{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T23:25:36Z","timestamp":1784157936601,"version":"3.55.0"},"reference-count":45,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"CAPES (Coordination for the Improvement of Higher Education Personnel)","doi-asserted-by":"publisher","award":["88881.504727\/2020-01"],"award-info":[{"award-number":["88881.504727\/2020-01"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Objective: Analyze the presence of PTSD symptoms and their risk among the pregnant women during the COVID-19 pandemic. Methods: This is a cross-sectional study of pregnant women that received receiving prenatal care at two university hospitals in S\u00e3o Paulo, Brazil, during the COVID-19 pandemic, from April to June 2020. The sociodemographic and health data of the participants and their exposure to individuals suspected or confirmed to have COVID-19 were evaluated. The Impact of Event Scale-Revised and the State-Trait Anxiety Inventory were used to assess PTSD and anxiety symptoms, respectively. Results: A total of 149 pregnant women were included in this study. The risk of PTSD among the participants was 55.1%. The independent risk factors for PTSD were state anxiety (ORadj = 2.6), trait anxiety (ORadj = 10.7), changes in routine due to the pandemic (ORadj = 4.7) and contact with a confirmed case of COVID-19 person (ORadj = 7.1). Conclusions: The COVID-19 pandemic had a significant negative impact on the mental health of pregnant women, more than half of the participants of the present study showed a risk of PTSD, exacerbated by anxiety symptoms and exposure to individuals with a confirmed case of COVID-19.<\/jats:p>","DOI":"10.3390\/ijerph21040461","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T03:07:48Z","timestamp":1712718468000},"page":"461","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Post-Traumatic Stress Disorder in Brazilian Pregnant Women at the Beginning of the Coronavirus Disease Pandemic"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1844-2312","authenticated-orcid":false,"given":"J\u00e9ssica Gorr\u00e3o Lopes","family":"Albertini","sequence":"first","affiliation":[{"name":"Disciplina de Obstetr\u00edcia, Departamento de Obstetr\u00edcia e Ginecologia, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05508-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gl\u00e1ucia Rosana Guerra","family":"Benute","sequence":"additional","affiliation":[{"name":"Coordination of the Psychology Course, Sao Camilo University Center, S\u00e3o Paulo 04263-200, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria de Lourdes","family":"Brizot","sequence":"additional","affiliation":[{"name":"Disciplina de Obstetr\u00edcia, Departamento de Obstetr\u00edcia e Ginecologia, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05508-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stela Verzinhasse","family":"Peres","sequence":"additional","affiliation":[{"name":"Disciplina de Obstetr\u00edcia, Departamento de Obstetr\u00edcia e Ginecologia, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05508-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9981-8069","authenticated-orcid":false,"given":"Rossana Pulcineli Vieira","family":"Francisco","sequence":"additional","affiliation":[{"name":"Disciplina de Obstetr\u00edcia, Departamento de Obstetr\u00edcia e Ginecologia, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05508-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0016-1803","authenticated-orcid":false,"given":"Marco Aur\u00e9lio Knippel","family":"Galletta","sequence":"additional","affiliation":[{"name":"Disciplina de Obstetr\u00edcia, Departamento de Obstetr\u00edcia e Ginecologia, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05508-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e20958","DOI":"10.1016\/j.heliyon.2023.e20958","article-title":"Psychiatric illness and pregnancy: A literature review","volume":"9","author":"Abdelhafez","year":"2023","journal-title":"Heliyon"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.4088\/JCP.18r12527","article-title":"The Prevalence of Anxiety Disorders During Pregnancy and the Postpartum Period: A Multivariate Bayesian Meta-Analysis","volume":"80","author":"Fawcett","year":"2019","journal-title":"J. Clin. Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.jad.2019.05.016","article-title":"Prevalence, onset and course of anxiety disorders during pregnancy: A systematic review and meta-analysis","volume":"255","author":"Viswasam","year":"2019","journal-title":"J. Affect. Disord."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/j.jad.2021.08.079","article-title":"Prenatal maternal posttraumatic stress disorder as a risk factor for adverse birth weight and gestational age outcomes: A systematic review and meta-analysis","volume":"295","author":"Sanjuan","year":"2021","journal-title":"J. Affect. Disord."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.jad.2016.10.009","article-title":"The prevalence of posttraumatic stress disorder in pregnancy and after birth: A systematic review and meta-analysis","volume":"208","author":"Yildiz","year":"2017","journal-title":"J. Affect. Disord."},{"key":"ref_6","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 COVID-19 pandemic","volume":"99","author":"Berthelot","year":"2020","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2423","DOI":"10.1590\/1413-81232020256.1.10502020","article-title":"Social distancing measures to control the COVID-19 pandemic: Potential impacts and challenges in Brazil","volume":"25","author":"Aquino","year":"2020","journal-title":"Ci\u00eancia Sa\u00fade Coletiva"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1002\/ijgo.13300","article-title":"The tragedy of COVID-19 in Brazil: 124 maternal deaths and counting","volume":"151","author":"Takemoto","year":"2020","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"G\u00f3mez-Salgado, J., Andr\u00e9s-Villas, M., Dom\u00ednguez-Salas, S., D\u00edaz-Milan\u00e9s, D., and Ruiz-Frutos, C. (2020). Related Health Factors of Psychological Distress During the COVID-19 Pandemic in Spain. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17113947"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.comppsych.2011.02.003","article-title":"Depression after exposure to stressful events: Lessons learned from the severe acute respiratory syndrome epidemic","volume":"53","author":"Liu","year":"2011","journal-title":"Compr. Psychiatry"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"560389","DOI":"10.3389\/fpubh.2020.560389","article-title":"Prevalence of Mental Health Problems During Virus Epidemics in the General Public, Health Care Workers and Survivors: A Rapid Review of the Evidence","volume":"8","author":"Kerksieck","year":"2020","journal-title":"Front. Public Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S2215-0366(20)30168-1","article-title":"Multidisciplinary research priorities for the COVID-19 pandemic: A call for action for mental health science","volume":"7","author":"Holmes","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.bbi.2020.04.028","article-title":"A longitudinal study on the mental health of general population during the COVID-19 epidemic in China","volume":"87","author":"Wang","year":"2020","journal-title":"Brain Behav. Immun."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"113138","DOI":"10.1016\/j.psychres.2020.113138","article-title":"Correlates of symptoms of anxiety and depression and mental wellbeing associated with COVID-19: A cross-sectional study of UK-based respondents","volume":"291","author":"Smith","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1007\/s11469-020-00340-x","article-title":"Associations Between Fear of COVID-19, Mental Health, and Preventive Behaviours Across Pregnant Women and Husbands: An Actor-Partner Interdependence Modelling","volume":"20","author":"Ahorsu","year":"2020","journal-title":"Int. J. Ment. Health Addict."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1590\/S0102-311X2012000300019","article-title":"Cross-cultural adaptation of the Brazilian version of the Impact of Event Scale\u2014Revised (IES-R)\/[Adapta\u00e7\u00e3o transcultural da vers\u00e3o brasileira da Escala do Impacto do Evento\u2014Revisada\/[Cross-cultural adaptation of the Brazilian version of the Event Impact Scale\u2014Revised (IES-R)]","volume":"28","author":"Caiuby","year":"2012","journal-title":"Cad. Sa\u00fade P\u00fablica"},{"key":"ref_17","first-page":"185","article-title":"The Impact of Event Scale\u2014Revised: Psychometric properties of the Lithuanian version in a sample of employees exposed to workplace bullying","volume":"23","year":"2016","journal-title":"Acta Med. Litu."},{"key":"ref_18","unstructured":"Spielberger, C.D., Gorsuch, R.L., and Lushene, R.E. (1970). The State-Trait Anxiety Inventory (Test Manual), Consulting Psychologists Press."},{"key":"ref_19","unstructured":"Biaggio, A.M.B., and Natal\u00edcio, L. (1979). Manual for the State-Trait Anxiety Inventory \/[Manual para o Invent\u00e1rio de Ansiedade Tra\u00e7o-Estado (IDATE)], Centro Editor de Psicologia Aplicada-CEPA."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1590\/1806-9282.65.3.434","article-title":"The positive impact of physical activity on the reduction of anxiety scores: A pilot study","volume":"65","author":"Alves","year":"2019","journal-title":"Rev. Da Assoc. M\u00e9dica Bras. (RAMB)"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ferri, C.P., Mitsuhiro, S.S., Barros, M.C.M., Chalem, E., Guinsburg, R., Patel, V., Prince, M., and Laranjeira, R. (2007). The impact of maternal experience of violence and common mental disorders on neonatal outcomes: A survey of adolescent mothers in Sao Paulo, Brazil. BMC Sa\u00fade P\u00fablica, 7.","DOI":"10.1186\/1471-2458-7-209"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1016\/j.psychres.2013.08.053","article-title":"Prevalence of psychiatric disorders in the first trimester of pregnancy and factors associated with current suicide risk","volume":"210","author":"Farias","year":"2013","journal-title":"Psychiatry Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"100516","DOI":"10.1016\/j.srhc.2020.100516","article-title":"Potentially traumatic events, fear of childbirth and posttraumatic stress disorder during pregnancy in Stockholm, Sweden: A cross-sectional study","volume":"25","author":"Persson","year":"2020","journal-title":"Sex. Reprod. Healthc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1762310","DOI":"10.1080\/20008198.2020.1762310","article-title":"The effects of PTSD treatment during pregnancy: Systematic review and case study","volume":"11","author":"Melanie","year":"2020","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"113552","DOI":"10.1016\/j.psychres.2020.113552","article-title":"Risk factors for depression, anxiety, and PTSD symptoms in perinatal women during the COVID-19 Pandemic","volume":"295","author":"Liu","year":"2021","journal-title":"Psychiatry Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"114920","DOI":"10.1016\/j.psychres.2022.114920","article-title":"Correlation between psychiatric impact of COVID-19 during pregnancy and fetal outcomes in Egyptian women","volume":"317","author":"Ahmed","year":"2022","journal-title":"Psychiatry Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.jpsychires.2021.02.056","article-title":"Impact of the COVID-19 pandemic on mental health, access to care, and health disparities in the perinatal period","volume":"137","author":"Masters","year":"2021","journal-title":"J. Psychiatr. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1177\/0706743720963917","article-title":"Association entre la fr\u00e9quence de consultation des m\u00e9dias d\u2019information et la d\u00e9tresse psychologique chez les femmes enceintes durant la pand\u00e9mie de COVID-19\/[Association between news media consulting frequency and psychological distress in pregnant women during the COVID-19 pandemic]","volume":"66","author":"Lemieux","year":"2021","journal-title":"Can. J. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1007\/s00737-020-01086-0","article-title":"Previous psychopathology predicted severe COVID-19 concern, anxiety, and PTSD symptoms in pregnant women during \u201clockdown\u201d in Italy","volume":"23","author":"Ravaldi","year":"2020","journal-title":"Arch. Women\u2019s Ment. Health"},{"key":"ref_30","doi-asserted-by":"crossref","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":"ref_31","doi-asserted-by":"crossref","unstructured":"Delanerolle, G., McCauley, M., Hirsch, M., Zeng, Y., Cong, X., Cavalini, H., Sajid, S., Shetty, A., Rathod, S., and Shi, J.Q. (2023). The prevalence of mental ill-health in women during pregnancy and after childbirth during the COVID-19 pandemic: A systematic review and Meta-analysis. BMC Pregnancy Childbirth, 23.","DOI":"10.1186\/s12884-022-05243-4"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Basu, A., Kim, H.H., Basaldua, R., Choi, K.W., Charron, L., Kelsall, N., Hernandez-Diaz, S., Wyszynski, D.F., and Koenen, K.C. (2021). A cross-national study of factors associated with women\u2019s perinatal mental health and wellbeing during the COVID-19 pandemic. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0249780"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1089\/jwh.2022.0400","article-title":"Factors Associated with Post-Traumatic Stress Symptoms in Pregnant and Postpartum Women","volume":"32","author":"Motrico","year":"2023","journal-title":"J. Women\u2019s Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"521","DOI":"10.24869\/psyd.2020.521","article-title":"Anxiety and Post-Traumatic Stress Disorder Symptoms in Pregnant Women during the COVID-19 Pandemic\u2019s Delay Phase","volume":"32","author":"Hocaoglu","year":"2020","journal-title":"Psychiatr. Danub."},{"key":"ref_35","first-page":"17455057221112935","article-title":"Impact of coronavirus 2019 pandemic on post-traumatic stress disorder symptoms among pregnant women in Jordan","volume":"18","author":"Bataineh","year":"2022","journal-title":"Women\u2019s Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.jad.2021.09.091","article-title":"HC-FMUSP-Obstetric COVID19 Study Group. Postpartum depressive symptoms of Brazilian women during the COVID-19 pandemic measured by the Edinburgh Postnatal Depression Scale","volume":"296","author":"Galletta","year":"2022","journal-title":"J Affect. Disord."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"188","DOI":"10.3389\/fpubh.2020.00188","article-title":"The Battle Against COVID-19 in Jordan: An Early Overview of the Jordanian Experience","volume":"8","year":"2020","journal-title":"Front. Public Health"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"112954","DOI":"10.1016\/j.psychres.2020.112954","article-title":"Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 epidemic in China: A web-based cross-sectional survey","volume":"288","author":"Huang","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Forte, G., Favieri, F., Tambelli, R., and Casagrande, M. (2020). The Enemy Which Sealed the World: Effects of COVID-19 Diffusion on the Psychological State of the Italian Population. J. Clin. Med., 9.","DOI":"10.3390\/jcm9061802"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.bbi.2020.05.040","article-title":"Mental Health Consequences during the Initial Stage of the 2020 Coronavirus Pandemic (COVID-19) in Spain","volume":"87","author":"Saiz","year":"2020","journal-title":"Brain Behav. Immun."},{"key":"ref_41","first-page":"561","article-title":"Sociodemographic inequalities and maternity care of puerperae in Southeastern Brazil, according to skin color: Data from the Birth in Brazil national survey (2011\u20132012)","volume":"25","author":"Diniz","year":"2016","journal-title":"Sa\u00fade Soc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1186\/s12978-016-0227-8","article-title":"Factors associated with unintended pregnancy in Brazil: Cross-sectional results from the Birth in Brazil National Survey, 2011\/2012","volume":"13","author":"Baldisserotto","year":"2016","journal-title":"Reprod. Health"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1590\/S1807-59322010001100013","article-title":"Depression during pregnancy in women with a medical disorder: Risk factors and perinatal outcomes","volume":"65","author":"Benute","year":"2010","journal-title":"Clinics"},{"key":"ref_44","first-page":"87","article-title":"Major depression in high-risk obstetric inpatients and outpatients","volume":"1","author":"Juhas","year":"2014","journal-title":"MedicalExpress"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s00406-006-0654-6","article-title":"Post-traumatic stress disorder","volume":"256","author":"Hapke","year":"2006","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/4\/461\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:25:23Z","timestamp":1760106323000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/4\/461"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,10]]},"references-count":45,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["ijerph21040461"],"URL":"https:\/\/doi.org\/10.3390\/ijerph21040461","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,10]]}}}