IMPACT IN PRENATAL EVALUATION OF PREGNANT WOMEN WITH RHEUMATIC DISEASES BY THE SARS-COV2 PANDEMIC

BackgroundDue to the SARS-CoV-2 pandemic, an increase in stress, anxiety, and depression has been seen, as well as greater use of substances and a decrease in prenatal care in pregnant women. (1) Women of childbearing age with autoimmune rheumatic diseases (ARDs) experience greater psychological stress, which can negatively influence behavior. (2)ObjectivesThis study aims to compare changes in prenatal laboratory and ultrasound tests by trimester, as well as the detection of anxiety and depression in pregnant women with ARDs due to the SARS CoV-2 pandemic.MethodsThis study was carried out on pregnant patients with ARDs from the Pregnancy and Rheumatic Diseases clinic of the rheumatology department of the University Hospital “Dr. José Eleuterio González” during the period from February 2018 to August 2021.Two standardized evaluations of anxiety and depression were carried out using the Inventory of Trait and State Anxiety (IDARE) and the Edinburgh Postpartum Depression Scale (EPDS) respectively in the third trimester of pregnancy. Maternal report of alcohol consumption during any trimester of pregnancy, as well as adherence to routine laboratory studies such as structural ultrasound and gestational diabetes screening, was addressed.Positive COVID-19 nasopharynx PCR results were evaluated during pregnancy beginning in the pandemic period (March 2020). The pre-pandemic recruited group was compared with the pandemic group.The comparison of the groups was carried out using the Chi-Square and Fisher tests. A significant value of p < 0.05 was considered. Statistical analysis was performed using the IBM SPSS v.25 program.Results50 pregnant patients with ARDs were recruited, of which 24 were included in the pre-pandemic group and 26 in the pandemic group. Compared with the pre-pandemic group, pregnant women recruited during the pandemic had a statistically significant higher positivity for state anxiety (p=0.023), likewise trait anxiety, depression, and suicidal ideation were detected more frequently, but the difference was not statistically significant, a higher rate of adherence to laboratory and cabinet studies was found, being significant for laboratories performed in the 1st and 2nd trimesters (0.005 and 0.025 respectively). See Table 1.Table 1.Characteristics of pregnant women with autoimmune rheumatic diseases before and during the SARS-CoV-2 pandemic.MeasureBefore pandemicn=24During pandemic Covid Negativen=22During pandemic Covid Positiven=4P valueaEPDS Positive depression detection (≥10)16.7%36.4%50%.197suicidal ideation16.7%0%25%.099IDARE Positive state anxiety detection (>45)12.5%27.3%75%.023IDARE Positive trait anxiety detection (>45)8.3%13.6%50%.204Any alcohol consumption during pregnancy20.8%4.5%0%.176Structural Ultrasound – Mid-Pregnancy66.7%95.5%100%.025Gestational diabetes screening75%86.4%100%.376LaboratoriesFirst trimester20.8%50%0%0.005Second quarter45.8%77.3%100%0.025Third trimester58.3%81.8%75%0.216IDARE= State and Trait Anxiety Inventory, EPDS= Edinburgh Postpartum Depression Scale.A Chi-square test for categorical variables or Fisher’s exact test where the expected cell nConclusionA higher frequency of positivity for state anxiety was demonstrated in pregnant women with ARDs recruited during the pandemic, as well as higher trait anxiety, depression, and suicidal ideation, although this increase was not statistically significant. On the other hand, concern about the pandemic and health status could positively influence better adherence to screening and routine studies during pregnancy.References[1]Johnson D, Dave H, Cd LYC. Pandemic-Associated Complications in Pregnant Women with Rheumatic Diseases.:261.[2]Skinner-Taylor CM, Perez-Barbosa L, Corral-Trujillo ME, Perez-Onofre I, Barriga- Maldonado ES, Cardenas-de la Garza JA, et al. Anxiety and depression in reproductive age women with rheumatic diseases. Rheumatology International [Internet]. 2020;40(9):1433–8. Available from: https://doi.org/10.1007/s00296-020-04591-8Disclosure of InterestsNone declared