An exploration of the relationship between pandemic-related stress and dietary behaviours during pregnancy

Pregnancy during the early phases of the COVID-19 pandemic was characterized by an increased prevalence of stress, with many pregnant individuals fearing the social and health impacts of an infection by the virus. Stress has been demonstrated to negatively impact dietary quality in those who are pregnant. Given the importance of adequate nutrition during pregnancy, this analysis aimed to explore the relationship between pandemic-related pregnancy stress and eating behaviours among Canadians. Data were collected retrospectively via an online survey. Eligibility criteria included living in Canada, giving birth during the pandemic (March 2020-2023), and being at least 18 years of age. Stress was measured using the perinatal infection subscale of the Pandemic Related Pregnancy Stress Scale (PREPS) questionnaire (items measured on a 5-point Likert scale, with higher scores indicating higher levels of stress). Participants also rated the quality of their diet (excellent/good, average, or poor/very poor), indicated whether it was rather difficult or easy to adopt a healthy diet during pregnancy, and reported factors that supported or hindered healthy eating. Data were analyzed using Welch’s ANOVA, independent t-test, and descriptive statistics. Participants (n=264) were primarily White (81%), Canadian-born (89%), living with a spouse or common-law partner (87%), and nearly half (46%) were primiparous. The mean ± SD perinatal infection stress score was 3.37±1.0. Stress scores differed significantly by diet quality (p<0.001): individuals with poor/very poor diet quality had higher mean stress scores (3.86±0.84) than those with good/excellent diet quality (3.11±1.04). Additionally, higher stress scores were obtained for individuals who reported that healthy eating during pregnancy was rather difficult, as compared to rather easy (3.66±0.88 vs 3.03±1.00, p<0.001). Commonly cited factors impeding healthy eating were having limited access to healthy foods (24%) and lacking knowledge about nutritious foods (17%), while factors supporting healthy eating included having help from a partner or family member (43%) and having sufficient time to eat healthy (12%). Our findings suggest a link between pandemic-related stress and dietary behaviours during pregnancy. Targeted interventions may be needed for individuals who have experienced stressful events during pregnancy to promote adequate nutrition. (Funding: Faculty of Health Sciences, University of Ottawa).