Prevalence of and relevant factors for depression and anxiety symptoms among pregnant women on the eastern seaboard of China in the post-COVID-19 era: a cross-sectional study

Abstract

Background Antenatal depression and anxiety symptoms may have negative consequences for both mothers and offspring, and upward trends in the prevalence of these symptoms were especially apparent during the COVID-19 epidemic. The purpose of this study was to evaluate the prevalence of and relevant factors influencing depressive and anxiety symptoms in Chinese pregnant women in the post-COVID-19 era. Methods We conducted an online survey of 1,963 pregnant women in Jiangsu Province, using a cross-sectional design, and collected their general demographic data. The nine-item Patient Health Questionnaire 9 (PHQ-9) was used to evaluate depression symptoms, and the seven-item Generalized Anxiety Disorder 7 (GAD-7) was used to measure anxiety symptoms. Results The prevalence of reported antenatal depressive symptoms, anxiety symptoms, and depression combined with anxiety symptoms was 25.2%, 27.9%, and 18.6%, respectively. Of the respondents, the prevalence of moderate to severe depression, and anxiety was 7.9% and 7.7%, respectively. Binary logistic regression analysis demonstrated that age, low level of education, rural area, unemployment, pregnancy complications, poor marital relationship, and fair household income were positively association with both depressive and anxiety symptoms (all P < 0.05). The proportion of women reporting anxiety symptoms in the third trimester was 1.91-fold higher than in first trimester. Parity was a relevant factor for depression and anxiety symptoms (all P < 0.05). Conclusions In the post-COVID-19 era, the prevalence of depression and anxiety symptoms in pregnant women was higher than expected, and it is vital to establish hospital, community, and family psychological health screening systems based on relevant factors and enhance early preventive measures.

Prevalence of Perinatal Anxiety and Related Disorders in Low- and Middle-Income Countries

“…This subgroup included only 9 studies, all of which were performed in Turkey. The lowest prevalence was found in East Asia and the Pacific (12.7%; 95% CI, 10.5%-15.1%; 61 studies; n = 103 180). Of the studies conducted in East Asia and the Pacific, 53 (86.9%) were conducted in China (eFigure 7 in Supplement 1).…”

“…While investigating generalized anxiety by country income status, we found a higher prevalence among studies performed in lower-middle–income countries (27.6%; 95% CI, 21.6%-33.9%; 59 studies; n = 25 109) compared with low-income countries (24.0%; 95% CI, 15.3%-33.8%; 11 studies; n = 4961). Upper-middle–income countries had the lowest prevalence (19.1%; 95% CI, 16.0%-22.4%; 110 studies; n = 138 496).…”

“…Generalized anxiety disorder (including anxiety not specified) was the most commonly reported anxiety disorder, examined by 184 of 203 studies (90.6%) . The pooled point prevalence for generalized anxiety disorder was 22.2% (95% CI, 19.4%-25.0%; n = 173 553).…”

“…Our search identified 10 617 studies; 1231 full texts were reviewed, and of these, 203 studies were included (Figure 1; eTable 2 in Supplement 1). Cumulatively, outcomes were reported for 212 318 perinatal women (from conception to 12 months post birth) from 33 LMICs. The prevalence estimates of 6 anxiety and related disorders were reported: generalized anxiety disorder, social anxiety disorder, posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, and adjustment disorder.…”

“…The majority of studies reported the prevalence of generalized anxiety antenatally (150 [81.5%]). Among these, the pooled point prevalence was 23.9% (95% CI, 20.5%-27.4%; n = 149 485).…”