Table 3.

Emotional state of pregnant women during the COVID-19 pandemic.

Ref.	Design	Objective	Materials and Methods	Results
Wu, China [112]	Cross-sectional study, multicenter	To examine the impact of COVID-19 on the prevalence of depressive symptoms and anxiety among pregnant women across China	G.1: 2839 pregnant women, recruited from 1 January to 20 January G.2: 1285 pregnant women, recruited from 21 January to 8 February (after the declaration of the COVID-19 epidemic); assessment: EPDS	Pregnant women from G.2. had significantly higher rates of depressive symptoms (p = 0.02) and more likely had thoughts of self-harm (p = 0.005). The depressive rates were associated with the number of COVID-2019 cases, suspected infections, and deaths.
Saccone, Italy [113]	Cross-sectional study	To evaluate the psychological impact and anxiety during the COVID-19 pandemic	One hundred pregnant women (17 in the first, 35 in the second, and 48 in the third trimester). Assessment: IES-R to measure the psychological impact of COVID-19 and six-item short form of the state scale of STAI and VAS to measure anxiety due to COVID-19	Most women rated the psychological impact of the COVID-19 outbreak as severe and reported high anxiety regarding the vertical transmission of the disease. The anxiety and psychological impact were more among women who were in the first trimester of pregnancy.
Zanardo, Italy [116]	Nonconcurrent case–control study	To explore whether quarantine and hospital policies increased psychoemotional distress among women in the early postpartum period who were giving birth in a COVID-19 area in Italy	G.1: (COVID-19) women aged over 18, delivery between 8 March 8 and 3 May 2020 G.2: (control) women aged over 18, lived in the same geographic area, and delivered from March to May 2019 Assessment: EPDS	The COVID-19 study group had significantly higher mean EPDS scores (p < 0.001) and higher scores for anhedonia and depression. Concerns about the risk of COVID-19 and quarantine measures during the COVID-19 pandemic affected the emotions of mothers, worsening their depressive symptoms.
Qiu Ju Ng, China [114]	Cross-sectional study	Assessment of knowledge about COVID-19 and the levels of depression, stress, and anxiety in pregnant women	324 pregnant women, From 31 March to 25 April, assessment: DASS-21, a survey about women’s knowledge of COVID-19	Women who believed that the SARS-CoV-2 could be transmitted to the baby during pregnancy and could cause fetal anomalies and intrauterine death had elevated levels of anxiety.
Effati-Daryani, Iran [118]	Cross-sectional study	The levels of depression, stress, and anxiety and their predictors in Iranian pregnant women during the COVID-19 pandemic	205 pregnant women, examined from of March to April 2020, no one had COVID-19 Assessment: DASS-21, sociodemographic questionnaire	Marital life satisfaction, a high level of spousal education, and income were associated with reduced symptoms of stress, anxiety, and depression in pregnant women.
Zhou, China [117]	Cross-sectional study	Assessment of depression in pregnant women and comparison of the emotional level with nonpregnant women	544 pregnant and 315 nonpregnant women from 41 cities of China, they were examined from 28 February to 12 March 2020 Assessment: PHQ-9, GAD-7, ISI, SCL-90, PCL-5	During the pandemic, pregnant women had lower levels of depression, anxiety, insomnia, and PTSD compared to women at reproductive age but who are not currently pregnant

EPDS—Edinburgh Postnatal Depression Scale; IES-R—Impact of Event Scale-Revised; STAI—Spielberger State-Trait Anxiety Inventory; VAS—Visual Analog Scale; DASS-21—Depression, Anxiety and Stress Scale—21; PHQ-9—The Patient Health Questionnaire; GAD-7—General Anxiety Disorders-7; ISI—Insomnia Severity Index; SCL-90—The Symptom Chechlist-90; PCL-5—Post-traumatic Stress Disorder Checklist-5; PTSD—Post-traumatic stress disorder.