The risk and protective factors of heightened prenatal anxiety and depression during the COVID-19 lockdown

Stefania Vacaru*, Roseriet Beijers, Pamela D. Browne, Mariëlle Cloin, Hedwig Van Bakel, Marion I. Van Den Heuvel, Carolina De Weerth

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

21 Citations (Scopus)
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While pregnant women are already at-risk for developing symptoms of anxiety and depression, this is heightened during the COVID-19 pandemic. We compared anxiety and depression symptoms, as indicators of psychological distress, before and during COVID-19, and investigated the role of partner, social network and healthcare support on COVID-19-related worries and consequently on psychological distress. A national survey, conducted during the first lockdown in The Netherlands, assessed COVID-19 experiences and psychological distress (N = 1421), whereas a comparison sample (N = 1439) was screened for psychological distress in 2017–2018. During COVID-19, the percentage of mothers scoring above the questionnaires’ clinical cut-offs doubled for depression (6% and 12%) and anxiety (24% and 52%). Women reported increased partner support during COVID-19, compared to pre-pandemic, but decreased social and healthcare support. Higher support resulted in lower COVID-19-related worries, which in turn contributed to less psychological distress. Results suggest that a global pandemic exerts a heavy toll on pregnant women’s mental health. Psychological distress was substantially higher during the pandemic than the pre-pandemic years. We identified a protective role of partner, social, and healthcare support, with important implications for the current and future crisis management. Whether increased psychological distress is transient or persistent, and whether and how it affects the future generation remains to be determined.
Original languageEnglish
Article number20261
Number of pages11
JournalScientific Reports
Publication statusPublished - 2021


  • Adult
  • COVID-19/epidemiology
  • Depression
  • Female
  • Humans
  • Mental Health
  • Netherlands
  • Pandemics
  • Pregnancy
  • Pregnant Women/psychology
  • Psychological Distress
  • Quarantine/psychology
  • Stress, Psychological
  • Surveys and Questionnaires
  • Women's Health


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