Fear of COVID-19 among pregnant women in Pakistan: a cross-sectional study

Sidrah Nausheen, Shelia Bhamani, Areeba Makhdoom, Lumaan Sheikh


Background: The emergence of COVID-19 and its pandemic nature has exacerbated fears worldwide. Pregnant women are considered a vulnerable group during the COVID-19 pandemic because the physiological changes make them more susceptible to infections. Pregnant women are found expressing much of the fear related to their course of pregnancy, the in-utero transmission of the disease, and questions related to infection control in healthcare settings. Hence, the purpose of this paper was to explore the fears faced by pregnant women related to COVID.

Methods: It was a cross-sectional survey among 201 pregnant women attending antenatal clinics of Aga Khan University Hospital. The survey tool contains demographic variables and a 7-item scale of “Fear in COVID” which is pre tested in the Iranian population. The survey form was made on google drive and sent to pregnant females on WhatsApp.

Results: 201 pregnant women mostly belonging to middle and low socioeconomic class were enrolled. The majority (80%) of women were less than 30 years of age. Only 26 (12.9%) were primigravids, remaining were multigravidas of a different order of pregnancy. 60% of our study population showed high fear scores (27-35) from coronavirus whereas another 30% had moderate fear. No association of study variables was found with fear scores.

Conclusions: We found a high level of fear of COVID-19 among the pregnant population with a higher level of anxiety and stress related symptoms. The amount of fear and stress is independent of the trimester or order of pregnancy.


Fear of COVID-19, Mental health, Pregnant

Full Text:



Guan WJ, Ni ZY, Hu Y. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382:1708-20.

Haung C, Wang Y, Li X. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.

Lin CY. Social reaction towards the 2019 novel coronavirus (COVID-19). Social Health Behav. 2020;3:1-2.

Organization WH. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). 2005.

Sher L. COVID-19, anxiety, sleep disturbances and suicide. Sleep Medicine. 2020;70:124.

Zandifar A, Badrfam R. Iranian mental health during the COVID-19 epidemic. Asian J Psychiatry. 2020;51:101990.

Zhao X, Jiang Y, Zhao Y, Xi H, Liu C, Qu F. Analysis of the susceptibility to COVID-19 in pregnancy and recommendations on potential drug screening. Eur J Clin Microbiol Infect Dis. 2020;23:1-12.

Woods SM, Melville JL, Guo Y, Fan MY. Psychosocial stress during pregnancy. Am J Obst Gynecol. 2010;202(1):61-7.

Elshafeey F, Magdi R, Hindi N, Elshebiny M, Farrag N. A systematic scoping review of COVID‐19 during pregnancy and childbirth. Int J Gynecol Obst. 2020;150(1):47-52.

Ahorsu DK, Lin CY, Imani V. The fear of COVID-19 scale: development and initial validation. Int J Ment Health Addict. 2020:1-9.

Haider SB. Stressful times: What it feels like to be pregnant amid the pandemic. Available at Accessed on 12 July 2020.

Hossain N, Samuel M, Sandeep R, Imtiaz S, Zaheer S. Perceptions, generalized anxiety and fears of pregnant women about corona virus infection in the heart of pandemic. Available at https:// assets. Accessed on 10 August 2020.

Javaid S, Javaid MK. Survey on corona virus: a case study in Pakistan. Int J Med Sci Clin Res Review. 2020;3(02):223-7.

Butt WA. Covid-19 rate among pregnant women alarming. Available at https:// www. dawn. com/news/1555401/covid-19-rate-among-pregnant-women-alarming. Accessed on 20 August 2020.

Garza A. How social media is shaping our fears of and response to the coronavirus. Available at Accessed on 20 August 2020.

Karasneh R, Azzam S, Muflih S, Soudah O, Hawamdeh S, Khader Y. Media's effect on shaping knowledge, awareness risk perceptions and communication practices of pandemic COVID-19 among pharmacists. Res Social Admin Pharmacy. 2020;4:55-9.

Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian J Psychiatr. 2020;52:102066.

Aschwanden D, Strickhouser JE, Sesker AA. Psychological and behavioural responses to coronavirus disease 2019: the role of personality. Eur J Pers. 2020;10:1002.

Altena E, Baglioni C, Espie CA, Ellis J, Gavriloff D, Holzinger B, Riemann D. Dealing with sleep problems during home confinement due to the COVID‐19 outbreak: Practical recommendations from a task force of the European CBT‐I Academy. J Sleep Res. 2020;3:e13052.

Mukhtar MS. Mental health and psychosocial aspects of coronavirus outbreak in Pakistan: psychological intervention for public mental health crisis. Asian J Psychiatr. 2020;51:102069.

Mir AM. Keeping mothers safe while battling Covid-19. Available at https:// tribune. /story/2180499/6-keeping-mothers-safe-battling-covid-19/. Accessed on 20 August 2020.

CDC. Pregnancy and breastfeeding. Available at Accessed on 20 August 2020.

UNICEF. Millions of pregnant mothers and babies born during COVID-19 pandemic threatened by strained health systems and disruptions in services - UNICEF. Available at https:// www. unicef. org/rosa/press-releases/millions-pregnant-mothers-and-babies-born-during-covid-19-pandemic-threatened. Accessed on 20 August 2020.

Li W, Yang Y, Liu ZH, Zhao YJ, Zhang Q, Zhang L, et al. Progression of mental health services during the COVID-19 outbreak in China. Int J Biol Sci. 2020;16(10):1732.

AKU. COVID-19: Risks and precautions during pregnancy and after childbirth. Available at Accessed on 20 August 2020.

The News International. Covid disparities. Available at Accessed on 20 August 2020.

Kowal M, Martín CT, Ikizer G, Rasmussen J, Eichel K, Studzinska A, et al. Who is the most stressed during covid-19 isolation? Asian J Psychiatr. 2020;1:102-9.