We can precisely find out the recession of
quantity of deliveries and frequency of prenatal visits in 2020 in our
research, compared to 2019. Prenatal care services aim at lowering
maternal and neonatal morbidity and mortality and improving the quality
of global population. By means of prenatal physical examination, history
taking and imagological and laboratory examination, obstetricscan offer
the helpful advice and suggestion for lifestyles, identify the
complications associated with pregnancy and provide the appropriate
treatment, the treatment that pregnant women might benefit from. For
example, the pregnant women whose frequency of prenatal visits was
insufficient suffered higher risk of perinatal complications, especially
macrosomia[10], which is the same result in our
research. And the prenatal care can efficiently stem the congenital
syphilis cases[11] and pregnancy-induced
hypertension[12].We believe that people,
especially the pregnant, reduce the need of regular hospital check-ups,
even refuse to walk out the door to preventCOVID-19 because of fear and
worry. It also means they chose to cut down the frequency of
prenatal care services as well as fail to get the professional obstetric
advises from doctors, which might avoid certain obstetric complications.
What’s more, it is well-known that the childbearing age women held a
large percentage of floating population and migrant workers. The
non-indigenous pregnant women hold nearly half of the patients of our
clinic. Atthe same time, the Chinese government took a series of
measurements to cut-off the dissemination way. Because of
self-protection of native pregnant and traffic restriction of ecdemic
ones, the selective prenatal visits and patient’s loss explained the
change of frequency of prenatal
visits.
In China, 11.1% and 10.3% of pregnant women were suffering from
anxiety and depression, respectively[13].On the
surface, pregnancy is a constantly changing process for physiological
structure. In fact, endogenous hormone levels and stimulation from
external environment catalyze psychological activities. It is a
susceptible period that the negative life stuff could lead to prenatal
anxiety and depression, which have been global public health problems in
the last decade [14].Except for pregnancy-related
anxiety and depression, the panic for COVID-19, as an updated socially
channel, aggravates these pathogenic factors. During this epidemic, the
worldwide economy suffered a hard blow. Pregnant women, especially elder
ones, confront salary cuts and unemployment, which threatens their
socioeconomic status, which accelerates depression and age-related
anxiety[13]. While prenatal anxiety and depression
to a certain extent may be treated as a common occurrence during
pregnancy, an important life-phase for a women, from a girl to a mom,
high levels of them may have long-lasting adversely influence on both
the her behavior and her child’s future development, such as preterm
birth[15], low birth
weight[16] and weight
increase[17]. Nonetheless, our research failed to
validate the hypothesis above and a opposite result showed. The results
of psychological assessment during hospital admission show equivalent
score of two years’ women. Women’s weight increase, rate of preterm
birth and neonates’ birth weight in our research suggest the parallel
consequence. It turned out that pregnant women, who delivered in March
and April, 2020 avoid the additional anxiety and depression on account
of COVID-19. The feasible explanation is the better family concern. When
it comes to scores of health related quality of life (HRQoL), pregnant
women, especially during the third trimester, got the significantly
lower one than non-pregnant women of the same age, and some
sociodemographic factors which could improve the well-being, involving
the social support and partner support. Researches declared the
importance of social support during pregnancy, especially family
care [16]. Pregnant women who are in
absence
of social support tend to be pessimistic and
suffer
from low self-esteem or self-worth[17]. Thanks to
the epidemic, less work makes family members pay more attention to the
pregnant ones, which can moderate the stimulation from life stuff and
exoteric environment. When a pregnant woman gets adequate social support
from her family and friends who provide nutrient-rich diet, physical and
mental solicitude, and medical suggestion, she is motivated to take care
of herself which is a true indicator of her HRQoL, which could decrease
negative affection such as depression and anxiety. Moreover, more
consideration from the partner could elevate marital satisfaction and
the pregnant women who have higher marital satisfaction have a healthier
life attitude, which means satisfying diets and less abnormal
psychological problems [18]. A long-term and
stable marriage relationship could increase the happiness and counteract
external pressure from the society.
Meeting the optimal fetal development and sufficient nutrition for
mother is the basic requirement for a healthy, balanced diet. A study
with Asian subjects indicated that the total energy expenditure of women
during their pregnancy was significantly lower than that before they
became pregnant[19].In the Chinese tradition, a
big newborn symbolizes jubilation and abundance. Although many women
realize the importance of balanced diet during pregnancy, lack of
professional introduction and food cravings, a strong
impetus[20], during pregnancy facilitate excess
calorie intake. As a result, women get more GWG during this period. In
current, thanks to the propaganda and education from obstetric stuff,
Chinese pregnant women have become sensitive and learned to control the
GWG, based on appropriate growth rate of the fetus. This achievement can
be found out in our research that there was no significant disparity of
GWG in 2019 and 2020. However, clinically, less GWG might correspond to
heavier fetal weight. In our study, the average weight of newborns in
2020 was equal to it in 2019, whereas the rate of macrosomia was higher.
Physical activity is the main pathway to accelerate the energy
expenditure. The benefits of physical activity during pregnancy include
improved physical fitness, reduced risk of excessive weight gain,
reduced risk of preeclampsia and pre-term birth, reduced low back pain,
improved sleep, reduced anxiety and depressive symptoms, and improved
health perception and self-reported body
image[21].It is recommended that, without medical
restrictions of physical activity and under the applicable exercise
intensity, pregnant women should aim to perform 30 min for most days of
the week with the guidelines published by the United States or 60 min of
aerobic exercise for 2–3 times per week suggested by the Japanese
guidelines[22]. Nevertheless, the pregnant women
who reach the recommended level of physical activity are in the minority
both in the developed and developing
countries[23].On one hand, the Asia’s idea about
lifestyle during duration of pregnancy is highly diverse compared to
western world, especially in China. The continuation of the family line
is an extremely important affair in Chinese tradition. Hence pregnant
women spontaneously avoid doing some things which might have negative
influence on pregnancy and fetus and the intensity of exercise is lower
than the occidental. On another hand, A meta-analysis found out an
opposite correlation between physical activity and the occurrence of
macrosomia[24]. This is a possible explanation for
high level of macrosomia emerging in our study.