PCR100 COVID-19 Experiences of Pregnant and Postpartum Persons and Their Impact on Health-Related Quality-of-Life

ObjectivesThis study assesses the impact of experiences with COVID-19 on health-related quality-of-life (HRQoL) in the perinatal period.MethodsWe conducted an online, national US survey (EuroQol grant:260-2020RA) between May and June 2021. Respondents completed the EQ-5D-5L, self-reported their experiences with COVID-19, including COVID-19 diagnoses for themselves, family and friends. Respondents also completed the Wijma Delivery Expectancy/Experience Questionnaire(WDEQ), a validated tool for measuring fear-of-childbirth, and rated their level of concerns for their health and the health of their family during the pandemic. Association between the EQ-5D-5L outcomes and the COVID-19 experiences and concerns were assessed using quantile and logistic regression. Post-stratification weights were applied to ensure data representation of age and race. Comparative analyses was performed for participants residing in high COVID-19 activity areas compared with low COVID-19 activity areas based on zip code-level COVID-19 rates reported in June 2021.ResultsAmong 3,361 pregnant and postpartum participants, 55% reported concerns about COVID-19 being a severe disease; 39.5% reported concerns about being pregnant during the pandemic. Among participants who gave birth during 2020 (n=536), each unit increase in concerns about being pregnant during COVID-19 was associated with a 0.02 decline in the EQ-5D-5L utility score (95%CI -0.04,-0.01). When we evaluated EQ-5D-5L items individually, respondents diagnosed with severe COVID-19 reported more problems related to anxiety/depression (OR1.27;95%CI 0.70,4.11) and problems with performing their usual activities (OR1.31;95%CI 0.66,4.87). We also observed lower EQ-5D-5L utility values among pregnant persons with higher WDEQ scores (95%CI -3.18,-1.28).This association was only observed in areas with higher COVID-19 activity. We did not observe any changes in EQ-5D-5L utility values associated with fear-of-childbirth among postpartum persons.ConclusionsLower HRQoL is associated with increasing severity COVID-19 infection, as well as greater level of fear-for-childbirth, especially in areas with higher COVID-19 activities in the US. Problems with anxiety/depression contributed most strongly to lowered HRQoL during pregnancy. ObjectivesThis study assesses the impact of experiences with COVID-19 on health-related quality-of-life (HRQoL) in the perinatal period. This study assesses the impact of experiences with COVID-19 on health-related quality-of-life (HRQoL) in the perinatal period. MethodsWe conducted an online, national US survey (EuroQol grant:260-2020RA) between May and June 2021. Respondents completed the EQ-5D-5L, self-reported their experiences with COVID-19, including COVID-19 diagnoses for themselves, family and friends. Respondents also completed the Wijma Delivery Expectancy/Experience Questionnaire(WDEQ), a validated tool for measuring fear-of-childbirth, and rated their level of concerns for their health and the health of their family during the pandemic. Association between the EQ-5D-5L outcomes and the COVID-19 experiences and concerns were assessed using quantile and logistic regression. Post-stratification weights were applied to ensure data representation of age and race. Comparative analyses was performed for participants residing in high COVID-19 activity areas compared with low COVID-19 activity areas based on zip code-level COVID-19 rates reported in June 2021. We conducted an online, national US survey (EuroQol grant:260-2020RA) between May and June 2021. Respondents completed the EQ-5D-5L, self-reported their experiences with COVID-19, including COVID-19 diagnoses for themselves, family and friends. Respondents also completed the Wijma Delivery Expectancy/Experience Questionnaire(WDEQ), a validated tool for measuring fear-of-childbirth, and rated their level of concerns for their health and the health of their family during the pandemic. Association between the EQ-5D-5L outcomes and the COVID-19 experiences and concerns were assessed using quantile and logistic regression. Post-stratification weights were applied to ensure data representation of age and race. Comparative analyses was performed for participants residing in high COVID-19 activity areas compared with low COVID-19 activity areas based on zip code-level COVID-19 rates reported in June 2021. ResultsAmong 3,361 pregnant and postpartum participants, 55% reported concerns about COVID-19 being a severe disease; 39.5% reported concerns about being pregnant during the pandemic. Among participants who gave birth during 2020 (n=536), each unit increase in concerns about being pregnant during COVID-19 was associated with a 0.02 decline in the EQ-5D-5L utility score (95%CI -0.04,-0.01). When we evaluated EQ-5D-5L items individually, respondents diagnosed with severe COVID-19 reported more problems related to anxiety/depression (OR1.27;95%CI 0.70,4.11) and problems with performing their usual activities (OR1.31;95%CI 0.66,4.87). We also observed lower EQ-5D-5L utility values among pregnant persons with higher WDEQ scores (95%CI -3.18,-1.28).This association was only observed in areas with higher COVID-19 activity. We did not observe any changes in EQ-5D-5L utility values associated with fear-of-childbirth among postpartum persons. Among 3,361 pregnant and postpartum participants, 55% reported concerns about COVID-19 being a severe disease; 39.5% reported concerns about being pregnant during the pandemic. Among participants who gave birth during 2020 (n=536), each unit increase in concerns about being pregnant during COVID-19 was associated with a 0.02 decline in the EQ-5D-5L utility score (95%CI -0.04,-0.01). When we evaluated EQ-5D-5L items individually, respondents diagnosed with severe COVID-19 reported more problems related to anxiety/depression (OR1.27;95%CI 0.70,4.11) and problems with performing their usual activities (OR1.31;95%CI 0.66,4.87). We also observed lower EQ-5D-5L utility values among pregnant persons with higher WDEQ scores (95%CI -3.18,-1.28).This association was only observed in areas with higher COVID-19 activity. We did not observe any changes in EQ-5D-5L utility values associated with fear-of-childbirth among postpartum persons. ConclusionsLower HRQoL is associated with increasing severity COVID-19 infection, as well as greater level of fear-for-childbirth, especially in areas with higher COVID-19 activities in the US. Problems with anxiety/depression contributed most strongly to lowered HRQoL during pregnancy. Lower HRQoL is associated with increasing severity COVID-19 infection, as well as greater level of fear-for-childbirth, especially in areas with higher COVID-19 activities in the US. Problems with anxiety/depression contributed most strongly to lowered HRQoL during pregnancy.