Author: Maegan Diep, Class of 2028

Pregnant women are among the many groups negatively impacted by the COVID-19 pandemic. Encountering several stressors including social isolation, financial difficulties, and an increase in domestic violence, pregnant women are especially at risk for mental health issues. Exposure to stress during pregnancy can have numerous detrimental effects for both the mother and the infant. The mother becomes vulnerable to mental health disorders (e.g. postpartum depression) and physical diseases (e.g. diabetes); the newborn is subject to short and long-term repercussions, including low birth weight, increased risk of autism, and premature death.

An international research team, including Dr. Heidi Preis, Dr. Marci Lobel, and Dr. Brittain Mahaffey of Stony Brook University, sought to further assess the impact of the pandemic on pregnancy, focusing specifically on its associated stress. This psychometric study included 7,922 participants over the age of 18 across seven different Western countries: the United States of America, Germany, Switzerland, Israel, Italy, Poland, and Spain. In the Spanish and Italian studies, women were invited to attend a prenatal appointment with a midwife during the pandemic, while studies in the other countries recruited participants online via social media (e.g. Facebook, Instagram, and Reddit). 

To assess the pandemic-specific stress during their pregnancy, participants were subjected to the Pandemic-Related Pregnancy Stress Scale (PREPS), a 15-item tool meant to psychologically measure specific stressors that affected pregnant women. There were three areas that PREPS measured: 1) stress related to lack of birth and postpartum preparedness, 2) stress related to perinatal infection concerns, and 3) positive appraisal during pandemic pregnancy. Each item had five response categories, ranging from 1 (“very little”) to 5 (“very much”). To thoroughly analyze the psychometric properties of the PREPS, the Rating Scale Model was implemented, allowing researchers to evaluate the different aspects together. Furthermore, the differential item functioning was examined to ensure that the standards of stress were similar across different countries.

Results conclude that the areas of stress that PREPS investigated appropriately represent prenatal stress across different sociocultural contexts. Though there were differences in sampling (e.g. cultural and pandemic differences, eligibility criteria, recruitment process, etc), the study sought to emphasize international diversity, which allows for the assessment tools to be generalizable across women experiencing prenatal mood disorders worldwide. In having more accurate measurements of maternal stress levels due to the pandemic, the associated myriad of health issues can be combatted through several different approaches—such as via policy-making, identifying women in need of intervention—and overall reducing the threat of long-term consequences. 

Figure 1.  An image of a pregnant woman.

Work’s Cited:

[1] Riquelme-Gallego, B., Ordoñez-Carrasco, J. L., Suárez-Yera, C., Rojas-Tejada, A. J., Preis, H., Lobel, M., Mahaffey, B., Castro, R. A., Atzil, S., Balestrieri, M., Brandt-Salmeri, A., Colli, C., Driul, L., Garzitto, M., Ilska, M., Kołodziej-Zaleska, A., La Marca-Ghaemmaghami, P., Meyerhoff, H., Penengo, C., Reuveni, I., Schaal, N. K., Yirmiya, K., & Caparros-Gonzalez, R. A. (2025). Assessment of pandemic-related pregnancy stress from seven western countries using Rasch analyses. Journal of Psychiatric Research, 182, 92-99. https://doi.org/10.1016/j.jpsychires.2024.12.045.

[2] Image retrieved from: https://commons.wikimedia.org/wiki/File:Pregnant-woman.jpg