Study design and participants
This is a cross-sectional study through a self-administered
questionnaire. The anonymous survey questionnaire was designed with four
modules to collect a wide range of data regarding: (1) background
information of demographic, pregnancy and COVID-19 epidemic; (2)
attitudes towards COVID-19; (3) anxiety status, by using Self-Rating
Anxiety Scale (SAS) 23,24, which is widely used and
demonstrated to have excellent reliability and validity among pregnant
mothers 25,26; (4) various obstetrical choices. The
content of the questionnaire was reviewed and pretested by professors in
Psychiatry (Xinyu Zhou and his colleagues) and Obstetrics (Hongbo Qi and
Xin Luo). Eventually, the validity was proved following appropriate
revision. The main content of the questionnaire is shown in Figure 1 and
the translated version of the full questionnaire (from Chinese to
English) in the Appendix.
From February 3 to 9, 2020, the questionnaires were distributed, mainly
through a widely-used big data platform for pregnant mothers
(YunYiTong27, covering more than 250,000 WeChat users
nationwide) to those registered for prenatal care in hospitals in Wuhan
and Chongqing only. Two distribution strategies, namely, one-by-one
WeChat message and advertising on the official accounts, were applied.
Additional questionnaires were distributed by obstetricians in both
cities to those referred for outpatient services. Of note, through
backstage set, each participant could only fill in this questionnaire
once and only completed questionnaires could be submitted.
We followed relevant guidelines to ensure that the study was voluntary
and confidential. The study was approved by the ethics committee of the
First Affiliated Hospital of Chongqing Medical University (20200501),
and an electronic informed consent was obtained before completing the
questionnaire.