COVID-19 and mental health of pregnant women in Ceará, Brazil




Pregnant women, Coronavirus infections, psychology, Mental disorders, Social isolation


OBJECTIVE To assess the perceptions of pregnant women about COVID-19 and the prevalence of common mental disorders during the implemented social distancing period. METHODS This was an observational, cross-sectional study using digital media, of pregnant women exposed to social distancing due to the COVID-19 pandemic, in Fortaleza, Ceará, Northeastern Brazil. Common mental disorders were estimated using the modified Self-Report Questionnaire-20 (SRQ-20) scale, and the feelings towards COVID-19 were assessed using the Fear of COVID-19 scale through telephone calls made in May 2020. COX multivariate regression models were used to verify the associations. RESULTS Of the 1,041 pregnant women, 45.7% (95%CI: 42.7–48.8) had common mental disorders (CMD). All items of the Fear of COVID-19 Scale showed a significant association with the prevalence of CMD (p < 0.001). A CMD risk gradient was observed, going from a prevalence ratio of 1.52 (95%CI: 1.13–2.04) in pregnant women with two positive items to 2.70 (95%CI: 2.08–3.51) for those with four positive items. Early gestational age and the lack of prenatal care were also associated with CMD. CONCLUSIONS The prevalence of common mental disorders in pregnant women was high during the period of social distancing and was aggravated by negative feelings towards COVID-19.


Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20(5):533-4. [ Links ]

Ministério da Saúde (BR), Secretaria de Vigilância em Saúde. Doença pelo Coronavírus COVID-19. Bol Epidemiol Espec. 2020 [cited 2020 Sep 1];(40):1-75. Available from: [ Links ]

Saccone G, Florio A, Aiello F, Venturella R, De Angelis MC, Locci M, et al. Psychological impact of coronavirus disease 2019 in pregnant women. Am J Obstet Gynecol. 2020;223(2):293-5. [ Links ]

Costa DO, Souza FIS, Pedroso GC, Strufaldi MWL. Mental disorders in pregnancy and newborn conditions: longitudinal study with pregnant women attended in primary care. Cienc Saude Coletiva. 2018;23(3):691-700. [ Links ]

National Collaborating Centre for Mental Health (UK). Common mental health disorders: identification and pathways to care. Leicester (UK): British Psychological Society; 2011. [ Links ]

Lucchese R, Simões ND, Monteiro LHB, Vera I, Fernandes IL, Castro PA, et al. Factors associated with the probability of common mental disorders in pregnant women: a cross-sectional study. Esc Anna Nery. 2017;21(3):e20160094. [ Links ]

Inui M, Yokoyama Y. [Childcare burdens perceived by mothers with an inter-pregnancy interval less than 12 months]. Nihon Koshu Eisei Zasshi. 2019;66(10):638-48. Japanese. [ Links ]

Grigoriadis S, VonderPorten EH, Mamisashvili L, Tomlinson G, Dennis CL, Koren G, et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry. 2013;74(4):e321-41. [ Links ]

Mate A, Reyes-Goya C, Santana-Garrido A, Vázquez CM. Lifestyle, maternal nutrition and healthy pregnancy. Curr Vasc Pharmacol. 2021;19(2)132-40. [ Links ]

Kotabagi P, Fortune L, Essien S, Nauta M, Yoong W. Anxiety and depression levels among pregnant women with COVID-19. Acta Obstet Gynecol Scand. 2020;99(7):953-4. [ Links ]

Vandenbroucke JP, Elm E, Altman DG, Gotzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Int J Surg. 2014;12(12):1500-24. [ Links ]

Beusenberg M, Orley JH, compilators; World Health Organization. Division of Mental H. A User’s guide to the self reporting questionnaire (SRQ). Geneva: World Health Organization; 1994 [cited 2020 Sep 1]. Available from: [ Links ]

Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The Fear of COVID-19 Scale: development and initial validation. Int J Ment Health Addict. 2020 Mar:1-9. Epub ahead of print [ Links ]

Barros AJD, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3:21. [ Links ]

Ornell F, Moura HF, Scherer JN, Pechansky F, Kessler FHP, Diemen L. The COVID-19 pandemic and its impact on substance use: implications for prevention and treatment. Psychiatry Res. 2020;289:113096. [ Links ]

Reardon S. Ebola’s mental-health wounds linger in Africa. Nature. 2015;519(7541):13-14. [ Links ]

Purgato M, Gastaldon C, Papola D, Ommeren M, Barbui C, Tol WA. Psychological therapies for the treatment of mental disorders in low- and middle-income countries affected by humanitarian crises. Cochrane Database Syst Rev. 2018;7:CD011849-CD011849. [ Links ]

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. [ Links ]

World Health Organization. COVID-19 and the Need for Action on Mental Health. Policy brief. Geneva (CH): WHO; 2020. [ Links ]

Kumar A, Somani A. Dealing with Corona virus anxiety and OCD. Asian J Psychiatr. 2020;51:102053. [ Links ]

Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-7. [ Links ]

Torales J, O’Higgins M, Castaldelli-Maia JM, Ventriglio A. The outbreak of COVID-19 coronavirus and its impact on global mental health. Int J Soc Psychiatry. 2020;66(4):317-20. [ Links ]

Wu Y, Zhang C, Liu H, Duan C, Li C, Fan J, et al. Perinatal depressive and anxiety symptoms of pregnant women during the coronavirus disease 19 outbreak in China. Am J Obstet Gynecol. 2020;223(2):240.e1-240.e9. [ Links ]

Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016;27(2):89-94. [ Links ]

Faure-Bardon V, Salomon LJ, Leruez-Ville M, Ville Y. How should we treat pregnant women infected with SARS-CoV-2? BJOG. 2020;127(9):1050-2. [ Links ]

Rashid Fakari F, Simbar M. Coronavirus pandemic and worries during pregnancy; a letter to editor. Arch Acad Emerg Med. 2020;8(1):e21. [ Links ]

Banerjee D, Rai M. Social isolation in Covid-19: the impact of loneliness. Int J Soc Psychiatry. 2020;66(6):525-7. [ Links ]

Malay DS. COVID-19, pandemic, and social distancing. J Foot Ankle Surg. 2020;59(3):447-8. [ Links ]

Nicol GE, Piccirillo JF, Mulsant BH, Lenze EJ. Action at a distance: geriatric research during a pandemic. J Am Geriatr Soc. 2020;68(5):922-5. [ Links ]

Plagg B, Engl A, Piccoliori G, Eisendle K. Prolonged social isolation of the elderly during COVID-19: between benefit and damage. Arch Gerontol Geriatr. 2020;89:104086. [ Links ]




How to Cite

Machado, M. M. T., Rocha, H. A. L., Castro, M. C. ., Sampaio, E. G. M., Oliveira, F. A., Silva, J. P. F. da, Aquino, C. M. de ., Sousa, L. de A. R. de ., Carvalho, F. H. C., Altafim, E. R. P. ., & Correia, L. L. . (2021). COVID-19 and mental health of pregnant women in Ceará, Brazil. Revista De Saúde Pública, 55, 37.



Original Articles