ABSTRACT
Background: Due 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) Objectives: This 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. Methods: This 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 gesta-tional 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. Results: 50 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 signifcant 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 signifcant, a higher rate of adherence to laboratory and cabinet studies was found, being signifcant for laboratories performed in the 1st and 2nd trimesters (0.005 and 0.025 respectively). See Table 1. Conclusion: A 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 signifcant. On the other hand, concern about the pandemic and health status could positively influence better adherence to screening and routine studies during pregnancy.
ABSTRACT
Objectives: We aimed to describe the fear of COVID-19 scale in women with autoimmune rheumatic diseases (ARDs) from Mexico. Methods: A cross-sectional study was conducted from September to November 2020 at the Pregnancy and Rheumatic Diseases Clinic from the University Hospital Dr. JoseE. Gonzalez in Monterrey, Mexico. Women with ARDs were invited to participate. The Fear of COVID-19 scale (FCV-19S) was applied. The instrument consists of seven items, each with a five-point Likert scale of options. The maximum possible total is 35 points, with cutoff point score of 16.5. The validated Spanish FCV-19S version was used. Also, sociodemographic data were collected from the medical charts. Results: A total of 83 women were included: 46 were in childbearing age, 32 were postpartum women, 4 were pregnant and 1 was going through menopause. The most frequent diagnosis was rheumatoid arthritis in 41 (49.4%), followed by systemic lupus erythematosus 31 (37.3%), 8 (9.6%) with other diagnosis (Sjogren's syndrome 2, antiphospholipid syndrome 3, and dermatomyositis 2 and psoriatic arthritis 1 patient). The demographic variables are shown in Table 1. The mean level of fear was 18.09 points, which means the fear of COVID-19 screening was highly positive. Regarding the rheumatic diseases group, women in the category of Other diagnoses had a greater mean FCV-19S score (19.0), than patients with systemic lupus erythematosus (17.45) and rheumatoid arthritis (18.8). Also, in the reproductive status classification the postpartum women had the highest mean score (19.68). Only the group of Non diagnostic yet, had a score below the cutoff point. Conclusion: Postpartum women with ARDs had a higher FCV-19S score than women with a different reproductive status. Women with ARDs and especially postpartum women should receive psychological support and be screened for symptoms of depression and anxiety.
ABSTRACT
Background: In Mexico, the SARS-CoV-2 pandemic has totaled almost two million cases and exceeded 150,000 deaths (29/01/2021). Currently, COVID-19 has become the leading cause of death in pregnant women in Mexico. COVID-19 has additionally impacted the psychological health of individuals including women with rheumatic diseases. Objectives: The aim of this study is to compare the Fear of COVID-19 Scale (FCV-19S) in postpartum women with and without autoimmune rheumatic diseases. Methods: A cross-sectional, descriptive, and comparative study was conducted. The Spanish FCV-19S version was applied by telephone or e-mail. The instrument consists of seven items, each with a five-point Likert scale of options. The participant must choose the options that best represent their perception about the statements presented. The maximum possible total is 35 points. Sociodemographic information was collected from the clinical charts. The Kolmogorov-Smirnov test was used to determine normality of the data. Statistical analysis was done using the Mann-Whitney U test. Results: Forty-four postpartum women were included (22 from the Pregnancy and Rheumatic Diseases Clinic and 22 from the Obstetrics Department, both groups from the University Hospital Dr. José E. González in Monterrey, México). The mean level of fear found in women with rheumatic disease was 16 (6.6) points versus 14 (4.6) points in the non-rheumatic patients group. No significant difference was found between groups (p=0.65). Regarding the rheumatic diseases group, women in the category of other diagnoses (that included Sjögren's Syndrome, antiphospholipid syndrome, and dermatomyositis) had a greater mean FCV-19S score (20.2), than patients with systemic lupus erythematosus (17.3) and rheumatoid arthritis (15.4). Conclusion: Women with postpartum rheumatic disease had a higher FCV-19S score than postpartum women without rheumatic diseases, although this difference was not statistically significant.