Alone and Expecting: The Role of Social Support and Isolation in Pandemic-related Pregnancy Stress in a Canadian Cohort

BACKGROUND AND AIMS: Although associations between social support, isolation, and perinatal mental health are well established, the impact of prolonged COVID-19 public health restrictions on pregnant individuals' experiences of support and specific dimensions of pandemic-related stress remains poorly understood. This study aimed to identify key social determinants influencing social support and isolation and to examine their associations with pandemic-related pregnancy stress. METHODS: A cross-sectional study with retrospective recall was conducted among 273 Canadian individuals who gave birth between March 2020 and March 2023 using the ORIGIN survey. Online questionnaires collected sociodemographic information and measures of social support, isolation, and pregnancy-related stress. A composite Social Support Score was derived from four constructs: social life, community belonging, companionship, and isolation. RESULTS: Participants who were not in a relationship, belonged to the lowest or higher-middle income brackets, expressed concerns about job stability, or identified as LGBTQ+ reported significantly lower social support than their counterparts (all p ≤0.02). Lower social support and greater isolation were significantly associated with higher levels of infection- and preparedness-related stress (all p ≤0.01). The overall Social Support Score was inversely correlated with both stress domains (infection: r = -0.35, p <0.0001; preparedness: r = -0.49, p <0.0001). CONCLUSION: Findings underscore the importance of targeted interventions to reduce stress among socially isolated pregnant individuals, particularly during public health crises requiring social distancing. Strengthening social support networks may buffer pregnancy-related stress and enhance maternal well-being during periods of societal disruption.