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      Mental health and preventive behaviour of pregnant women in China during the early phase of the COVID-19 period

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          Abstract

          Background

          The COVID-19 has caused significant toll over the globe. Pregnant women are at risk of infection. The present study examined the frequency of washing hands with soap and wearing face mask when going out, prevalence of depression and anxiety, and identified their associated factors among pregnant women during the early phase of COVID-19 outbreak in China.

          Methods

          A cross-sectional online survey was conducted between 24 February and 3 March 2020. A total of 15 428 pregnant women who were using maternal health care services in China completed a questionnaire which assessed their socio-demographic and pregnancy-related characteristics, contextual, cognitive and social factors related to COVID-19, frequency of washing hands and wearing face masks, and depression and anxiety. Logistics regression analyses were performed to identify the associated factors of preventive behaviours and mental health.

          Results

          The prevalence of probable anxiety and depression was 28.2% and 43.6% respectively. 19.8% reported always wearing face mask when going out, and 19.1% reported washing hands with soap for more than 10 times per day. Results from logistic regression analyses showed that older age was associated with lower levels of depression and anxiety ( OR = 0.42–0.67) and higher frequency of washing hands ( OR = 1.57–3.40). Higher level of education level was associated with probable depression ( OR = 1.31–1.45) and higher frequency of wearing face mask ( OR = 1.50–1.57). After adjusting for significant socio-demographic and pregnancy-related factors, place of residence being locked down (a OR = 1.10–1.11), being quarantined (a OR = 1.42–1.57), personally knowing someone being infected with COVID-19 (a OR = 1.80–1.92), perception that COVID-19 would pose long term physical harm to human (a OR = 1.25–1.28) were associated with higher levels of depression and anxiety, while the perception that the disease will be under control in the coming month was associated with lower levels of depression and anxiety (a OR = 0.59–0.63) and lower tendency of always wearing face mask (a OR = 0.85). Social support was associated with lower levels of depression and anxiety (a OR = 0.86–0,87) and higher frequency of washing hands (a OR = 1.06).

          Conclusions

          The mental health and preventive behaviours of pregnant women during COVID-19 outbreak was associated with a range of socio-demographic, pregnancy-related, contextual, cognitive and social factors. Interventions to mitigate their mental health problems and to promote preventive behaviours are highly warranted.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s40249-021-00825-4.

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          Most cited references27

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          G*Power (Erdfelder, Faul, & Buchner, 1996) was designed as a general stand-alone power analysis program for statistical tests commonly used in social and behavioral research. G*Power 3 is a major extension of, and improvement over, the previous versions. It runs on widely used computer platforms (i.e., Windows XP, Windows Vista, and Mac OS X 10.4) and covers many different statistical tests of the t, F, and chi2 test families. In addition, it includes power analyses for z tests and some exact tests. G*Power 3 provides improved effect size calculators and graphic options, supports both distribution-based and design-based input modes, and offers all types of power analyses in which users might be interested. Like its predecessors, G*Power 3 is free.
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            A brief measure for assessing generalized anxiety disorder: the GAD-7.

            Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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              COVID-19 and mental health: A review of the existing literature

              Highlights • Subsyndromal mental health concerns are a common response to the COVID-19 outbreak. • These responses affect both the general public and healthcare workers. • Depressive and anxiety symptoms have been reported in 16–28% of subjects screened. • Novel methods of consultation, such as online services, can be helpful for these patients. • There is a need for further long-term research in this area, especially from other countries
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                Author and article information

                Contributors
                linhong@chinawch.org.cn
                Journal
                Infect Dis Poverty
                Infect Dis Poverty
                Infectious Diseases of Poverty
                BioMed Central (London )
                2095-5162
                2049-9957
                24 March 2021
                24 March 2021
                2021
                : 10
                : 37
                Affiliations
                [1 ]GRID grid.198530.6, ISNI 0000 0000 8803 2373, National Center for Women and Children’s Health, Chinese Center for Disease Control and Prevention, ; Beijing, China
                [2 ]GRID grid.10784.3a, ISNI 0000 0004 1937 0482, Center for Health Behaviours Research, School of Public Health and Primary Care, , The Chinese University of Hong Kong, ; Hong Kong, China
                [3 ]GRID grid.460018.b, ISNI 0000 0004 1769 9639, Shandong Province Hospital for Women and Children’s Health, ; Jinan, China
                [4 ]GRID grid.24696.3f, ISNI 0000 0004 0369 153X, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, ; Beijing, China
                [5 ]Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
                [6 ]Women and Children’s Health Care Hospital of Liaoning Province, Shenyang, China
                [7 ]GRID grid.13402.34, ISNI 0000 0004 1759 700X, School of Medicine, Women’s Hospital, , Zhejiang University, ; Hangzhou, China
                [8 ]GRID grid.459579.3, Guangdong Women and Children Hospital, ; Guangzhou, China
                [9 ]Chong Qing Health Center for Women and Children, Chong Qing, China
                [10 ]GRID grid.452438.c, First Affiliated Hospital of Medical College of Xi’an Jiaotong University, ; Xi’an, China
                [11 ]GRID grid.508400.9, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, ; 13# Rd Nanwei, Xicheng, Beijing, China
                Article
                825
                10.1186/s40249-021-00825-4
                7988630
                33761984
                d87454a9-27e8-4597-8a4f-76522e870bd5
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 10 September 2020
                : 12 March 2021
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                covid-19,personal preventive behaviour,depression,anxiety,mental health,pregnant women,china

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