Pregnant in a Pandemic: Mental Wellbeing and Associated Healthy Behaviors Among Pregnant People in California During COVID-19.

WELL-being; CROSS-sectional method; MULTIVARIATE analysis; NUTRITION; PREGNANT women; SURVEYS; SLEEP; PHYSICAL activity; HEALTH behavior; DESCRIPTIVE statistics; MENTAL depression; RESEARCH funding; PRENATAL care; DATA analysis software; ANXIETY; COVID-19 pandemic; HEALTH promotion

Introduction: Pregnancy is a time of increased vulnerability to mental health disorders. Additionally, the COVID-19 pandemic has increased the incidence of depression and anxiety. Thus, we aimed to assess mental health and associated healthy behaviors of pregnant people in California during the pandemic in order to contextualize prenatal well-being during the first pandemic of the twenty-first century. Methods: We conducted an online cross-sectional study of 433 pregnant people from June 6 through July 29, 2020. We explored 3 hypotheses: (1) mental health would be worse during the pandemic than in general pregnant samples to date; (2) first-time pregnant people would have worse mental health; and (3) healthy behaviors would be positively related to mental health. Results: Many of our participants (22%) reported clinically significant depressive symptoms and 31% reported clinically significant anxiety symptoms. Multiparous pregnant people were more likely to express worries about their own health and wellbeing and the process of childbirth than were primiparous pregnant people. Additionally, as pregnancy advanced, sleep and nutrition worsened, while physical activity increased. Lastly, anxious-depressive symptomology was significantly predictive of participant sleep behaviors, nutrition, and physical activity during the past week. Discussion: Pregnant people had worse mental health during the pandemic, and this was associated with worse health-promoting behaviors. Given that the COVID-19 pandemic and associated risks are likely to persist due to low vaccination rates and the emergence of variants with high infection rates, care that promotes mental and physical well-being for the pregnant population should be a public health priority. Significance: Consistent with other studies, we found that anxiety, depression, and stress levels in our pregnant cohort were higher than reported pre-pandemic and that anxious-depressive symptomology predicted worse sleep, poorer nutrition, and less physical activity. New in this study was that these relationships were the same for primiparous and multiparous pregnant people, did not change with gestational age, and that while sleep and nutrition worsened throughout pregnancy, physical activity actually increased, regardless of anxious-depressive symptomology. Also new to this study was that multiparous pregnant people had more worries about their and their baby's wellbeing than first time mothers. [ABSTRACT FROM AUTHOR]

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