Implications of COVID-19 Induced Anxiety of Pregnant Women on Neonatal Health

Anxiety disorders during pregnancy can lead to adverse neonatal outcomes in different ways. This research aimed to investigate the association between anxiety levels in pregnant women and neonatal health outcomes during COVID-19 pandemic. This was a prospective cohort study in which pregnant women were recruited via a prenatal teaching clinic between March and July 2020, at Hafez Hospital in Shiraz, Iran. Neonate health outcomes were recorded, including the living status, gestational age, route of delivery, the APGAR at the 1st and the 5th minutes of life, anomalies, head circumference, weight, and height. To compare the effect of stress and anxiety of mothers during the first trimester of pregnancy on neonate health outcomes, we used the short form of the Depression Anxiety Stress Scales (DASS-21) score available from the previous phase of the study. In the present work, 146 pregnant women were recruited. There was no significant difference in terms of living status, APGAR scores, and congenital anomalies of neonates born to mothers without anxiety (n=121) compared to those with an abnormal level of COVID-19-related anxiety (n=25) during their pregnancy (P>0.05 for all). Furthermore, our results revealed no association between COVID-19-related anxiety during pregnancy and poor neonatal outcomes, such as low birth weight, NICU admission, macrocephaly, or microcephaly (P=0.85). The obtained findings revealed that COVID-19-induced anxiety did not affect neonatal clinical outcomes. However, the concern still exists regarding the potential effect of COVID-19-induced anxiety on pregnancy and neonatal outcomes. Further investigation could be thus recommended using laboratory assessments.