Introduction
In late December 2019, China reported a cluster of pneumonia caused by a
novel coronavirus (2019-nCoV).1 This pathogen was
eventually named SARS-CoV-2 by WHO,2 with its
associated disease named COVID-19.3 As of 3 April
2020, 81,620 cases of infection have been confirmed in China, especially
in Hubei Province (N=67,802),4 however, SARS-CoV-2 has
spread to at least 151 countries/territories/areas with over 800,000
cases outside of China,5 leading to the successive WHO
announcements of ”public enemy number one” and ”a very high level of
global risk”.6,7
The rapid transmission and life-threatening characteristics of COVID-19
have been reported transparently in China currently. The public,
influenced by both accurate and erroneous news, are
stressed.8 All provinces in mainland China with
confirmed cases of COVID-19 have adopted the first-level PHE responses,
including travel bans and executive orders on daily
life.9 Consequently, the Chinese New Year holiday was
seriously disrupted and public anxiety was aggravated about
life-convenience and established arrangements.
Pregnant women, as a vulnerable population,10 may be
of a particular concern, as anxiety itself has already been documented
as a common psychological problem during pregnancy.11Recently, the discussion on COVID-19 complicated pregnancy mainly
focused on the therapeutic aspect 12-14 while little
is known regarding their mental status and psychological needs during
the epidemic.
Prenatal care is vital to a healthy pregnancy.15Recently, the emergency traffic bans have made some medical resources
inaccessible and the anxiety may deter women to attend routine prenatal
care,16 all of which could eventually threaten
pregnancy outcomes. Of particular importance are ectopic pregnancy,
first-trimester spontaneous abortion, delayed detection of fetal
congenital anomalies, uncontrolled hypertension and preeclampsia (which
may develop into heart failure), post-term delivery and
dystocia.17-19 These obstetrical adverse events may
have more devastating consequences than COVID-19 infection
itself.8,20,21 Certainly, professional advice on
choosing obstetrical care was desired 22, but we know
little about women’s decisions during the COVID-19 and other PHEs.
We conducted a survey in pregnant women in Wuhan (the hardest-hit area)
and Chongqing (a neighboring city) during the COVID-19 outbreak, to
investigate anxiety status and its influence factors, to demonstrate and
explain the vital prenatal choices, and finally to guide social and
medical practice.