
4. Lei L, Huang X, Zhang S, Yang J, Yang L, Xu M. Comparison
of prevalence and associated factors of anxiety and depression
among people affected by versus people unaffected by quarantine
during the COVID‑19 epidemic in Southwestern China. Medical
science monitor: international medical journal of experimental
and clinical research. 2020;26:e924609‑1.
5. Mazza C, Ricci E, Biondi S, Colasanti M, Ferracuti S, Napoli C,
Roma P. A nationwide survey of psychological distress among
Italian people during the COVID‑19 pandemic: immediate
psychological responses and associated factors. International
journal of environmental research and public health. 2020 Jan;
17 (9):3165.
6. Jelly P, Chadha L, Kaur N, Sharma S, Sharma R, Stephen S,
Rohilla J. Impact of COVID‑19 Pandemic on the Psychological
Status of Pregnant Women. Cureus. 2021 Jan; 13 (1).
7. Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the
women at risk of antenatal anxiety and depression: A systematic
review. J Affect Disord 2016;191:62‑77.
8. Chen Y, Li Z, Zhang YY, Zhao WH, Yu ZY. Maternal health care
management during the outbreak of coronavirus disease 2019.
Journal of medical virology. 2020 Jul;92(7):731-9.
9. Bayrampour H, Tomfohr L, Tough S. Trajectories of perinatal depressive and anxiety symptoms in a community cohort. J Clin
Psychiatry 2016;77:1467‑73.
10. Glover V. Maternal depression, anxiety and stress during
pregnancy and child outcome; what needs to be done. Best
practice & research Clinical obstetrics & gynaecology. 2014 Jan
1;28(1):25-35.
11. Lovibond PF, Lovibond SH. The structure of negative emotional
states: Comparison of the Depression Anxiety Stress Scales (DASS)
with the Beck Depression and Anxiety Inventories. Behaviour
research and therapy. 1995 Mar 1;33 (3):335‑43.
12. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical
characteristics and intrauterine vertical transmission potential
of COVID-19 infection in nine pregnant women: A retrospective
review of medical records. Lancet 2020; 395:809-15.
13. Agarwal N, Garg R, Singh S, Agrawal A. Coronavirus disease
2019 in pregnancy: Maternal and perinatal outcome. Journal of
Education and Health Promotion. 2021 Jan 1;10(1):194.
14. Kurian S, Ajith S, Raghavan M. Depression, anxiety and stress
among COVID positive pregnant women. Int J Reprod Contracept
Obstet Gynecol. 2021 Mar 1;10(3):1057-62.
15. Amin S, Khan AW. Life in conflict: Characteristics of Depression
in Kashmir. Int J Health Sci (Qassim) 2009;3:213‑23.
16. Shahid R, Raza MR, Umar M, Zeb S, Shehryar M, Ambreen S, et al.
Assessment of depression, anxiety and stress among COVID-19
patients by using DASS 21 Scales. J Med Case Rep Rev. 2020 Jun
27;3(06).
17. Alaya F, Worrall AP, O’toole F, Doyle J, Duffy RM, Geary MP.
Health-related quality of life and quality of care in pregnant and
postnatal women during the coronavirus disease 2019 pandemic:
A cohort study. International Journal of Gynecology & Obstetrics.
2021 Jan 1.
18. Kotabagi P, Fortune L, Essien S, Nauta M, Yoong W. Anxiety and
depression levels among pregnant women with COVID-19. Acta
obstetricia et gynecologica Scandinavica. 2020 Jul; 99 (7):953.
19. López‑Morales H, Del Valle MV, Canet‑Juric L, Andrés
ML, Galli JI, Poó F, et al. Mental health of pregnant women
during the COVID‑19 pandemic: A longitudinal study.
Psychiatry Res 2021;295:113567.
20. Kurian S, Ajith S, Raghavan M. Depression, anxiety and stress
among COVID positive pregnant women. International Journal
of Reproduction, Contraception, Obstetrics and Gynecology. 2021
Mar 1;10(3):1057-62.
21. Saccone G. Psychological impact of coronavirus disease 2019 in
pregnant women. Am J Obstet Gynecol 2020;223:293‑5.
22. Othman N. Depression, anxiety, and stress in the time of
COVID-19 pandemic in Kurdistan region, Iraq. Kurdistan J Appl
Res. 2020 May 5:37-44.
23. Engidaw NA, MekonnenAG, Amogne FK. Perceived stress and its
associated factors among pregnant women in Bale zone Hospitals,
Southeast Ethiopia: a cross‑sectional study. BMC research notes.
2019 Dec; 12 (1):1‑6.
24. Zhang Y, Ma ZF. Impact of the COVID‑19 pandemic on mental
health and quality of life among local residents in liaoning
province, China: A cross‑sectional study. Int J Environ Res Public
Health 2020;17:2381.
25. Singh KK, Kumar A, Goel A, Gulati S, Nayak BB. Prevalence of
anxiety, stress, and depression among health care and nonhealthcare professionals in India. J Edu Health Promot. 2021 Jan
1;10(1):83.
26. Leight KL, Fitelson EM, Weston CA, Wisner KL. Childbirth and
mental disorders. Int Rev Psychiatry 2010;22:453‑71.
27. Ross LE, McLean LM. Anxiety disorders during pregnancy and
the postpartum period: A systematic review. J Clin Psychiatry
2006;67:1285‑98.
28. Woods SM, Melville JL, Guo Y, Fan MY, Gavin A. Psychosocial
stress during pregnancy. AJOG. 2010 Jan 1;202(1):61-e1.
29. Schetter CD, Tanner L. Anxiety, depression and stress in
pregnancy: implications for mothers, children, research, and
practice. Current opinion in psychiatry. 2012 Mar; 25 (2):141.
30. Rehman U, Shahnawaz MG, Khan NH, Kharshiing KD,
Khursheed M, Gupta K, et al. Depression, anxiety and stress
among indians in times of COVID‑19 lockdown. Community
Ment Health J 2020;57:42‑8.