The structural analysis of mental disorders in pregnant women with COVID‑19 pneumonia

Alimova Kh.P., Voitova G.A.

1) Republican Specialized Infectious Diseases Zangiota-1 Hospital, Tashkent Region, Uzbekistan; 2) Tashkent City Center of Women's Reproductive Health, Tashkent, Uzbekistan
Objective: To make a structural analysis of psychoemotional disorders in pregnant women with COVID-19 pneumonia. Hamilton Anxiety Rating Scale
Materials and methods: The prospective investigation enrolled 3080 pregnant women infected with SARS-CoV-2; of them 889 were in the first trimester; 1056 and 1135 were in the second and third trimesters, respectively. The vast majority (64.3%; 1980/3080) of cases were diagnosed with moderate COVID-19 pneumonia. Psychoemotional disorders were identified and its severities were assessed using. The Hamilton Anxiety Rating Scale-7 was used to identify psychoemotional disorders and to assess their severity; posttraumatic stress disorders (PTSDs) were detected using the IES-6 and depressive syndrome was identified using the PHQ-9.
Results: A considerable part (80.1%; 2467/3080) of pregnant women during COVID-19 infection was noted to have psychoemotional disorders; with 100% (n=1056) in the second trimester of pregnancy. Depressive syndrome was evident in the first trimester, while anxiety states and PTSDs were more characteristic for the second trimester. There was a higher incidence of mixed mental disorders with the higher pregnancy status. The most of pregnant women with psychoemotional disorders (51.5%; 1585/3080) was assigned to a cohort of patients with moderate COVID-19; in the same pattern of moderate COVID-19 pneumonia, there was a preponderance of cases of PTSDs (59.5%; 1178/1980).
PTSDs showed a practically equal incidence among pregnant women with severe and very severe COVID-19 (54.3 and 52.7%, respectively), as well as anxiety (28.6 and 28.4%, respectively) and depressive (17.1 and 18.9, respectively) states. The high incidence of mixed psychoemotional disorders was characteristic for pregnant women with severe and very severe COVID-19 pneumonia (46.7 and 52.7%, respectively, which indicates the aggravation of the clinical presentations of psychoemotonal disorders during COVID-19 pneumonia progression.
Conclusion: Psychoсихоemotional disorders during COVID-19 infection are characteristic for a considerable part of pregnant women. Moreover, their early detection using specialized questionnaire scales (HARS-7, IES-6, and PHQ-9) can be favorable to the timely inclusion of a psychological component of treatment policy and prevent poor perinatal and social consequences.

Authors' contributions: Alimova Kh.P. – development of the design of the investigation, analysis of the findings, writing the text of the manuscript; Voitova G.A. – collection of data to be analyzed and their statistical processing, review of publications on the topic of the article, writing the text of the manuscript.
Conflicts of interest: The authors declare that there are no possible conflicts of interest.
Funding: The investigation has not been sponsored.
Ethical Approval: The investigation has been approved by the Ethics Committee, Republican Specialized Infectious Diseases Zangiota-1 Hospital, Ministry of Health of Uzbekistan.
Patient Consent for Publication: During the clinical trial, the patients signed an informed consent form to publication of their data.
Authors' Data Sharing Statement: The data supporting the conclusions of this investigation are available upon request from the authors.
For citation: Alimova Kh.P., Voitova G.A.
The structural analysis of mental disorders in pregnant women with COVID-19 pneumonia.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (5): 100-107 (in Russian)


COVID-19 pneumonia
posttraumatic stress disorder


  1. ВОЗ. Практические аспекты организации ведения случаев COVID-19 в лечебных учреждениях и на дому. Женева: ВОЗ; 2020. [WHO. Practical aspects of COVID-19 case management in health facilities and homes. Geneva: WHO; 2020. (in Russian)].
  2. Ayaz R., Hocaoğlu M., Günay T., Yardımcı O.D., Turgut A., Karateke A. Anxiety and depression symptoms in the same pregnant women before and during the COVID-19 pandemic. J. Perinat. Med. 2020; 48(9): 965-70.
  3. Poon L.C., Yang H., Lee J.C., Copel J.A., Leung T.Y., Zhang Y. et al. ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals. Ultrasound Obstet. Gynecol. 2020; 55(5): 700-8.
  4. Di Mascio D., Khalil A., Saccone G., Rizzo G., Buca D., Liberati M. et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am. J. Obstet. Gynecol. MFM. 2020; 2(2): 100107.
  5. Juan J., Gil M.M., Rong Z., Zhang Y., Yang H., Poon L.C. Effect of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcome: systematic review. Ultrasound Obstet. Gynecol. 2020; 56(1): 15-27.
  6. Diriba K., Awulachew E., Getu E. The effect of coronavirus infection (SARS-CoV-2, MERS-CoV, and SARS-CoV) during pregnancy and the possibility of vertical maternal-fetal transmission: a systematic review and meta-analysis. Eur. J. Med. Res. 2020; 25(1): 39.
  7. López-Morales H., Del Valle M.V., Canet-Juric L., Andrés M.L., Galli J.I., Poó F., Urquijo S. Mental health of pregnant women during the COVID-19 pandemic: A longitudinal study. Psychiatry Res. 2021; 295: 113567.
  8. Tomfohr-Madsen L.M., Racine N., Giesbrecht G.F., Lebel C., Madigan S. Depression and anxiety in pregnancy during COVID-19: A rapid review and meta-analysis. Psychiatry Res. 2021; 300: 113912.
  9. Esteban-Gonzalo S., Caballero-Galilea M., González-Pascual J.L., Álvaro-Navidad M., Esteban-Gonzalo L. Anxiety and worries among pregnant women during the COVID-19 pandemic: a multilevel analysis. Int. J. Environ. Res. Public Health. 2021; 18(13): 6875.
  10. Ahmad M., Vismara L. The sychological impact of COVID-19 pandemic on women's mental health during pregnancy: a rapid evidence review. Int. J. Environ. Res. Public Health. 2021; 18(13): 7112. 10.3390/ijerph18137112.
  11. Green S.M., Furtado M., Inness B.E., Frey B.N., McCabe R.E. Characterizing worry content and impact in pregnant and postpartum women with anxiety disorders during COVID-19. Clin. Psychol. Psychother. 2022; 29(3):1144-57.
  12. Ostacoli L., Cosma S., Bevilacqua F., Berchialla P., Bovetti M., Carosso A.R. et al. Psychosocial factors associated with postpartum psychological distress during the Covid-19 pandemic: a cross-sectional study. BMC Pregnancy Childbirth. 2020; 20(1):703.
  13. Spitzer R.L., Kroenke K., Williams J.B., Löwe B. A brief measure for assessing generalized anxiety disorder. Arch. Intern. Med. 2006; 166(10): 1092-7.
  14. Опросник ГТР-7 (GAD-7) и рекомендации WFSBP по терапии генерализованного тревожного расстройства. Журнал «Обозрение психиатрии и медицинской психологии имени В.М.Бехтерева». 2013; 2: 71. [The GTR-7 (GAD-7) questionnaire and the WFSBP guidelines for therapy of generalized anxiety disorder. The V.M. Bekhterev Journal of Psychiatry and Medical Psychology. 2013; (2): 71. (in Russian)].
  15. Thoresen S., Tambs K., Hussain A., Heir T., Johansen V.A., Bisson J.I. Brief measure of posttraumatic stress reactions: impact of Event Scale-6. Soc. Psychiatry Psychiatr. Epidemiol. 2010; 45(3): 405-12.
  16. Погосова Н.В., Довженко Т.В., Бабин А.Г., Курсаков А.А., Выгодин В.А. Русскоязычная версия опросников PHQ-2 и 9: чувствительность и специфичность при выявлении депрессии у пациентов общемедицинской амбулаторной практики. Кардиоваскулярная терапия и профилактика. 2014; 13(3): 18-24. [Pogosova N.V., Dovzhenko T.V., Babin A.G., Kursakov A.A., Vygodin V.A. Russian version of the PHQ-2 and 9 questionnaires: sensitivity and specificity in detecting depression in general medical outpatients. Cardiovascular Therapy and Prevention. 2014; 13(3): 18-24. (in Russian)].
  17. Green S.M., Inness B., Furtado M., McCabe R.E., Frey B.N. Evaluation of an augmented cognitive behavioural group therapy for perinatal generalized anxiety disorder (GAD) during the COVID-19 pandemic. J. Clin. Med. 2021; 11(1): 209.
  18. Basu A., Kim H.H., Basaldua R., Choi K.W., Charron L., Kelsall N. et al. A cross-national study of factors associated with women's perinatal mental health and wellbeing during the COVID-19 pandemic. PLoS One. 2021; 16(4): e0249780.
  19. Wyszynski D.F., Hernandez-Diaz S., Gordon-Dseagu V., Ramiro N., Basu A., Kim H.H., Koenen K.C. Frequency and source of worries in an International sample of pregnant and postpartum women during the Covid-19 pandemic. BMC Pregnancy Childbirth. 2021; 21(1): 768.
  20. Farrell T., Reagu S., Mohan S., Elmidany R., Qaddoura F., Ahmed E.E. et al.. The impact of the COVID-19 pandemic on the perinatal mental health of women. J. Perinat. Med. 2020; 48(9): 971-6.
  21. Alfayumi-Zeadna S., Bina R., Levy D., Merzbach R., Zeadna A. Elevated perinatal depression during the COVID-19 pandemic: A National Study among Jewish and Arab Women in Israel. J. Clin. Med. 2022; 11(2): 349.
  22. Ceulemans M., Foulon V., Ngo E., Panchaud A., Winterfeld U., Pomar L. et al. Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic-A multinational cross-sectional study. Acta Obstet. Gynecol. Scand. 2021; 100(7): 1219-29.
  23. Chen Q., Li W., Xiong J., Zheng X. Prevalence and risk factors associated with postpartum depression during the COVID-19 pandemic: a literature review and meta-analysis. Int. J. Environ. Res. Public Health. 2022; 19(4): 2219.

Received 02.09.2022

Accepted 28.11.2022

About the Authors

Khilola P. Alimova, Dr. Med. Sci., Deputy Director, Republican Specialized Infectious Disease Hospital Zangiota No. 1,,, 100059, Uzbekistan, Tashkent, Yakkasaroy district, Dzambula str., 6.
Gavkhar A. Voitova, M.D., obstetrician-gynecologist, perinatal psychologist, Tashkent City Center of Women's Reproductive Health; Senior Researcher,
Republican Specialized Infectious Diseases Hospital Zangiota No. 1,,, 111805, Uzbekistan, Tashkent region, Zangiata district, K. Abdullayev str., 42.

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