{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:32:29Z","timestamp":1788345149527,"version":"build-2803163510"},"reference-count":41,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T00:00:00Z","timestamp":1625529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The COVID-19 pandemic outbreak influenced general and mental health worldwide. The objective of this study was to assess the anxiety level during the COVID-19 pandemic among pregnant women and compare it between COVID-infected and non-infected groups. We prospectively assessed the daily routine and anxiety level using a bespoke questionnaire and GAD-7 scale validated for pregnant women. With logistic regression, we established possible risk factors of generalized anxiety disorder spectrum and main causes of concern. The dataset included 439 responders of our survey. Of which, 21% had COVID-19 infection during pregnancy; 38% were screened for possible generalized anxiety disorder and the proportion was higher in women who suffered from COVID-19 (48% vs. 35%, p = 0.03). Pre-pregnancy anxiety or depression diagnosis and intentional social contact avoidance increased the risk of anxiety (aOR 3.4 and 3.2). Fetal wellbeing was the main concern for 66% of the responders. The COVID-19 pandemic and related restrictions substantially altered daily lives of pregnant women, exaggerating the prevalence of anxiety compared with the pre-COVID-19 studies (38% vs. 15%). COVID-19 infection during pregnancy was associated with increased levels of generalized anxiety scores. Patient-tailored psychological support should be a mainstay of comprehensive antenatal medical care in order to avoid anxiety- and stress-related complications.<\/jats:p>","DOI":"10.3390\/ijerph18147221","type":"journal-article","created":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T11:36:44Z","timestamp":1625571404000},"page":"7221","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["COVID-19 Pandemic-Related Anxiety in Pregnant Women"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8220-969X","authenticated-orcid":false,"given":"Urszula","family":"Nowacka","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute of Mother and Child, Kasprzaka 17a, 01-211 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Szymon","family":"Kozlowski","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute of Mother and Child, Kasprzaka 17a, 01-211 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5098-0156","authenticated-orcid":false,"given":"Marcin","family":"Januszewski","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology CSKMSWiA, Woloska 137, 02-507 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janusz","family":"Sierdzinski","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Litewska 14\/16, 00-581 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7373-7690","authenticated-orcid":false,"given":"Artur","family":"Jakimiuk","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology CSKMSWiA, Woloska 137, 02-507 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3647-3550","authenticated-orcid":false,"given":"Tadeusz","family":"Issat","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute of Mother and Child, Kasprzaka 17a, 01-211 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,6]]},"reference":[{"key":"ref_1","unstructured":"(2021, April 14). WHO|COVID-19 Resources and Guidance. Available online: https:\/\/www.who.int\/health-cluster\/news-and-events\/news\/COVID19-Resources\/en\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.bbi.2020.04.027","article-title":"Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms","volume":"Volume 87","author":"Troyer","year":"2020","journal-title":"Brain, Behavior, and Immunity"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1002\/jmv.26105","article-title":"Potential neuroinvasive pathways of SARS-CoV-2: Deciphering the spectrum of neurological deficit seen in coronavirus disease-2019 (COVID-19)","volume":"92","author":"Baig","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_4","first-page":"1","article-title":"Mental Health Strategies to Combat the Psychological Impact of Coronavirus Disease 2019 (COVID-19) Beyond Paranoia and Panic","volume":"49","author":"Hui","year":"2020","journal-title":"Ann. Acad. Med. Singapore"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., and Xu, Y. (2020). A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. Gen. Psychiatry, 33.","DOI":"10.1136\/gpsych-2020-100213"},{"key":"ref_6","doi-asserted-by":"crossref","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":"ref_7","doi-asserted-by":"crossref","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":"ref_8","doi-asserted-by":"crossref","unstructured":"Feduniw, S., Modzelewski, J., Sys, D., Kwiatkowski, S., and Kajdy, A. (2021). Anxiety of pregnant women in time of catastrophic events, including COVID-19 pandemic\u2013a systematic review and metanalysis protocol. Protocols.io.","DOI":"10.17504\/protocols.io.bq9zmz76"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e21279","DOI":"10.1097\/MD.0000000000021279","article-title":"Risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic: A web-based cross-sectional survey","volume":"99","author":"Kajdy","year":"2020","journal-title":"Medicine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/S0140-6736(20)30628-0","article-title":"COVID-19: Consider cytokine storm syndromes and immunosuppression","volume":"395","author":"Mehta","year":"2020","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Hussein, J. (2020). COVID-19: What implications for sexual and reproductive health and rights globally?. Sex. Reprod. Health Matters, 28.","DOI":"10.1080\/26410397.2020.1746065"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1002\/uog.22088","article-title":"Effect of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcome: Systematic review","volume":"56","author":"Juan","year":"2020","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3320","DOI":"10.1136\/bmj.m3320","article-title":"Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: Living systematic review and meta-analysis","volume":"370","author":"Allotey","year":"2020","journal-title":"BMJ"},{"key":"ref_14","first-page":"388","article-title":"Attitudes about the 2009 H1N1 Influenza Pandemic among Pregnant Japanese Women and the Use of the Japanese Municipality as a Source of Information","volume":"44","author":"Sasaki","year":"2013","journal-title":"Southeast Asian J. Trop. Med. Public Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1590\/2237-6089-2017-0134","article-title":"Effectiveness of psycho-educational counseling on anxiety in preeclampsia","volume":"41","author":"Abazarnejad","year":"2019","journal-title":"Trends Psychiatry Psychother."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Virgara, R., Maher, C., and van Kessel, G. (2018). The comorbidity of low back pelvic pain and risk of depression and anxiety in pregnancy in primiparous women. BMC Pregnancy Childbirth, 18.","DOI":"10.1186\/s12884-018-1929-4"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Sinesi, A., Maxwell, M., O\u2019Carroll, R., and Cheyne, H. (2019). Anxiety scales used in pregnancy: Systematic review. BJPsych Open, 5.","DOI":"10.1192\/bjo.2018.75"},{"key":"ref_18","unstructured":"(2021, April 17). Overview|Antenatal and Postnatal Mental Health: Clinical Management and Service Guidance|Guidance|NICE. Available online: https:\/\/www.nice.org.uk\/guidance\/cg192."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Zhong, Q.Y., Gelaye, B., Zaslavsky, A.M., Fann, J.R., Rondon, M.B., S\u00e1nchez, S.E., and Williams, M.A. (2015). Diagnostic validity of the generalized anxiety disorder-7 (GAD-7) among pregnant women. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0125096"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Schwartz, D.A., and Graham, A.L. (2020). Potential maternal and infant outcomes from coronavirus 2019-NCOV (SARS-CoV-2) infecting pregnant women: Lessons from SARS, MERS, and other human coronavirus infections. Viruses, 12.","DOI":"10.3390\/v12020194"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1192\/bjp.bp.116.187179","article-title":"Prevalence of antenatal and postnatal anxiety: Systematic review and meta-analysis","volume":"210","author":"Dennis","year":"2017","journal-title":"Br. J. Psychiatry"},{"key":"ref_22","unstructured":"(2021, April 17). Poland: WHO Coronavirus Disease (COVID-19) Dashboard with Vaccination Data|WHO Coronavirus (COVID-19) Dashboard with Vaccination Data. Available online: https:\/\/covid19.who.int\/region\/euro\/country\/pl."},{"key":"ref_23","doi-asserted-by":"crossref","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":"ref_24","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1111\/1475-5890.12239","article-title":"The Mental Health Effects of the First Two Months of Lockdown during the COVID-19 Pandemic in the UK*","volume":"41","author":"Banks","year":"2020","journal-title":"Fisc. Stud."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Etheridge, B., and Spantig, L. (2021, June 23). The gender gap in mental well-being during the Covid-19 outbreak: Evidence from the UK. ISER Work. Pap. Ser., Available online: https:\/\/ideas.repec.org\/p\/ese\/iserwp\/2020-08.html.","DOI":"10.1016\/j.euroecorev.2022.104114"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ejogrb.2020.04.022","article-title":"Health anxiety and behavioural changes of pregnant women during the COVID-19 pandemic","volume":"249","author":"Corbett","year":"2020","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.jad.2020.07.126","article-title":"Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic","volume":"277","author":"Lebel","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1001\/archpsyc.65.7.805","article-title":"Psychiatric disorders in pregnant and postpartum women in the United States","volume":"65","author":"Blanco","year":"2008","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1097\/OGX.0b013e31820eddbe","article-title":"Disasters and perinatal health: A systematic review","volume":"65","author":"Harville","year":"2010","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_30","unstructured":"(2021, June 21). Coronavirus Infection and Pregnancy. Available online: https:\/\/www.rcog.org.uk\/en\/guidelines-research-services\/guidelines\/coronavirus-pregnancy\/covid-19-virus-infection-and-pregnancy\/."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"617001","DOI":"10.3389\/fpsyg.2020.617001","article-title":"Mental Health of Pregnant and Postpartum Women during the Coronavirus Disease 2019 Pandemic: A Systematic Review and Meta-Analysis","volume":"11","author":"Yan","year":"2020","journal-title":"Front. Psychol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Fan, S., Guan, J., Cao, L., Wang, M., Zhao, H., Chen, L., and Yan, L. (2021). Psychological effects caused by COVID-19 pandemic on pregnant women: A systematic review with meta-analysis. Asian J. Psychiatry, 56.","DOI":"10.1016\/j.ajp.2020.102533"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.wombi.2020.07.002","article-title":"Pregnant women voice their concerns and birth expectations during the COVID-19 pandemic in Italy","volume":"34","author":"Ravaldi","year":"2021","journal-title":"Women Birth"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1111\/inm.12726","article-title":"The COVID-19 pandemic and mental health impacts","volume":"29","author":"Usher","year":"2020","journal-title":"Int. J. Ment. Health Nurs."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.jad.2018.09.057","article-title":"A randomized controlled trial of \u2018MUMentum Pregnancy\u2019: Internet-delivered cognitive behavioral therapy program for antenatal anxiety and depression","volume":"243","author":"Loughnan","year":"2019","journal-title":"J. Affect. Disord."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Piekarski, P., Sateja, M., Maciejewski, T., and Issat, T. (2021). No COVID-19 cases detected between April and September 2020 after screening all 838 admissions to a maternity unit in Poland. Med. Sci. Monit., 27.","DOI":"10.12659\/MSM.929123"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Sedgwick, P. (2013). Questionnaire surveys: Sources of bias. BMJ, 347.","DOI":"10.1136\/bmj.f5265"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/S2215-0366(20)30057-2","article-title":"Prenatal and perinatal risk and protective factors for psychosis: A systematic review and meta-analysis","volume":"7","author":"Davies","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.jogn.2017.02.001","article-title":"Maternal Anxiety Related to Prenatal Diagnoses of Fetal Anomalies That Require Surgery","volume":"46","author":"Wilpers","year":"2017","journal-title":"JOGNN-J. Obstet. Gynecol. Neonatal Nurs."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"60","DOI":"10.3109\/01674821003681472","article-title":"Referral for fetal echocardiography is associated with increased maternal anxiety","volume":"31","author":"Rosenberg","year":"2010","journal-title":"J. Psychosom. Obstet. Gynecol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.ejogrb.2020.10.055","article-title":"Does having a high-risk pregnancy influence anxiety level during the COVID-19 pandemic?","volume":"255","author":"Sinaci","year":"2020","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/14\/7221\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:26:34Z","timestamp":1760163994000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/14\/7221"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,6]]},"references-count":41,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2021,7]]}},"alternative-id":["ijerph18147221"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18147221","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,6]]}}}