NUTRITION AND COVID-19 PHOBIA IN PREGNANCY IN THE PANDEMIC

Öz

Objective: The anxiety of individuals in the coronavirus epidemic affects their eating behaviours. Nutrition during pregnancy is an important factor for pregnancy and fetal health. This study was aimed to determinate the effect of anxiety and phobia caused by the coronavirus 19 disease (COVID-19) on the nutritional status and eating habits of pregnant women. Method: In this cross-sectional study, a total of 87 pregnant women who applied to a private medical center obstetrics and gynecology clinic in Istanbul Sultangazi between April and May 2021 participated to this study. The research data were obtained by using the questionnaire form applied by the researcher, 24-hour food consumption record, coronavirus 19 phobia scale (C19P-S), and the changes in eating behaviour during the COVID-19 pandemic using face-to-face interview technique. Results: It was determined that the median total amount of energy intakes of women was 1565 kcal/day, and the median values of energy ratios of carbohydrate, protein, and fat were 45%, 15%, and 38%, respectively. It has been shown that dietary intakes of vitamin K and sodium was high, while the intake of micronutrients such as B1, B6, B9, and D and iron were insufficient. The median total score of the C19P-S scale was calculated as 57. There was no significant difference between the history of COVID-19 death or diagnose of women and the C19P-S scale scores (p>0.05). It has been found that there was a change in the amount of food that individuals take daily during the pandemic, and this change was mostly due to pregnancy (p<0.05). Conclusion: It was determined that the pandemic caused a moderate level of phobia in pregnant women. It was detected that the nutritional status and eating habits of pregnant women during the pandemic changed due to pregnancy, not because of the pandemic, but during the pandemic, the pregnant women did not reach dietary goals according to the recommendations for pregnancy.

Anahtar Kelimeler

• Anxiety
• Pregnant
• Phobia
• Nutrition

GEBELERDE PANDEMİDE BESLENME VE COVID-19 FOBİSİ

Öz

Amaç: Bireylerin koronavirüs salgınındaki kaygı durumları beslenme davranışlarını etkilemektedir. Gebelikte beslenme gebe ve fetüs sağlığı açısından önemli bir faktördür. Bu çalışma koronavirüs 19 hastalık (COVID-19) fobisinin gebelerin beslenme durum ve alışkanlıkları üzerindeki etkisini araştırmak amacıyla planlandı. Yöntem: Kesitsel olarak planlanan bu çalışmaya Nisan-Mayıs 2021 tarihleri arasında İstanbul Sultangazi’de bulunan özel bir tıp merkezi kadın doğum polikliniğine başvuran toplam 87 gebe kadın katıldı. Araştırma verileri araştırmacı tarafından uygulanan anket formu, 24 saatlik besin tüketim kaydı, koronavirüs 19 fobisi ölçeği (C19P-S) ve COVID-19 pandemisinde gebe beslenmesindeki değişimler yüz yüze görüşme tekniği kullanılarak elde edildi. Bulgular: Gebelerin toplam enerji alım miktarı medyanı 1565kkal/gün ve enerjinin karbonhidrat, protein ve yağdan karşılanan medyan değerleri sırasıyla %45, %15 ve %38’idi. Gebelerin günlük diyetle aldığı mikro besin öğelerinden B1, B6, B9 ve D vitamini ile demir yetersiz alım düzeyinde iken K vitamini ve sodyum alımlarının yüksek alım düzeyinde olduğu saptandı. Bireylerin C19P-S ölçeği toplam puan medyanı 57 olarak bulundu. Gebelerde COVID-19 geçirme ve vefat durumu ile C19P-S ölçeği skorları anlamlı farklılık göstermedi (p>0.05). Bireylerin salgın sürecinde günlük aldıkları besin miktarlarında değişiklik olduğu ve bu değişimin çoğunlukla gebelik sebebiyle olduğu tespit edildi (p<0.05). Sonuç: Pandeminin gebelerde orta düzeyde bir fobi yarattığı saptandı. Pandemi sürecinde gebelerin beslenme durum ve alışkanlıklarının pandemi sebebiyle değil gebelik sebebiyle değiştiği ancak salgın döneminde gebelerin önerilene göre iyi beslenmediği belirlendi.

Anahtar Kelimeler

• COVID-19
• Kaygı
• Gebe
• Fobi
• Beslenme

Kaynakça

1. Virit O, Akbaş E, Savaş HA, Sertbaş G, Kandemir, H. Gebelikte depresyon ve kaygı düzeylerinin sosyal destek ile ilişkisi. Nöropsikiyatri Arşivi. 2008:45(1):9-13.
2. Trujillo J, Vieira MC, Lepsch J, et al. A systematic review of the associations between maternal nutritional biomarkers and depression and/or anxiety during pregnancy and postpartum. J Affect Disord. 2018;232:185-203.
3. Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among pregnant individuals during the Covid-19 pandemic. J Affect Disord. 2020;277:5-13.
4. Moyer CA, Compton SD, Kaselitz E, Muzik M. Pregnancy-related anxiety during Covid-19: a nationwide survey of 2740 pregnant women. Arch Womens Ment Health. 2020;23(6):757-765.
5. Saccone G, Florio A, Aiello F, et al. Psychological impact of coronavirus disease 2019 in pregnant women. Am J Obstet Gynecol. 2020;223(2):293-295.
6. Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The Fear of Covid-19 Scale: development and initial validation. Int J Ment Health Addict. 2022;20(3):1537-1545.
7. Kaya S, Uzdil Z, Cakiroğlu FP. Evaluation of the effects of fear and anxiety on nutrition during the Covid-19 pandemic in Turkey. Public Health Nutr. 2021;24(2):282-289.
8. American Psychiatric Association (APA) Author. American Psychiatric Publication; 2013. Diagnostic and statistical manual of mental disorders (DSM-5).

9. Arpaci I, Karataş K, Baloğlu M. The development and initial tests for the psychometric properties of the Covid-19 Phobia Scale (C19P-S). Pers Individ Dif. 2020;164:110108.
10. Arpaci I, Karatas K, Baloglu M, Haktanir A. Covid-19 Phobia in the United States: validation of the Covid-19 Phobia Scale (C19P-SE). Death Stud. 2022;46(3):553-559.
11. Delibaş L. Covid-19 Fobisi ve endişe şiddeti; meslek yüksekokulu örneği. Hastane Öncesi Dergisi. 2020;6(2):201-212.
12. Karkın PÖ, Sezer G, Şen S, Duran M. Sağlık alanında çalışan kadınlar ile sağlık alanı dışındaki kadınların coronavirüs-19 fobisinin karşılaştırılması. Batı Karadeniz Tıp Dergisi. 2021;5(2):198-203.
13. WHO A healthy lifestyle- WHO recommendations. Erişim tarihi: 1 Mayıs 2021 https://www.who.int/europe/news-room/fact-sheets/item/a-healthy-lifestyle---who-recommendations#:~:text=Note.,24.9%20as%20a%20normal%20BMI.
14. Rakıcıoğlu N, Acar Tek N, Ayaz A, Pekcan G. Yemek ve Besin Fotoğraf Kataloğu Ölçü ve Miktarlar. 7. Baskı. Ankara; Ata Ofset Matbaacılık; 2017.
15. Türkiye Beslenme Rehberi 2015 (TÜBER). T.C. Sağlık Bakanlığı. Erişim tarihi: 1 Ağustos 2022 https://dosyasb.saglik.gov.tr/Eklenti/10915,tuber-turkiye-beslenme-rehberipdf.pdf.
16. Jouanne M, Oddoux S, Noël A, Voisin-Chiret AS. Nutrient Requirements during Pregnancy and Lactation. Nutrients. 2021;13(2):692.
17. Dubois L, Diasparra M, Bedard B, Colapinto CK, Fontaine-Bisson B, Morisset AS et al. Adequacy of nutritional intake from food and supplements in a cohort of pregnant women in Québec, Canada: the 3D Cohort Study. Am J Clin Nutr. 2017;106(2):541-548.
18. Fujita M, Tsubota M, Ishida M. A qualitative study of women’s perceptions of provider advice about diet and physical activity during pregnancy. Int J Nurs Clin Pract. 2015;115(2):1-4.
19. Türkiye Beslenme ve Sağlık Araştırması (TBSA). (2019). T.C. Sağlık Bakanlığı. Ağustos 2022 tarihinde erişildi. https://hsgm.saglik.gov.tr/depo/birimler/saglikli-beslenme-hareketli-hayat-db/Yayinlar/kitaplar/TBSA_RAPOR_KITAP_20.08.pdf
20. Garipağaoğlu M, Budak N, Elmacıoğlu F, Bulut A. İstanbul’da yaşayan bir grup gebe kadının beslenme durumunun değerlendirilmesi. Türk Aile Hekimi Dergisi. 2007;11(1):27-31.
21. Kocyłowski R, Lewicka I, Grzesiak M, et al. Assessment of dietary intake and mineral status in pregnant women. Arch Gynecol Obstet. 2018;297(6):1433-1440.
22. Aşcı Ö, Rathfisch G. Effect of lifestyle interventions of pregnant women on their dietary habits, lifestyle behaviors, and weight gain: a randomized controlled trial. J Health Popul Nutr. 2016;35:7.
23. Bostan S, Erdem R, Öztürk YE, Kılıç T, Yılmaz A. The effect of Covid-19 pandemic on the Turkish society. Electronic Journal of General Medicine. 2020;7(6):1-8.
24. Bakioğlu F, Korkmaz O, Ercan H. Fear of Covid-19 and positivity: mediating role of intolerance of uncertainty, depression, anxiety, and stress. Int J Ment Health Addict. 2021;19(6):2369-2382.
25. Hamel L, Salganicoff A. Is there a widening gender gap in coronavirus stress? Erişim tarihi: 1 Eylül 2022. https://www.kff.org/coronavirus-policy-watch/is-there-widening-gender-gap-in-coronavirusstress
26. Tzur Bitan D, Grossman-Giron A, Bloch Y, Mayer Y, Shiffman N, Mendlovic S. Fear of Covid-19 scale: Psychometric characteristics, reliability and validity in the Israeli population. Psychiatry Res. 2020;289:113100.
27. Özdin S, Bayrak Özdin Ş. Levels and predictors of anxiety, depression and health anxiety during Covid-19 pandemic in Turkish society: The importance of gender. Int J Soc Psychiatry. 2020;66(5):504-511.
28. Cansel N, Ucuz İ, Arslan AK, et al. Prevalence and predictors of psychological response during immediate Covid-19 pandemic. Int J Clin Pract. 2021;75(5):e13996.
29. Dennis CL, Falah-Hassani K, Shiri R. Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry. 2017;210(5):315-323.
30. Ding W, Lu J, Zhou Y, Wei W, Zhou Z, Chen M. Knowledge, attitudes, practices, and influencing factors of anxiety among pregnant women in Wuhan during the outbreak of Covid-19: a cross-sectional study. BMC Pregnancy Childbirth. 2021;21(1):80.
31. Öztürk Y, Üstünalan D, Metin B. Pandemi sürecinde kadınların ev içindeki deneyimleri ve evde kalmanın duyguları. Feminist Tahayyül. 2020;1(2):185-225.
32. Sadeghi O, Keshteli AH, Afshar H, Esmaillzadeh A, Adibi P. Adherence to Mediterranean dietary pattern is inversely associated with depression, anxiety and psychological distress. Nutr Neurosci. 2021;24(4):248-259.
33. Saghafian F, Malmir H, Saneei P, et al. Consumption of fruit and vegetables in relation with psychological disorders in Iranian adults. Eur J Nutr. 2018;57(6):2295-2306.
34. Yannakoulia M, Panagiotakos DB, Pitsavos C, et al. Eating habits in relations to anxiety symptoms among apparently healthy adults. A pattern analysis from the ATTICA Study. Appetite. 2008;51(3):519-525.
35. Macht M. How emotions affect eating: a five-way model. Appetite. 2008;50(1):1-11.
36. Wallis DJ, Hetherington MM. Emotions and eating. Self-reported and experimentally induced changes in food intake under stress. Appetite. 2009;52(2):355-362.
37. Caso D, Miriam C, Rosa F, Mark C. Unhealthy eating and academic stress: The moderating effect of eating style and BMI. Health Psychol Open. 2020;7(2):2055102920975274.
38. Baskin R, Hill B, Jacka FN, O'Neil A, Skouteris H. Antenatal dietary patterns and depressive symptoms during pregnancy and early post-partum. Matern Child Nutr. 2017;13(1):e12218.
39. Noğay NH. Gebe Kadınların Beslenme Durumlarının Değerlendirilmesi. Ejovoc. 2011;1(1):51-57.