Keywords
Anxiety
Pregnancy
Mental health
Prenatal care
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Abstract
Objective: To evaluate the anxiety levels of pregnant women during the COVID-19 pandemic and related factors. Methods: A cross-sectional study was conducted with 1,208 pregnant women in Brazil between July and August 2020. Data was collected using an online digital questionnaire of the State-Trait Anxiety Inventory (STAI-E). Descriptive and inferential analyses were performed, complemented by multiple regression analysis. Results: Pregnant women over 18 years of age were included, and those who did not complete at least 80% of the questionnaire were excluded. The average anxiety score was 50, considered medium-high. Factors such as sadness, fear of death, anxiety, difficulty accessing prenatal care, financial worries, fear of the child having health problems, cohabitants with suspected COVID-19, and the impact of the pandemic on pregnancy increased anxiety. Feelings of tranquility, optimism, and confidence reduced anxiety. Conclusion: The level of anxiety found in pregnant Brazilian women during the COVID-19 pandemic was medium-high. Sadness, fear of death, financial worries, difficulty accessing prenatal care, and the impact of the pandemic on pregnancy were the main factors that increased this state. The results reinforce the urgent need for psychosocial support and attention to the mental health of these women in the context of the crisis.
References
AMINI-RARANI M, et al. Estimation of the prevalence of anxiety during the COVID-19 pandemic: A meta-analysis of meta-analyses. BMC Public Health, 2024; 24: 19729.
ARZAMANI N, et al. The COVID-19 pandemic and mental health in pregnant women: A review article. Front Psychiatry, 2022; 13: 949239.
AWANDA NI e HANDYANI D. Literature Review: Anxiety in Pregnant Women during the Covid-19 Pandemic. Disease Prevention and Public Health Journal, 2023; 17(1): 32-38.
AYERS S, et al. COVID-19 and anxiety in pregnancy and postpartum: a longitudinal survey. BMC Public Health, 2025; 25(1): 1146.
BARRIO-MARTÍNEZ S, et al. Implications of COVID-19 on mental health of pregnant women: does timing of infection matter? Eur. J. Psychiatry, 2024; 38(4): Article 100269.
BARTMANN, C. et al. The impact of the early COVID-19 pandemic on maternal mental health during pregnancy and postpartum, 2024; 19(9): 1-16.
BERMÚDEZ-GONZÁLEZ M, et al. Impact of the COVID-19 pandemic on maternal anxiety during pregnancy: A prevalence study. Clin Invest Ginecol Obstet., 2022; 49(4): 100776.
BIAGGIO AMB e NATALÍCIO L. Manual do Inventário de Ansiedade Traço-Estado (IDATE). Rio de Janeiro: Centro Editor de Psicologia Aplicada (CEPA); 2003.
BLOCKLINGER KL, et al. Depression in the time of COVID-19: examination of prenatal and postpartum depression, rurality, and the impact of COVID-19. Journal of Affective Disorders, 2025; 370: 337-347.
BORINE MS. Ansiedade, neuroticismo e suporte familiar: Evidência de validade do Inventário de Ansiedade Traço-Estado (IDATE). Tese de Doutorado, Programa de Pós-graduação Strictu Sensu em Psicologia, Universidade São Francisco, Itatiba. São Paulo, 2011.
CAFFIERI A, et al. Global prevalence of perinatal depression and anxiety during the COVID-19 pandemic: An umbrella review and meta-analytic synthesis. Acta Obstet Gynecol Scand., 2024; 103(2): 210-224.
CHEN H, et al. Perinatal Anxiety and Depression During COVID-19. The Journal for Nurse Practitioners, 2021; 17(1): 26-31.
CHILDREN’S NATIONAL INNOVATION DISTRICT. Pandemic stress in pregnant mothers may affect anxiety regions of babies’ brains. 2024.
CIOLAC L, et al. Unveiling the Mental Health of Postpartum Women During and After COVID-19: Analysis of Two Population-Based National Maternity Surveys in Romania. Healthcare, 2025; 13(8): 911.
CONSELHO NACIONAL DE SAÚDE. Resolução n. 466, de 12 de dezembro de 2012. Diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. DOU nº 12, 13 de junho de 2013, 1; 59.
DAW JR, et al. Tendências e disparidades na saúde mental e física materna autorrelatada. JAMA Internal Medicine, 2025; 185(7): 857-865.
DUNN JR, et al. REDLetr: Workflow and tools to support the migration of legacy clinical data capture systems to REDCap. International Journal of Medical Informatics, 2016; 93: 103-110.
ERBIL N e BOYRAZ H. Depression, Anxiety, and Stress Levels in High-Risk Pregnant Women in the COVID-19 Pandemic. International Journal of Caring Sciences, 2023; 16(3): 1716-1727.
GROULX T, et al. Prenatal Care Disruptions and Associations With Maternal Mental Health During the COVID-19 Pandemic. Front Glob Womens Health, 2021; 2: 648428.
JEONG W, et al. Factors associated with COVID-19 infection in pregnant women: Focusing on maternal anxiety. PLoS One, 2024; 19(10): e0312300.
LIU X, et al. Maternal depressive symptoms and early childhood development: the role of mother-child interactions among mother-child dyads in rural areas of Central and Western China. PeerJ, 2021; 9: e11060.
LÓPEZ-MORALES H, et al. Mental health of pregnant women during the COVID-19 pandemic: A longitudinal study. Psychiatry Res., 2021; 295: 113567.
LÓPEZ-MORALES H, et al. Maternal anxiety, exposure to the COVID-19 pandemic and socioemotional development of offspring. Journal of Applied Developmental Psychology, 2023; (86): 1-12.
MARIÑO-NARVAEZ C, et al. Pregnant women’s mental health during the COVID-19 pandemic according to the trimester of pregnancy. J Reprod Infant Psychol., 2025; 43(3): 557-572.
MOKHTARI M e KOUHPAYEH H. A systematic review of COVID-19's impact on pregnancy outcomes. Ann Med Surg., 2025; 87(7): 4384-4394.
MUÑOZ-VELA FJ, et al. Fear and Anxiety in Pregnant Women During the COVID-19 Pandemic: A Systematic Review. Int J Public Health, 2023; 68: 1605587.
NAZZARI S, et al. Pandemic babies: A systematic review of the association between maternal pandemic-related stress during pregnancy and infant development. Neurosci Biobehav Rev., 2024; 162: 105723.
PANKAEW K, et al. The Impact of Covid-19 on Women's Mental Health and Wellbeing During Pregnancy and the Perinatal Period: A Mixed-Methods Systematic Review. Inquiry, 2024; 61: 469580241301521.
PENNA AL, et al. Impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices: a global scoping review. BMC Public Health, 2023; 23(1): 388.
SPIELBERGER CD, et al. Manual for the state-trait anxiety inventory. Palo Alto, California: Consulting Psychologist Press; 1970.
VACARU S, et al. The risk and protective factors of heightened prenatal anxiety and depression during the COVID-19 lockdown. Sci Rep., 2021; 11(1): 20261.
VICTOR A, et al. Risk factors for mental disorders in pregnant women in two cities from São Paulo, Brazil: A cohort study. PLoS One, 2025; 20(9): e0330921.
WONDMENEH TG e WOGRIS M. Depression and anxiety among pregnant women during COVID 19 pandemic in Ethiopia: a systematic review and meta-analysis. Front Glob Womens Health, 2024; 5: 1453157.
ZHANG L, et al. Maternal mental health during COVID-19: A global perspective on anxiety and depression in pregnancy. International Journal of Environmental Research and Public Health, 2024; 21(8): 1045.