Women perception of SARS-CoV-2 vaccination during pregnancy and subsequent maternal anxiety: a prospective observational study

The use of Coronavirus 2 (SARS-CoV-2) vaccine in pregnant women is controversial and still not performed in Italy. Our objective was to evaluate the propensity of a population of Italian women to receive the vaccine and its psychological impact. A prospective, observational study was performed on pregnant women attending Ospedale Cristo Re Università Roma TorVergata. A multi-section questionnaire was sent to each included woman on the first day of available SARS-CoV-2 vaccination. Part-A was finalized to acquire maternal characteristics and to test the women’s perception of vaccinations in pregnancy and their fear-induced by vaccines. Part-B included the State-Trait-Anxiety-Inventory (STAI) a validated test for scoring trait anxiety (basal anxiety, STAI-T) and state anxiety (STAI-S). An abnormal value of STAI was considered when ≥40. Comparisons of maternal variables were performed according to their vaccine attitude. The questionnaire was completed by 161 women (80.5% of the population considered). A positive attitude toward the vaccine was present in 136 (84.5%) women (positive) while the remaining 25.5% considered the vaccine not useful (negative). Among the former group 52.9% were favorable to obtain the vaccine during pregnancy despite the current national limitations, a percentage significantly higher (p = .02) than in the negative groups. Women with a negative attitude to the vaccine had a lower educational (p = .002) and employment level (p = .016) when compared to the positive group. In all the women a significant increase of STAI-S from STAI-T values was evidenced (p p = .81), while there was a significant increase of STAI-S values in the negative group (negative 88.0%; vs positive 63.4%; p = .018) The majority of pregnant women considered have a positive attitude to SARS-CoV-2 vaccine. Vaccine campaign seems to increase the maternal level of anxiety and this increase is more marked with a negative attitude toward the vaccine.

孕妇接种新型冠状病毒2型（SARS-CoV-2）疫苗的相关议题仍存在争议，且意大利目前尚未开展该类接种。本研究旨在评估意大利孕妇群体对接种SARS-CoV-2疫苗的意愿及其心理影响。
本研究针对就诊于罗马第二大学克里斯托雷医院的孕妇开展了一项前瞻性观察性研究。在可获取的SARS-CoV-2疫苗接种首日，我们向所有纳入研究的孕妇发放了多维度调查问卷。问卷分为A、B两部分：A部分用于收集孕产妇的基本特征，并调研孕妇对孕期接种疫苗的认知及疫苗相关恐惧心理；B部分采用状态-特质焦虑量表（State-Trait-Anxiety-Inventory, STAI）这一经过验证的测评工具，分别评估特质焦虑（基础焦虑，STAI-T）与状态焦虑（STAI-S）得分，当得分≥40分时判定为焦虑值异常。
研究人员根据孕妇的疫苗接种态度对其相关变量进行了对比分析。最终共有161名孕妇完成了问卷，占纳入研究总人数的80.5%。其中136名（84.5%）孕妇对疫苗持积极态度，剩余25.5%的孕妇认为疫苗无接种必要（持消极态度）。尽管当前意大利国内存在相关接种限制，积极组中仍有52.9%的孕妇愿意在孕期接种疫苗，这一比例显著高于消极组（p=0.02）。与积极组相比，持消极态度的孕妇教育水平与就业层级均更低（教育水平：p=0.002；就业层级：p=0.016）。全体受访孕妇的状态焦虑得分均显著高于特质焦虑得分（p=0.81）；而在消极组中，状态焦虑得分的升高更为显著：消极组占比88.0%，积极组占比63.4%（p=0.018）。
本研究纳入的多数孕妇对SARS-CoV-2疫苗持积极态度。疫苗接种宣传活动似乎会提升孕产妇的焦虑水平，且这种焦虑升高在对疫苗持消极态度的群体中更为明显。