Anxiety and Depression Symptoms and Associated Factors in Pregnant and Breast Feeding Women During the COVID-19 Pandemic in Rasht, Iran, 2020

Background and purpose: The spread of COVID-19 can cause anxiety and depression and lead to adverse outcomes in perinatal period. This study aimed to evaluate anxiety and depression symptoms and associated factors in pregnant and breast feeding women during the COVID-19 pandemic. Materials and methods: This cross-sectional study included 450 pregnant and breast feeding women in Rasht, Iran during the second and third wave of COVID-19 (June-November 2020). Data were collected using convenience and multi-stage sampling in a teaching hospital and six healthcare centers. Anxiety and depression were evaluated by Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9, respectively. Descriptive statistics and analytical statistics, including independent t-test, Chi-square test, and logistic regression were used to analyze the data. Results: Generalized anxiety was seen in 16.9% of pregnant women and 10.7% of breast feeding women (P=0.057). Expectant mothers were 6.64 times more likely to have depressive symptoms compared with breast feeding women (ORAdj=6.64, 95% CI: 2.08-21.15). Comorbid anxiety-depressive symptoms were higher in pregnant women than breast feeding women (6.2% vs. 0.9%, P=0.002). Anxiety was found to be significantly associated with an unemployed husband, having chronic diseases, thinking about COVID-19, and high-risk individuals in the family (P<0.05). Also, there was a significant relationship between depression and pregnancy, less educated husband, and high-risk individuals in the family (P< 0.05). Conclusion: In this study, pregnant and breast feeding women showed more anxiety symptoms than depression symptoms during COVID-19. Expectant mothers were more likely to have depressive symptoms than breast feeding women. These results emphasize the importance of mental health monitoring to improve perinatal-care quality during epidemics/social crises.