Pregnant Women’s Health-related Behavior Changes and Psychological Status After the Peak of COVID-19 Outbreak in China: A Cross-sectional Study

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.