Impact of health literacy on anxiety and depressive symptoms in pregnant women in Japan during the COVID-19 pandemic

Abstract

To investigate the relationships between communicative and critical health literacy (CCHL) and anxiety and depressive symptoms (ADs) in pregnant women during the coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional study was conducted and 5466 pregnant women responded in Japan in September 2020. A Kessler 6 scale (K6) score ≥ 10, an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 13, and four CCHL groups were analyzed using a logistic regression model and trend test. The proportions of pregnant women with a K6 score ≥ 10 and EPDS score ≥ 13 were 13.5 and 15.4%, respectively. In comparisons with the low CCHL group, the adjusted odds ratio (95% CI) for anxiety symptoms was 0.770 (0.604–0.982) in the high CCHL group, while those for depressive symptoms were 0.777 (0.639–0.946), 0.665 (0.537–0.824), and 0.666 (0.529–0.838) in the lower, higher, and high CCHL groups (all p < 0.05), respectively, after adjustments for potential confounding factors, such as age, weeks of gestation, complications, history, number of children, marital status, education, employment, and income. Higher CCHL was associated with significantly lower adjusted odds ratios for anxiety (p for trend = 0.019) and depressive symptoms (p for trend < 0.001). These results suggest a relationship between CCHL and ADs in pregnant women during the COVID-19 pandemic.

Relationship between health literacy and health-related quality of life in Korean adults with chronic diseases

“…Adequate health literacy is linked to lower disease activity and improved physical functioning among patients with rheumatic diseases [57]. A number of studies find that better health literacy is associated with lower risks for anxiety and depressive symptoms [52,[58][59][60]. Consistent with the findings, this current study shows that adults with adequate literacy are more likely to report no problems with anxiety/depression than those with inadequate literacy.…”

The COVID-19 pandemic affects pregnancy complications and delivery outcomes in Japan: a large-scale nationwide population-based longitudinal study

“…Howevere, even such unenforceable lockdown, maternity checks among healthy pregnant women were reduced, attended delivery by families was restricted, and return to hometowns for delivery was refrained in many facilities following government requests. In addition, not only infected pregnant women, but also close contact pregnant women were restricted antenatal checkups until the end of the home care period [21][22][23] , and higher rates of anxiety and depression among pregnant women were reported during the epidemic 24,25 .Therefore, social changes have been observed since early in the pandemic and have both directly and indirectly impacted pregnancies. Morover, there is a study reporting delayed health-seeking due to canceled or postponed maternity care appointments, and avoiding or postponing hospital care visits due to fear of infection contributed to 44.7% of pregnancies with complications 26 .…”

Impact of long COVID-19 on posttraumatic stress disorder as modified by health literacy: an observational study in Vietnam

“…Health literacy can enhance people's understanding of COVID-19 symptoms, foster adherence to measures aimed at curbing the virus's spread (including hygiene practices, physical distancing, and behavioral changes), and support the uptake of COVID-19 vaccines [ 38 , 39 ]. Moreover, numerous studies have shown that individuals with adequate health literacy are less likely to suffer from mental health issues during the COVID-19 pandemic, such as depression, anxiety, and sleep disturbances [ 40 – 42 ]. However, research on the impact of health literacy on PTSD, particularly among patients with long COVID-19, remains limited.…”