Procedures
Data collection and input were automatically conducted. All data from the questionnaires were reviewed and the following questionnaires were excluded: (1) maternal age <14 or >60 years; (2) non-pregnant, with the answer of ”already delivered” or ”<0 or >45 weeks of gestational age”; (3) answers with wrong format; (4) illogical answers, choosing two options that contradict each other in multiple-choice questions. Figure 2 shows the flow chart of our study sample selection.
The residency was based on both the city they registered for check-up (Wuhan or Chongqing) and the region they actually in at the time of survey. As a result of the Chinese Festival travel rush, these two addresses may not be exactly the same sometimes. The registration area was used as the residency for the following analyses. As a reference, a map of the actual area is included in the study sample flow chart (Figure 2).
We classified those aged ≧35 years as elder gravida. Participants were assigned into three gestational age (GA) groups: (1) the first trimester: GA <14 complete weeks, (2) the second trimester: GA from 14 to 27+6 weeks, (3) the third trimester: GA ≧28 weeks. Parity was divided into nullipara and multipara. Other grouping standards are in accordance with the categorical options in the questionnaire.
Items measuring attitudes towards COVID-19 were designed on a five-point scale from ”totally disagree” to ”strongly agree”. Though this part was on the basis of three sections (Appendix), these 11 questions were analyzed separately.
The anxiety status was assessed using the Chinese version of the SAS scale 25, and the responses to the scale were summed as a standard score and a degree of anxiety by an established method24,25: the scores from 20 items were calculated to obtain a raw score ranging from 20 to 80, and the standard score was calculated using the raw score multiplied by 1.25; the standard score ≧50 indicates anxiety status; specifically, the standard score 50-59, 60-69 and ≧70 were considered mild, moderate and severe anxiety respectively.
The obstetrical choices included: (1) online consultation; (2) hospital preference; (3) prenatal visit or delivery schedule; (4) decision on the mode of delivery, child-feeding and postnatal resting; (5) the five-degree subjective impact on pregnancy of the items including changing schedule, reducing activities, and possible screening examination (e.g., chest CT scan). These unstructured questions were analyzed one-by-one.