| Objective : We investigated the anxiety state and obstetrical care intention of pregnant women in different areas during the outbreak of COVID-19,then we put forward and hope to verify a theoretical model of "background-cognition-anxiety state-obstetric medical behavior-pregnancy outcome".Methods:1.we carried out this self-report questionnaire survey of pregnant women in Wuhan and Chongqing.The information about their background,attitudes,anxiety status and medical choices were collected.And then we described and compared the city-based distribution of these factors to explain the relationship between the anxiety state of pregnant women and their choice of obstetrical care.2.we collected data on online obstetric consultations and participants’ satisfaction through YYT platform in the mild,moderate and severe epidemic areas which were defined according to the local confirmed cases.The primary outcomes were the reasons for online consultations by the severity of the epidemic.Chisquared test was used in the study.3.We retrospectively collected data of pregnancy outcomes among women hospitalized in the Obstetrics of Maternal and Child of Health Hospital of Hubei Province before and during the pandemic.The data included(1)changes of pregnant background,(2)rate of pregnancy comorbidity and complication,(3)indications for cesarean section,(4)birth defects,and(5)stillbirth.The distributions of the above factors in different stages were described and compared.Results: 1.We retrieved 1947 valid questionnaires,among which there were 932 from Wuhan and 1015 from Chongqing.Slight difference between two cities could be seen in personal and pregnant background,while epidemic background,undoubtedly,was quite different.The rate of anxiety was 24·47% for pregnant mothers in Wuhan,while 10·44% in Chongqing.Influence factors of anxiety included area,household income and some attitudes.Generally,only 2.61% of participants in Wuhan chose to complete their scheduled check face-to-face(21.61% in Chongqing),However,47.29% of participants in Wuhan intend to postpone hospital delivery(31.03% in Chongqing),12.66% of pregnant women in Wuhan would change delivery mode from vaginal delivery to caesarean section consequent upon the epidemic(6.01% in Chongqing).2.In this part,there were 2599 participants,of whom 448(17.24%),1332(51.25%)and 819(31.51%)women were from the mild,moderate and severe epidemic areas,respectively.The distribution of the amount of online consultations was significantly different not only in different areas(p<0.001),but also in different trimesters(p<0.001).3.A total of 52,737 hospitalized pregnant women were admitted from 2019 to 2020,with 30,027 and 22,710,respectively.The number of advanced maternal age and the incidence of common complications were significantly increased in 2020,with a higher cesarean delivery rate(49.77% vs 46.58%).The rate of stillbirth was significantly increased between February and April of 2020 than the same period of 2019.Conclusions: Geography,family income and some attitudes towards COVID-19 are indeed related to the anxiety state of pregnant women,which will further affect their obstetric care-seeking behaviours,thus affecting the outcome of pregnancy. |
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