Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic
Open accessAbstract
Rationale Women pregnant during the COVID-19 pandemic are experiencing moderate to high levels of emotional distress, which has previously been shown to be attributable to two types of pandemic-related pregnancy stress: stress associated with feeling unprepared for birth due to the pandemic (Preparedness Stress) and stress related to fears of perinatal COVID-19 infection (Perinatal Infection Stress). Objective Given the well-documented harms associated with elevated prenatal stress and the critical importance of developing appropriately targeted interventions, we investigated factors predictive of pandemic-related pregnancy stress. Method Between April 25 and May 15, 2020, 4,451 pregnant women in the U.S. were recruited via social media to complete an online questionnaire that included sociodemographic, medical, and COVID-19 situational factors, as well as the Pandemic-Related Pregnancy Stress Scale (PREPS). Binary logistic regression was used to calculate odds ratios for high stress. Results Nearly 30% of participants reported high Preparedness Stress; a similar proportion reported high Perinatal Infection Stress. Abuse history, chronic illness, income loss due to the pandemic, perceived risk of having had COVID-19, alterations to prenatal appointments, high-risk pregnancy, and being a woman of color were associated with greater levels of one or both types of stress. Access to outdoor space, older age, and engagement in healthy behaviors were protective against stress. Conclusions Practices that may alleviate pandemic-related stress such as minimizing disruptions to prenatal care, ensuring access to outdoor space, and motivating engagement in health behaviors are of vital importance. Particular attention is needed for more vulnerable populations including women of color, women with a history of abuse, and those with high-risk pregnancy. Research focused on the short and longer-term impact of pandemic-related pregnancy stress on maternal mental and physical health, perinatal outcomes, and child development is critical to identify these effects and marshal appropriate resources to reduce them.
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When exposed to stressful events, only a subgroup of individuals develops major depression.
“When exposed to stressful events, only a subgroup of individuals develops major depression.192–195”
From Epigenetic regulation in major depression and other stress-related disorders: molecular mechanisms, clinical relevance and therapeutic potential (2023) · cites this paper as [193]
The Results and Discussion (page unavailable) describe which pregnant participants experienced elevated pandemic-related stress, not which developed major depression after stressful events. Searches for major depression, depressive disorder, and depressive symptoms found no passage in our copy addressing the claimed outcome. (LLM, conf=0.76)
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- Authors
- Preis, H., Mahaffey, B., Heiselman, C., & Lobel, M.
- Affiliations
- Stony Brook University (US)
- Corresponding author
- Preis, Heidi
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2020-12
- Volume
- 266
- Pages
- 113348
- ISSN
- 0277-9536 (ISSN-L)
- PMC
- PMC7474815
- OpenAlex
- W3083211334
- Cited by
- 302
- References
- 30
- Citations by year
- 2026: 8 · 2025: 18 · 2024: 62 · 2023: 57 · 2022: 76 · 2021: 75 · 2020: 5
- FWCI
- 38.69
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Stony Brook University
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Obstetrics and Gynecology › COVID-19 Impact on Reproduction
- Keywords
- COVID-19 pandemic, pregnancy stress, prenatal stress, maternal mental health, stress risk factors, abuse history, chronic disease, income loss, health behavior, women of color, high-risk pregnancy
- MeSH terms
- COVID-19, SARS-CoV-2, Ethnic and Racial Minorities, Adult, Female, Humans, Motivation, Pregnancy, Pregnancy Complications, Socioeconomic Factors, Stress, Psychological, United States, Health Behavior, Logistic Models, Pregnant People, Resilience, Psychological, Pandemics
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