Depression and anxiety in Chinese pregnant women in the mid-phase of the COVID-19 pandemic: a cross-sectional study

Background This study aimed to evaluate the prevalence and associated factors of depressive and anxiety symptoms among Chinese pregnant women during the middle period of COVID-19. Methods From May to August 2021, a cross-sectional online survey was conducted among pregnant women in Shijiazhuang, Hebei Province. The data collected included demographic characteristics (age, occupation, region, parity, number of fetuses, pregnancy-related disorders, education level, awareness of common symptoms, attention to the epidemic, and frequency of temperature measurement). We recruited participants using a convenience sampling approach. Depression and anxiety were assessed using self-depression rating scale (SDS) and a self-rating anxiety scale (SAS). A univariate and multivariable binomial logistic regression model was applied to identify risk factors for depression and anxiety. Results Cronbach's α coefficients for SDS and SAS were 0.837 and 0.826, respectively. Among 1,036 participants, the prevalence of depressive and anxiety symptoms was 59.8% (620 cases) and 6.7% (69 cases), respectively. Factors associated with depression included the number of fetuses (OR = 2.98, 95% CI 1.22–7.31), education level (OR = 0.58, 95% CI 0.45–0.75), attention to the epidemic (OR = 0.65, 95% CI 0.42–0.91), and frequency of temperature measurement (OR = 0.62, 95% CI 0.41–0.93). Factors associated with anxiety included parity (OR = 0.51, 95% CI 0.31–0.83), attention to the epidemic (OR = 2.14, 95% CI 1.18–3.89), and frequency of temperature measurement (OR = 2.86, 95% CI 1.08–7.52). Multivariate binomial logistic regression analysis indicated that a higher education level was an associated factor for depression (adjusted OR = 0.52, 95% CI 0.38–0.70). However, the parity (adjusted OR = 0.46, 95% CI 0.26–0.82) and pregnancy-related disorders (adjusted OR = 2.55, 95% CI 1.46–4.45) were independent associated factors for anxiety. Conclusion Pregnant women with lower education levels, primipara status, and pregnancy-related disorders were association with higher levels of depression and anxiety during the middle period of COVID-19. These findings suggest the need for targeted interventions to support the mental health of pregnant women during pandemics.