Differences in levels of stress, social support, health behaviours, and stress-reduction strategies for women pregnant before and during the COVID-19 pandemic, and based on phases of pandemic restrictions, in Ireland.

The study compared separate groups of women surveyed before and during the pandemic, not the same women over time, so it cannot show that the pandemic caused the differences. Most participants were married or in a relationship and already had children, so the findings may not apply to single women or first-time mothers. Recruitment was largely online through pregnancy forums and social media, which may not represent all pregnant women in Ireland. The study did not ask whether women had or suspected COVID-19, so infection status and perceived risk could not be considered. Only outcomes included in both surveys could be compared, so maternity care satisfaction and other pandemic-specific factors were not examined. Alcohol and smoking were excluded from further analysis because too few women reported these behaviours. The stricter cut-off for many statistical tests makes small differences harder to detect.

The authors declared no conflicts of interest. The research was supported by an Evidence Synthesis Ireland and Health Research Board Trials Methodology Research Network COVID-19 emergency scholarship, and by a Health Research Board applying research into policy and practice fellowship. The funders had no role in the design, conduct, analysis or interpretation of the research.

Do not conclude that pandemic exposure increased antenatal stress. The stress score was higher on average, but the study did not meet its stricter threshold for a difference, and it compared separate groups of women rather than following the same women over time.