Pregnancies with cardiovascular (CV) complications are more likely to involve additional complications, poorer short and long-term health, and worse fetal outcomes. Additionally, CV complications are associated with poorer mental health, lower socioeconomic status, and non-White race/ethnicity. The COVID-19 pandemic has had negative effects on mental well-being and disproportionately affects people of lower socioeconomic status and non-White race/ethnicity. Thus, we hypothesized that the pandemic would differentially affect pregnant people with and without CV complications. We performed a cross-sectional survey of 465 pregnant people in California from June 6 through July 29, 2020. Twenty-three participants reported CV complications (e.g., hypertensive disorders, gestational diabetes) and 29 participants reported non-CV complications. The CV group was 56.5% (13 of 23) Latinx and 43.5% (10 of 23) White versus the uncomplicated pregnancy group, which was 33.7% (137 of 407) Latinx and 66.3% (270 of 407) White (chi-square, p=0.03; 6 respondents did not answer). The CV complications group was 9.5% (2 of 21) African American and the uncomplicated pregnancy group was 4.9% (19 of 392) African American (Fisher’s Exact, p=0.053; 23 respondents did not answer). We assessed 64 health behaviors reported on a Likert scale with the Wilcoxon 2-Sample Test and found the CV group reported more health-promoting behaviors, including: less likely to eat sweets (p=0.004), more likely to sanitize frequently used areas in their homes and their groceries (p=0.049 and 0.069, respectively). However, they were also more likely to smoke cigarettes (p=0.02). While the two groups did not differ significantly on stress, depression, or anxiety, the CV group was more likely to worry that their babies may be hospitalized after birth (p=0.01) and their provider may be unavailable during delivery (p=0.047). Concerns for self and baby trended towards significance for the CV group, which reported being more likely to worry about getting sick (p=0.077) and their babies being born early (p=0.079) or getting sick (p=0.098). While preliminary, these data suggest that COVID-19 disproportionately affects pregnant people with prenatal CV complications. Given limited research on pregnancy during COVID-19 and the primary focus on biological outcomes, these findings indicate a clear need to address the pandemic’s influence on behavioral and emotional health during pregnancy - especially for those with CV complications who are at higher risk of poor maternal and fetal outcomes.
The Mental Health and Grade Point Average among College Students from Lower Socioeconomic Status Based on Healthcare Data Analysis
