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      Variations in health behaviors among pregnant women during the COVID-19 pandemic

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          Abstract

          Purpose

          To examine changes in lifestyle behaviors early in the COVID-19 pandemic among pregnant women.

          Materials and methods

          A cross-sectional internet-based survey was completed by 706 pregnant women (mean age 29.6 years ± 3.2) residing in the United States in May 2020 to assess self-reported changes in diet, physical activity, and sleep during the COVID-19 pandemic. Logistic regression analyses examined whether sociodemographic, clinical, and pandemic-related characteristics were associated with health behavior changes.

          Results

          Approximately 17% of women reported their diets worsened during the COVID-19 pandemic, 42% reported improvements, and 41% reported no change. For physical activity, 22% reported they stopped being active, 2% reported they became active, and 76% reported no change. Nearly one-third of participants reported getting less sleep. The factors consistently associated with adverse lifestyle changes (worse diet, stopped being active, and reduced sleep) were experiences of pregnancy complications, loss of income due to COVID-19, and changes in social connections due to COVID-19.

          Conclusions

          A substantial proportion of pregnant women reported adverse lifestyle changes during the COVID-19 pandemic. Interventions during the pandemic to optimize health behaviors in pregnant women, especially among those with pregnancy complications, should address economic disadvantages and social support.

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          Most cited references34

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          Is Open Access

          OpenSAFELY: factors associated with COVID-19 death in 17 million patients

          COVID-19 has rapidly impacted on mortality worldwide. 1 There is unprecedented urgency to understand who is most at risk of severe outcomes, requiring new approaches for timely analysis of large datasets. Working on behalf of NHS England we created OpenSAFELY: a secure health analytics platform covering 40% of all patients in England, holding patient data within the existing data centre of a major primary care electronic health records vendor. Primary care records of 17,278,392 adults were pseudonymously linked to 10,926 COVID-19 related deaths. COVID-19 related death was associated with: being male (hazard ratio 1.59, 95%CI 1.53-1.65); older age and deprivation (both with a strong gradient); diabetes; severe asthma; and various other medical conditions. Compared to people with white ethnicity, black and South Asian people were at higher risk even after adjustment for other factors (HR 1.48, 1.29-1.69 and 1.45, 1.32-1.58 respectively). We have quantified a range of clinical risk factors for COVID-19 related death in the largest cohort study conducted by any country to date. OpenSAFELY is rapidly adding further patients’ records; we will update and extend results regularly.
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            Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey

            Highlights • The COVID-19 outbreak significantly affects the mental health of Chinese public • During the outbreak, young people had a higher risk of anxiety than older people • Spending too much time thinking about the outbreak is harmful to mental health • Healthcare workers were at high risk for poor sleep
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              Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey

              Background: Public health recommendations and governmental measures during the COVID-19 pandemic have resulted in numerous restrictions on daily living including social distancing, isolation and home confinement. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on health behaviours and lifestyles at home is undefined. Therefore, an international online survey was launched in April 2020, in seven languages, to elucidate the behavioural and lifestyle consequences of COVID-19 restrictions. This report presents the results from the first thousand responders on physical activity (PA) and nutrition behaviours. Methods: Following a structured review of the literature, the “Effects of home Confinement on multiple Lifestyle Behaviours during the COVID-19 outbreak (ECLB-COVID19)” Electronic survey was designed by a steering group of multidisciplinary scientists and academics. The survey was uploaded and shared on the Google online survey platform. Thirty-five research organisations from Europe, North-Africa, Western Asia and the Americas promoted the survey in English, German, French, Arabic, Spanish, Portuguese and Slovenian languages. Questions were presented in a differential format, with questions related to responses “before” and “during” confinement conditions. Results: 1047 replies (54% women) from Asia (36%), Africa (40%), Europe (21%) and other (3%) were included in the analysis. The COVID-19 home confinement had a negative effect on all PA intensity levels (vigorous, moderate, walking and overall). Additionally, daily sitting time increased from 5 to 8 h per day. Food consumption and meal patterns (the type of food, eating out of control, snacks between meals, number of main meals) were more unhealthy during confinement, with only alcohol binge drinking decreasing significantly. Conclusion: While isolation is a necessary measure to protect public health, results indicate that it alters physical activity and eating behaviours in a health compromising direction. A more detailed analysis of survey data will allow for a segregation of these responses in different age groups, countries and other subgroups, which will help develop interventions to mitigate the negative lifestyle behaviours that have manifested during the COVID-19 confinement.
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                Author and article information

                Journal
                Midwifery
                Midwifery
                Midwifery
                Elsevier Ltd.
                0266-6138
                1532-3099
                22 January 2021
                April 2021
                22 January 2021
                : 95
                : 102929
                Affiliations
                [a ]Department of Health and Human Physiology and Department of Epidemiology, University of Iowa, Iowa City, IA, United States
                [b ]Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
                [c ]Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
                Author notes
                [* ]Corresponding Author: Kara M. Whitaker, E116 Field House, Iowa City, IA 52242. Phone: 319-335-7907
                Article
                S0266-6138(21)00008-5 102929
                10.1016/j.midw.2021.102929
                7825911
                33508485
                deda3b10-6c9f-4374-b85c-3dbf9cc56e79
                © 2021 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 19 October 2020
                : 14 December 2020
                : 18 January 2021
                Categories
                Article

                Obstetrics & Gynecology
                covid-19,pregnancy,diet,physical activity,sleep
                Obstetrics & Gynecology
                covid-19, pregnancy, diet, physical activity, sleep

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