Abstract
Objectives This study objectives were to investigate maternal psychological distress, mothers' fear of their children contracting COVID-19, mothers' perceptions of the information available regarding children and COVID-19, changes in children's behavior during lockdown, and concerns of pregnant women in Saudi Arabia. Methods This cross-sectional study surveyed women aged 18 years and older who either had children under 10 years of age or were pregnant at the time of the survey. The outcomes included psychological distress, mothers' fear of their children contracting COVID-19, change in children's behaviors during COVID-19 lockdown and pregnant women's concerns. Multivariable ordinary least squares regression models were employed to examine the adjusted associations between sociodemographic factors and psychological distress, as well as fear of COVID-19. Results Of 628 women, 11.8% (n = 74) were pregnant at the time of survey. Most of the pregnant women (89.2%, n = 66) had some degree of concerns about their unborn babies getting infected during delivery in the hospital. Among mothers of children under 10 years of age (n = 564), half (n = 282) reported change in their children's behavior during the lockdown. Most mothers and pregnant women (94.9%, n = 569) had some degree of psychological distress. Mothers and pregnant women with a college degree had significantly lower psychological distress (beta = -1.346; p = 0.014) than women with a high school education or less. Similarly, mothers and pregnant women with monthly family income >= US$ 1,333 had lower psychological distress than those with < US$ 1,333. Women with pre-existing chronic physical (beta = 2.424; p < 0.001) or mental (beta = 4.733; p < 0.001) conditions had higher psychological distress than those without these conditions. Having children in the house was a contributory factor for higher psychological distress. For example, mothers with one child (beta = 2.602; p = 0.007) had significantly higher psychological distress compared to expectant mothers without children in the house. Conclusions Most mothers and expectant mothers in our study had moderate to high levels of psychological distress during the COVID-19 pandemic outbreak in Saudi Arabia. Education, family income and chronic mental and physical conditions were associated with high psychological distress in Saudi Arabia during COVID-19.