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.