Objective To assess risk factors for anxiety and depression among pregnant women during the COVID‐19 pandemic using Mind‐COVID, a prospective cross‐sectional study that compares outcomes in middle‐income economies and high‐income economies. Methods A total of 7102 pregnant women from 12 high‐income economies and nine middle‐income economies were included. The web‐based survey used two standardized instruments, General Anxiety Disorder‐7 (GAD‐7) and Patient Health Questionnaire–9 (PHQ‐9). Result Pregnant women in high‐income economies reported higher PHQ‐9 (0.18 standard deviation [SD], P < 0.001) and GAD‐7 (0.08 SD, P = 0.005) scores than those living in middle‐income economies. Multivariate regression analysis showed that increasing PHQ‐9 and GAD‐7 scales were associated with mental health problems during pregnancy and the need for psychiatric treatment before pregnancy. PHQ‐9 was associated with a feeling of burden related to restrictions in social distancing, and access to leisure activities. GAD‐7 scores were associated with a pregnancy‐related complication, fear of adverse outcomes in children related to COVID‐19, and feeling of burden related to finances. Conclusions According to this study, the imposed public health measures and hospital restrictions have left pregnant women more vulnerable during these difficult times. Adequate partner and family support during pregnancy and childbirth can be one of the most important protective factors against anxiety and depression, regardless of national economic status.

Objective To identify concerns, barriers and facilitators impacting the use of patient portals by older patients as well as desired features in future updates. Materials and Methods This is a cross-sectional study consisting of 2 focus group discussions culminating in an anonymous survey administered to women who were 65 years and older receiving urogynecologic care in Northwest Ohio. Results Of the 205 women surveyed (91% response rate), providers and healthcare systems play the primary 2 roles (73% and 69%, respectively) in facilitating patients’ use of patient portal systems and telehealth applications. Barriers to use revolved around technical difficulties (50%), privacy concerns (45%), and cost of technology (24%). The most important features desired were the ability to modify the text size within the application (47%) and an intuitive, simple interface (46%). Additional assistance for navigating technical challenges was suggested, specifically set-up of accounts (36%), saving and sharing information with caregivers (35%), and sign-in and navigation of portals (32%). Conclusion The paucity of age-aligned medical access software and products may lead to worsening of digital exclusion and disparities in healthcare. Portal application developers and healthcare systems must advance efforts that consider the needs of those who may be older when designing patient portals.

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