Investigation On The Psychological And Sleep Status Of Pregnant Women During The Epidemic Of COVID-19 And The Study Of Influencing Factors

ObjectivesTo describe the pregnant women’s psychological reaction,attention to media,and sleep quality from March to May 2020,during the COVID-19 epidemic in Hefei,and analyze the suspicious factors affecting psychological response and sleep quality,with a view to implementing classified intervention for different groups of people and minimizing the psychological stress response and psychological problems of pregnant women during the epidemic.The psychological health of pregnant women should fully integrated into overall management system of psychological crisis during the COVID-19 epidemic,which can provide a reference for the formulation of maternal mental health intervention strategies.MethodsA total of 1,693 pregnant women were selected in Hefei City from March to May2020,who were from Luyang District,Shushan District,Yaohai District,Baohe District,Changfeng County,Feidong County,Feixi County,Lujiang County,and Chaohu City,respectively.The pregnant women’s information was obtained from local maternal and child health care department.Using self-made questionnaires and filling in online surveys to collect relevant information that may affect the psychological response and sleep quality of pregnant women.The questionnaire included demographic data and the following three flow center scales,two self-made questionnaires:1)depression self-assessment scale and anxiety self-assessment scale;2)psychological questionnaires for public health emergencies;3)self-made media attention questionnaires during the epidemic;4)self-made sleep quality questionnaire for pregnant women during the epidemic.Statistical methods and indicators include:Pearson chi-square test,linearχ~2test,Fisher’s exact probability,and multi-factor logistic regression model analysis.Those statistical methods were used to analyze the factors affecting maternal psychological response and sleep quality during the epidemic.ResultsA total of 1,693 pregnant women completed the survey,and the participant’s average age was 27.92±4.36 years old,the youngest was 17 years old,and the oldest age was 45 years old.1,144 primigravida(67.57%),549 multipara(32.43%),their average gestational week was 22.06±9.66,the majority had a family size of<3,their average BMI value was(25.29±9.18)kg/m2,and the average BMI value was(20.79±3.07)kg/m~2before pregnancy,mostly engaged in workers and services(751cases,44.36%),the majority were in middle-income(908 cases,53.63%).(1)Psychological evaluation of pregnant women.1)In this study the anxiety and depression symptom were detected by using CES-D and SAS.A total of 162 people with depression symptoms were detected,and the detection rate of depression symptoms was 9.57%;a total of 145 people were detected with anxiety symptoms,and the detection rate of anxiety symptoms was 8.56%.There was a difference in the detection rate of depressive symptoms in the different age group,of which the detection rate was the highest in the≤23-year-old age group(17.11%)and the lowest detection rate in the≥35 age group(5.26%).Compared with normal BMI,the detection rate of depressive symptoms in low body weight,obesity,and overweight groups were increased,and the detection rate of normal BMI was the lowest.The above variables had no significant impact on the detection rate of anxiety symptoms.Variables such as age and complications of this pregnancy were significantly related to maternal fear and depression symptoms.The detection rate of maternal depression symptoms who maintain proper exercise was reduced during the epidemic.2)Using the results of the PQEEPH survey,the overall depressive symptom detection rate was 9.52%,the neurasthenia symptom detection rate was 9.38%,the fear psychology was 10.25%,the obsessive-anxiety was 6.55%,and the disease suspecting was 3.9%,in which the score of fear and depression was highest.There were differences of maternal fear and depressive symptoms detection rates in different age groups,BMI values,maternal economic status,and occupational types.Among them,the results of depression detection were consistent with the SDS and SAS detection results.(2)Investigation of pregnant women’s attention to the media..During the epidemic,paying attention to the media can have a significant impact on the mental health of pregnant women.The performance is presented as follows:with the increase of attention time,maternal fear deviation and fear disorder showed a significant increasing trend.Compared with the attention time<1 hour group,the risks of maternal fear deviation and fear disorder in attention time>5 hours group has increased by 1.713(95%CI:1.329-2.207)and 2.071(95%CI:1.392-3.082),respectively.In addition,paying attention to a lot of negative news could increase the risks of fear deviation and fear disorder by 1.738(95%CI:1.467-2.059)and 2.183(95%CI:1.696-2.810),respectively.Paying attention to negative news could increase the risk of depression deviation and depression disorder by 1.430(95%CI:1.211-1.688)and 1.723(95%CI:1.331-2.231),respectively,and increase the risks of neurasthenia deviation and neurasthenia disorder by 1.453(95%CI:1.241-1.702)and 1.879(95%CI:1.455-2.427),respectively,the risks of forced anxiety deviation and obsessive-compulsive anxiety disorder increased by 1.886(95%CI:1.57-2.266)and 1.875(95%CI:1.469-2.393),respectively,the risk of the occurrence of hypochondriac deviation and disorders increased by 1.636(95%CI:1.325-2.021).In addition,paying attention to methods of experts and government significantly reduced the risk of forced anxiety and hypochondriasis.(3)Survey on the sleep quality of pregnant women.During the COVID-19pandemic,the incidences of headache after waking up in early,mid and late pregnancy had increased significantly,with the risk of OR value(OR=7.81,95%CI:2.99-30.28),(OR=8.52,95%CI:3.22-25.56)and(OR=7.15,95%CI:3.03-30.24)respectively;The incidence of excessive daytime drowsiness increased in mid and late pregnancy,with the risk of OR value(OR=4.77,95%CI:2.25-12.51)and(OR=3.98,9 5%CI:2.39-17.52)respectively.Also the incidence of respiratory pain and sleep snoring symptoms in mid and late pregnancy had increased.The multi-factor dichotomous Logistic regression model analysis showed that pregnant women with early pregnancy anxiety had a significant risk of waking up with headache and daytime drowsiness.The OR value were(OR=10.85,95%CI:3.01-38.89)and(OR=4.22,95%CI:1.98-11.22)respectively.The risk of sleep snoring(OR=5.24,95%CI:2.79-15.21),laboured sleep breathing(OR=4.65,95%CI:1.58-16.21),waking up with headache(OR=6.07,95%CI:2.69-12.94),daytime drowsiness(OR=4.18,95%CI:2.08-12.18)were all significantly increased in mid pregnancy;For pregnant women with late pregnancy anxiety,the risk of sleep snoring(OR=2.94,95%CI:1.38-7.45),laboured sleep breathing(OR=5.65,95%CI:2.28-15.28),waking up with headache(OR=10.92,95%CI:3.03-38.21),short sleep duration(OR=3.94,95%CI:1.81-8.69)were all significantly increased.ConclusionThe results of this study suggest that the detection rate of maternal depression,anxiety,fear and sleep disturbance were significantly increased during the COVID-19epidemic.And there was significant variability in the impact of multiple demographic factors on maternal psychological stress responses.Therefore,as for different psychological stress,relieving psychological stress,paying attention to correct information in time,improving the quality of pregnancy,adopting different adjustment methods,proper exercise,and ensuring adequate sleep are of great significance to the maternal mental health intervention strategy.