Prenatal stress, health, and health behaviours during the COVID-19 pandemic: An international survey

BACKGROUND: Pregnant women’s stress, mental and physical health, and health behaviours can have important implications for maternal and child health outcomes. AIM: To examine pregnant women’s levels of stress, mental and physical health, and health behaviours during the COVID-19 pandemic. METHODS: A cross-sectional survey was conducted online, with recruitment and data collection occurring between 16/6/20 and 17/7/20. Participants were pregnant women recruited via online pregnancy/parenting communities. Participants self-reported their levels of general stress, pregnancy-specific stress and COVID-19 related stress, mental and physical health, general health behaviours, and COVID-19 related health behaviours. FINDINGS: 573 pregnant women participated in the survey. Participants were most commonly resident in the United States (42.6%, n = 243), Ireland (41.2%, n = 235) or the United Kingdom (10%, n = 57). The majority (80.0%, n = 457) were married and educated to degree level or above (79.3, n = 453). Pregnant women reported high levels of pregnancy-specific and COVID-19-related stress, and low levels of mental and physical health, during the pandemic. Encouragingly, pregnant women in this study generally reported high levels of adherence to public health advice and pregnancy health behaviours. Stress and general mental health outcomes were best predicted by well-being factors (including stress and social support). Health impairing behaviours (e.g. poor diet) were predicted by both well-being and demographic factors. DISCUSSION: Interventions targeting pregnancy- and pandemic-specific stress at the population level will be essential to support mental health and minimise adverse outcomes for women and children during the pandemic.