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Background: Little is known about the relationship between health-related behavior and psychological status of pregnant women during the COVID-19 outbreak. We aimed to describe the health-related behavior changes and psychological status of Chinese pregnant women, and to explore the relationship between pregnant women’s characteristics, health-related behavior and different psychological status following the peak of COVID-19 outbreak.Methods: We conducted an online survey through social media (WeChat) from March 14 to April 7. A self-designed questionnaire was used to investigate Chinese pregnant women’s health-related behavior changes. Generalized Anxiety Disorder scale, Edinburgh Postnatal Depression Scale and Perceived Stress Scale were used to assess anxiety, depression and stress among pregnant women. Wilcoxon signed-rank test was used to compare health-related behavior changes before and during the COVID-19 outbreak and Spearman’s rank correlation analysis or logistic regression analysis were used to explore the relationships between variables.Results: A total of 113 pregnant women were included in this study. Most pregnant women wore masks (98.2%), changed location or tried to stay away from those who seem to have a cold or fever (99.1%) and washed hands more often than before (96.5%). Pregnant women washed hands with soap or hand sanitizer more often and went out less often than before the outbreak. There were 41.6% pregnant women who didn’t have antenatal visits or weren’t on time for antenatal visits. Majority (77.9%) pregnant women sought help when feeling panic or anxiety, whereas few turned to psychological workers. The rates of pregnant women with anxiety, depression and health risk stress were 64.6%, 58.4% and 54.9%, respectively. Analysis of relationship between variables showed that household income, gestational age, pregnancy complications, knowledge about COVID-19 and maternal and child protection, perception of the likelihood of infection, the frequency of going out, prenatal check-up behavior, help-seeking behavior were significantly associated or correlated with psychological status. Conclusions: Attention should be paid to the mental health of pregnant women with specific health-related behaviors changes. Screening for mental health problems and psychological interventions among pregnant women are needed.

Background Reducing preventable adverse maternal and offspring outcomes is a global priority. The causes of adverse maternal and fetal outcomes are complex with multidimensional influencing factors. In addition, the Covid-19 epidemic has had a significant psychological and physical impact on people. China is now stepping into the post-epidemic era. We are curious about the psychological and physical situation of maternity in China at this stage. Therefore, we plan to initiate a prospective longitudinal study to investigate the multidimensional influences and mechanisms that affect maternal and offspring health. Method We will recruit eligible pregnant women at Renmin Hospital of Hubei Province, China. The expected sample size is 1490. We will assess socio-demographics, Covid-19 related information, social capital, sleep, mental health and medical records, including clinical examination and biochemical tests. Eligible pregnant women will be enrolled in the study with less than 14 weeks of gestation. Participants will receive a total of nine follow-up visits between mid-pregnancy and one year postpartum. The offspring will be followed up at birth, 6 weeks, 3 months, 6 months and one year. In addition, a qualitative study will be conducted to understand the underlying causes that affect maternal and offspring health outcomes. Discussion This is the first longitudinal study of maternity in Wuhan, Hubei Province which integrates physical, psychological and social capital dimensions. Wuhan is the first city to be affected by Covid-19 in China. As China moves into the post-epidemic era, this study will provide us with a better understanding of the long-term impact of the epidemic on maternal and offspring health outcomes. We will implement a range of rigorous measures to enhance participants’ retention rate and ensure the quality of data. The study will provide empirical results for maternal health in the post-epidemic era.

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