{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T08:03:04Z","timestamp":1773475384897,"version":"3.50.1"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T00:00:00Z","timestamp":1681430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The 2019 coronavirus disease (COVID-19) pandemic increased the risks of mental health challenges, especially anxiety and depression. However, the impact of COVID-19 on mental health during pregnancy has not been fully established. Therefore, we investigated the impact of the COVID-19 pandemic on maternal mental health.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two cohorts of pregnant women at their first antenatal care in the First Affiliated Hospital of Chongqing Medical University were enrolled in this study. One cohort was enrolled before the COVID-19 outbreak, from 1 June to 31 December 2019 (<jats:italic>n<\/jats:italic>\u2009=\u20095,728, pre-COVID-19 group), while the other was enrolled during the COVID-19 pandemic, from 24 January to 23 March 2020 (<jats:italic>n<\/jats:italic>\u2009=\u2009739, COVID-19 pandemic group). Symptoms of depression, anxiety, and somatization disorders were assessed by the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-15 (PHQ-15), with a cutoff point of 10 for moderate-to-severe depression, anxiety, and somatoform symptoms. The propensity score matching method (1:1) was used to balance differences in demographic characteristics between groups. A chi-square analysis was performed to compare differences in demographic characteristics between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prevalence of moderate-to-severe depression, anxiety, and somatoform symptoms among pregnant women at their first antenatal care visit during the COVID-19 pandemic (9.5, 2.2, and 20.8%, respectively) was significantly lower than those before the pandemic (16.3, 4.4, and 25.7%, respectively) (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05). Compared with the same period before the pandemic, during the pandemic, the number of women newly registered for antenatal care decreased by nearly 50%. There were significant differences in the distributions of demographic characteristics between the groups (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05). After matching the demographic characteristics, differences in the prevalence of maternal mental health disorders between the groups reversed dramatically. Prevalence of moderate-to-severe depression, anxiety, and somatoform symptoms during the COVID-19 pandemic in this population (2.3, 9.6, and 20.8%, respectively) was significantly higher than those before the pandemic (0.3, 3.9, and 10%, respectively) (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The COVID-19 pandemic increased mental health risks among pregnant women. As a large proportion of pregnant women with mental health challenges delay their prenatal care or change healthcare facilities after the outbreak of public health emergencies, there is a need to establish a balanced healthcare system in medical institutions at all levels.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1142461","type":"journal-article","created":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T05:24:55Z","timestamp":1681449895000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["A propensity score matching study: The prevalence of mental health problems among pregnant women at first antenatal care increased in Chongqing during the first wave of the COVID-19 pandemic"],"prefix":"10.3389","volume":"11","author":[{"given":"Jiamei","family":"Guo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinglan","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Ai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Gan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anhai","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wanjun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lulu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sisi","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyu","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Kuang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.1016\/s0140-6736(21)02143-7","article-title":"Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 Due to the COVID-19 pandemic","volume":"398","year":"","journal-title":"Lancet (London, England)"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"27277","DOI":"10.1073\/pnas.2009609117","article-title":"Economic hardship and mental health complaints during COVID-19","volume":"117","author":"Witteveen","year":"2020","journal-title":"Proc Natl Acad Sci U S A"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/j.jad.2020.07.092","article-title":"The psychological status of 8817 hospital workers during COVID-19 epidemic: a cross-sectional study in Chongqing","volume":"276","author":"Xiaoming","year":"2020","journal-title":"J Affect Disord"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e0250770","DOI":"10.1371\/journal.pone.0250770","article-title":"Disrupted rhythms of life, work and entertainment and their associations with psychological impacts under the stress of the COVID-19 pandemic: a survey in 5854 Chinese people with different sociodemographic backgrounds","volume":"16","author":"Yang","year":"2021","journal-title":"PLoS One"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/j.sleep.2021.05.028","article-title":"Circadian rhythm abnormalities during the COVID-19 outbreak related to mental health in China: a nationwide university-based survey","volume":"84","author":"Tao","year":"2021","journal-title":"Sleep Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1177\/1059840520988548","article-title":"Predictors of depression and anxiety among senior high school students during COVID-19 pandemic: the context of home quarantine and online education","volume":"37","author":"AlAzzam","year":"2021","journal-title":"J Sch Nurs"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1016\/j.jad.2020.10.016","article-title":"Mental health and its correlates among children and adolescents during COVID-19 school closure: the importance of parent-child discussion","volume":"279","author":"Tang","year":"2021","journal-title":"J Affect Disord"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3390\/ijerph17051729","article-title":"Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China","volume":"17","author":"Wang","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1002\/jnr.23859","article-title":"Sex differences in depression during pregnancy and the postpartum period","volume":"95","author":"Sundstr\u00f6m Poromaa","year":"2017","journal-title":"J Neurosci Res"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.3889\/oamjms.2019.270","article-title":"Systematic review of prevalence of antepartum depression during the trimesters of pregnancy","volume":"7","author":"Okagbue","year":"2019","journal-title":"Open Access Maced J Med Sci"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1186\/s12884-020-02929-5","article-title":"Epidemiology of antenatal depression in Africa: a systematic review and meta-analysis","volume":"20","author":"Dadi","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"3862","DOI":"10.1080\/14767058.2019.1701647","article-title":"Increased rates of adverse perinatal outcomes in women with gestational diabetes and depression","volume":"34","author":"Packer","year":"2021","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e0227323","DOI":"10.1371\/journal.pone.0227323","article-title":"Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: a systematic review and meta-analysis","volume":"15","author":"Fekadu Dadi","year":"2020","journal-title":"PLoS One"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1016\/s2215-0366(20)30132-2","article-title":"Maternal perinatal depressive symptoms and offspring psychotic experiences at 18 years of age: a longitudinal study","volume":"7","author":"Srinivasan","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1016\/j.ajog.2020.03.021","article-title":"Coronavirus disease 2019 (COVID-19) pandemic and pregnancy","volume":"222","author":"Dashraath","year":"2020","journal-title":"Am J Obstet Gynecol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"101919","DOI":"10.1016\/j.tmaid.2020.101919","article-title":"Maternal clinical characteristics and perinatal outcomes among pregnant women with coronavirus disease 2019. A systematic review","volume":"39","author":"Novoa","year":"2021","journal-title":"Travel Med Infect Dis"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1038\/s41467-021-27745-z","article-title":"Maternal-fetal immune responses in pregnant women infected with SARS-CoV-2","volume":"13","author":"Garcia-Flores","year":"2022","journal-title":"Nat Commun"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12978-021-01070-6","article-title":"The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review","volume":"18","author":"Kotlar","year":"2021","journal-title":"Reprod Health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e24053","DOI":"10.2196\/24053","article-title":"Association of Perceived Threat, negative emotions, and self-efficacy with mental health and personal protective behavior among Chinese pregnant women during the COVID-19 pandemic: cross-sectional survey study","volume":"23","author":"Mo","year":"2021","journal-title":"J Med Internet Res"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"240.e1","DOI":"10.1016\/j.ajog.2020.05.009","article-title":"Perinatal depressive and anxiety symptoms of pregnant women during the coronavirus disease 2019 outbreak in China","volume":"223","author":"Wu","year":"2020","journal-title":"Am J Obstet Gynecol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1038\/s41398-020-01006-x","article-title":"The prevalence of psychiatric symptoms of pregnant and non-pregnant women during the COVID-19 epidemic","volume":"10","author":"Zhou","year":"2020","journal-title":"Transl Psychiatry"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"18","DOI":"10.3390\/ijerph18084298","article-title":"Women\u2019s depressive symptoms during the COVID-19 pandemic: the role of pregnancy","volume":"18","author":"Yirmiya","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"8445","DOI":"10.1038\/s41598-022-12275-5","article-title":"Anxiety among pregnant women during the first wave of the COVID-19 pandemic in Poland","volume":"12","author":"Ilska","year":"2022","journal-title":"Sci Rep"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"949239","DOI":"10.3389\/fpsyt.2022.949239","article-title":"The COVID-19 pandemic and mental health in pregnant women: a review article","volume":"13","author":"Arzamani","year":"2022","journal-title":"Front Psych"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s12884-022-04387-7","article-title":"The mental health crisis of expectant women in the UK: effects of the COVID-19 pandemic on prenatal mental health, antenatal attachment and social support","volume":"22","author":"Filippetti","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1111\/aogs.14092","article-title":"Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic-a multinational cross-sectional study","volume":"100","author":"Ceulemans","year":"2021","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/s00127-021-02140-7","article-title":"The relationship between common mental disorders (CMDs), food insecurity and domestic violence in pregnant women during the COVID-19 lockdown in Cape Town, South Africa","volume":"57","author":"Abrahams","year":"2022","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1186\/s12884-021-03694-9","article-title":"Pregnancy-related anxiety and its associated factors during COVID-19 pandemic in Iranian pregnant women: a web-based cross-sectional study","volume":"21","author":"Hamzehgardeshi","year":"2021","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"938156","DOI":"10.3389\/fpubh.2022.938156","article-title":"The impact of COVID-19 on the mental health of pregnant women in Shanghai, China","volume":"10","author":"Zhang","year":"2022","journal-title":"Front Public Health"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"64","DOI":"10.4103\/indianjpsychiatry.indianjpsychiatry_1359_20","article-title":"Anxiety, depression, worry, and stress-related perceptions among antenatal women during the COVID-19 pandemic: single group repeated measures design","volume":"64","author":"Kakaraparthi","year":"2022","journal-title":"Indian J Psychiatry"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1111\/aogs.13925","article-title":"Uptrend in distress and psychiatric symptomatology in pregnant women during the coronavirus disease 2019 pandemic","volume":"99","author":"Berthelot","year":"2020","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1515\/jpm-2020-0380","article-title":"Anxiety and depression symptoms in the same pregnant women before and during the COVID-19 pandemic","volume":"48","author":"Ayaz","year":"2020","journal-title":"J Perinat Med"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1186\/s12884-021-04090-z","article-title":"The prevalence of and factors associated with antenatal depression among all pregnant women first attending antenatal care: a cross-sectional study in a comprehensive teaching hospital","volume":"21","author":"Guo","year":"2021","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1159\/000502294","article-title":"The accuracy of the patient health Questionnaire-9 algorithm for screening to detect major depression: an individual participant data meta-analysis","volume":"89","author":"He","year":"2020","journal-title":"Psychother Psychosom"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"e0125096","DOI":"10.1371\/journal.pone.0125096","article-title":"Diagnostic validity of the generalized anxiety disorder \u2013 7 (GAD-7) among pregnant women","volume":"10","author":"Zhong","year":"2015","journal-title":"PLoS One"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1097\/00006842-200203000-00008","article-title":"The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms","volume":"64","author":"Kroenke","year":"2002","journal-title":"Psychosom Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.jpsychores.2011.01.006","article-title":"Classification characteristics of the patient health Questionnaire-15 for screening somatoform disorders in a primary care setting","volume":"71","author":"K\u00f6rber","year":"2011","journal-title":"J Psychosom Res"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"e24162","DOI":"10.2196\/24162","article-title":"Intentions to seek mental health services during the COVID-19 pandemic among Chinese pregnant women with probable depression or anxiety: cross-sectional, web-based survey study","volume":"8","author":"Wang","year":"2021","journal-title":"JMIR Mental Health"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1186\/s12884-022-04876-9","article-title":"A qualitative analysis of feelings and experiences associated with perinatal distress during the COVID-19 pandemic","volume":"22","author":"Jones","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.jad.2021.05.014","article-title":"Prevalence and contributory factors of anxiety and depression among pregnant women in the post-pandemic era of COVID-19 in Shenzhen, China","volume":"291","author":"Wu","year":"2021","journal-title":"J. Affect Disord"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1001\/jama.2019.0007","article-title":"Interventions to prevent perinatal depression: US preventive services task force recommendation statement","volume":"321","author":"Curry","year":"2019","journal-title":"JAMA"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1038\/s41572-019-0110-3","article-title":"Nausea and vomiting of pregnancy and hyperemesis gravidarum","volume":"5","author":"Fejzo","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"484","DOI":"10.2471\/blt.20.254045","article-title":"Modelling the effects of Wuhan\u2019s lockdown during COVID-19, China","volume":"98","author":"Yuan","year":"2020","journal-title":"Bull World Health Organ"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1017410","DOI":"10.3389\/fpubh.2022.1017410","article-title":"Factors associated with the mental health status of pregnant women in China: a latent class analysis","volume":"10","author":"Pei","year":"2022","journal-title":"Front Public Health"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1007\/s10943-021-01448-7","article-title":"The relationship between the fear of Covid-19, depression, and spiritual well-being in pregnant women","volume":"61","author":"Durmu\u015f","year":"2022","journal-title":"J Relig Health"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.jad.2021.09.049","article-title":"Psychological factors and coping strategies in pregnancies complicated by hypertension: a cluster-analytic approach","volume":"296","author":"Chapuis-de-Andrade","year":"2022","journal-title":"J Affect Disord"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s00737-013-0387-2","article-title":"A cross-sectional study of antenatal depression and associated factors in Malawi","volume":"17","author":"Stewart","year":"2014","journal-title":"Arch Womens Ment Health"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"e28862","DOI":"10.1097\/md.0000000000028862","article-title":"Prevalence and risk factors of prenatal depression among pregnant women attending antenatal clinic at Adventist hospital, Bekwai municipality","volume":"101","author":"Acheanpong","year":"2022","journal-title":"Ghana Medicine"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1016\/j.jad.2018.06.014","article-title":"The role of social support in family socio-economic disparities in depressive symptoms during early pregnancy: evidence from a Chinese birth cohort","volume":"238","author":"Wei","year":"2018","journal-title":"J Affect Disord"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1186\/s12884-022-04553-x","article-title":"Self-reported mental health status of pregnant women in Sweden during the COVID-19 pandemic: a cross-sectional survey","volume":"22","author":"Ho-Fung","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1016\/j.jad.2020.07.046","article-title":"Prevalence of perinatal depression and its determinants in mainland China: a systematic review and meta-analysis","volume":"277","author":"Nisar","year":"2020","journal-title":"J Affect Disord"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"e45","DOI":"10.1016\/j.jtho.2020.11.030","article-title":"Using propensity score matching to balance the baseline characteristics","volume":"16","author":"Liang","year":"2021","journal-title":"J Thorac Oncol"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"764207","DOI":"10.3389\/fpsyt.2021.764207","article-title":"Becoming a mother during COVID-19 pandemic: how to protect maternal mental health against stress factors","volume":"12","author":"Bottemanne","year":"2021","journal-title":"Front Psych"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"e47","DOI":"10.1017\/gmh.2021.49","article-title":"Prevalence and risk factors of the symptoms of depression, anxiety, and stress during the COVID-19 pandemic in Bangladesh: a systematic review and meta-analysis","volume":"8","author":"Hosen","year":"2021","journal-title":"Glob Ment Health (Camb)"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"e18722","DOI":"10.2196\/18722","article-title":"Maternal mental health status and approaches for accessing antenatal care information during the COVID-19 epidemic in China: cross-sectional study","volume":"23","author":"Jiang","year":"2021","journal-title":"J Med Internet Res"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1142461\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T05:24:59Z","timestamp":1681449899000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1142461\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,14]]},"references-count":56,"alternative-id":["10.3389\/fpubh.2023.1142461"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1142461","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,14]]},"article-number":"1142461"}}