Did COVID-19 challenges psychological resilience of pregnant women? an evidence-based review with recommendation

Betsy Chakraborty


Any conflict, extreme stress, emergency situation, natural disaster multiplies mental health hazard. History of Spanish flu outbreak witnesses the damage of pregnant women i.e. as short-term impact inflate the rate of preterm deliveries and the baby’s who were in womb persist the risk of developing medical and psychiatric disorders like diabetes, coronary artery disease, cancer and schizophrenia in future. Pregnant women are considered more vulnerable for COVID-19 as pregnancy makes women prone to respiratory pathogen, which leads to severe pneumonia. Women are three times more prone to anxiety than man. Continuous strict restriction on consultancy visit and gathering, rumors and contradictory information, uncertainty about delivery plan & health of mother and baby indirectly affected women’s emotional and psychological health of perinatal period. Fear and stigma grasps them when anticipating social discrimination and segregation from baby if they become positive. Growing evidence shows psychological impacts i.e. high levels of anxiety, depression and stress are prevalent among pregnant women irrespective of geographical and cultural boundaries across countries like India, China, Canada, UK, Australia and Israel. WHO recommended for adopting holistic approach of care, consideration of major two aspects (i.e. clinical and psychological experiences) in pandemic situations for helping in better positive coping of mother, baby and family members. This present review aimed to find out triggering factors, challenges, major types of psychological issues, consequences of psychological impact among perinatal women due to COVID-19 and want to prescribe evidence-based resolution and preparedness for combating such pandemic situation.


COVID-19, Perinatal period, Psychological impact, Anxiety, Depression, Stress

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Nodoushan RJ, Alimoradi H, Nazari M. Spiritual Health and Stress in Pregnant Women During the Covid-19 Pandemic. SN Compr Clin Med. 2020:1-7.

Qi M, Li X, Liu S, Li Y, Huang W. Impact of the COVID-19 epidemic on patterns of pregnant women's perception of threat and its relationship to mental state: A latent class analysis. PLoS One. 2020;15(10):239697.

Mappa I, Distefano FA, Rizzo G. Effects of coronavirus 19 pandemic on maternal anxiety during pregnancy: a prospectic observational study. J Perinat Med. 2020;48(6):545-50.

WHO. Coronavirus disease (COVID-19) Situation Report-123, 2020. Available at: EBandSL/eb027e.pdf. Accessed on 23 May 2020.

WHO. WHO corona virus (COVID-19) dashboard, 2021. Available at: Accessed on 8 March 2021.

Ali NA, Shahil FA. Maternal mental health amidst the COVID-19 pandemic. Asian J Psychiatr. 2020;54:102261.

WHO. Maternal mental health, 2020. Available at:

aternal_mental_health/en/. Accessed on 30 March, 2020.

Topalidou A, Thomson G, Downe S. COVID-19 and maternal mental health: Are we getting the balance right?. Lancet 2020;7(4):15-6.

Farewell CV, Jewell J, Walls J, Leiferman JA. A Mixed-Methods Pilot Study of Perinatal Risk and Resilience During COVID-19. J Prim Care Community Health. 2020;11:74.

Kajdy A, Feduniw S, Ajdacka U, Modzelewski J, Baranowska B, Sys D, et al. Risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic: A web-based cross-sectional survey. Medicine (Baltimore). 2020;99(30):21279.

Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the preva- lence and incidence of perinatal depression. J Affect Disord. 2017;2(19):86-92.

Davenport MH, Meyer S, Meah VL, Strynadka MC, Khurana R. Moms Are Not OK: COVID-19 and Maternal Mental Health. Maternal Mental Health. Front Glob Womens Health. 2020;1(1):1-6.

Ghosh A, Sarkar S. The coronavirus (COVID-19) pandemic's impact on maternal mental health and questionable healthcare services in rural India. Int J Health Plann Manag. 2020;35(6):1626-8.

Salehi L, Rahimzadeh M, Molaei E, Zaheri H, Esmaelzadeh SS. The relationship among fear and anxiety of COVID-19, pregnancy experience, and mental health disorder in pregnant women: A structural equation model. Brain Behav. 2020;10(11):1835.

Moyer CA, Compton SD, Kaselitz E, Muzik M. Pregnancy-related anxiety during COVID-19: a nationwide survey of 2740 pregnant women. Arch Womens Ment Health. 2020;23(6):757-65.

Khatri S, Murthy SCAK, Hashim SCU, Kuruthukulangara CS, Kumari A, Lele CPR. Psychological status of pregnant women during COVID 19 Pandemic: A cross sectional study from Mumbai. J of marine medical society. 2020;22(1): 114-7.

Chen S, Zhuang J, Chen Q, Tan X. Psychological Investigation on Pregnant Women During The Outbreak of COVID 19. Res Square. 2020;1-17.

Berthelot N, Lemieux R, Garon BJ, Drouin MC, Martel É, Maziade M. Uptrend in distress and psychiatric symptomatology in pregnant women during the coronavirus disease 2019 pandemic. Acta Obstet Gynecol Scand. 2020;99(7):848-55.

Taubman BAO, Chasson M, Abu SS, Weiss E. Distress and anxiety associated with COVID-19 among Jewish and Arab pregnant women in Israel. J Reprod Infant Psychol. 2020;38(3):340-8.

Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. Int J Environ Res Public Health. 2020;17(5):1729.

Zhou Y, Shi H, Liu Z, Peng S, Wang R, Qi L, et al. The prevalence of psychiatric symptoms of pregnant and non-pregnant women during the COVID-19 epidemic Transl Psychiatry. 2020;10(1):319.

Mizrak SB, Kabakci EN. The experiences of pregnant women during the COVID-19 pandemic in Turkey: A qualitative study. Women Birth. 2021;34(2):162-9.

Qing XZ, Xiu MJ, Yan LRN, Gui HL, Yu PL, Yu LK, et al. The influence of psychological response and security sense on pregnancy stress during the outbreak of coronavirus disease 2019: A mediating model. J of Clinical Nurs. 2020;29:4248-52.

Glover V. Annual Research Review: Prenatal stress and the origins of psychopathology: an evolutionary perspective. J Child Psychol Psychiatry. 2011;52(4):356-67.

Hughes ME, Waite LJ, Hawkley LC, Cacioppo JT. A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies. Res Aging. 2004;26(6):655-72.

Thapa SB, Mainali A, Schwank SE, Acharya G. Maternal mental health in the time of the COVID-19 pandemic. Acta Obstet Gynecol Scand. 2020;99(7):817-8.

Feng J. COVID-19 Fuels Domestic Violence In China, 2020. Available at: domestic-violence-in-china/. Accessed on 24 March 2020.

Hermann A, Fitelson EM, Bergink V. Meeting Maternal Mental Health Needs During the COVID-19 Pandemic. JAMA Psychiatry. 2021;78(2):123-4.

Wiradnyani LA, Khusun H, Achadi EL, Ocviyanti D, Shankar AH. Role of family support and women's knowledge on pregnancy-related risks in adherence to maternal iron-folic acid supplementation in Indonesia. Public Health Nutr. 2016;19(15):2818-28.

Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395(10226):809-15.

Nodoushan RJ, Alimoradi H, Nazari M. Spiritual Health and Stress in Pregnant Women During the Covid-19 Pandemic. SN Compr Clin Med. 2020; 16:1-7.

Dong Y, Mo X, Hu Y, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics. 2020;1-30.

Li S, Wang Y, Xue J, Zhao N, Zhu T. The Impact of COVID-19 Epidemic Declaration on Psychological Consequences: A Study on Active Weibo Users. Int J Environ Res Public Health. 2020;17(6):2032.