Pregnant women may be especially susceptible to negative events (i.e. adversity) related to the coronavirus disease 2019 (COVID-19) pandemic and negative affective responses to these events (i.e. stress). We examined the latent structure of stress and adversity related to the COVID-19 pandemic among pregnant women, potential antecedents of COVID-19-related stress and adversity in this population, and associations with prenatal depressive symptoms.

We surveyed 725 pregnant women residing in the San Francisco Bay Area in March−May 2020, 343 of whom provided addresses that were geocoded and matched by census tract to measures of community-level risk. We compared their self-reported depressive symptoms to women matched on demographic factors and history of mental health difficulties who were pregnant prior to the pandemic.

Women who were pregnant during the pandemic were nearly twice as likely to have possible depression than were matched women who were pregnant prior to the pandemic. Individual- and community-level factors tied to socioeconomic inequality were associated with latent factors of COVID-19-related stress and adversity. Beyond objective adversity, subjective stress responses were strongly associated with depressive symptoms during the pandemic.

Highlighting the role of subjective responses in vulnerability to prenatal depression and factors that influence susceptibility to COVID-19-related stress, these findings inform the allocation of resources to support recovery from this pandemic and future disease outbreaks. In addition to policies that mitigate disruptions to the environment due to the pandemic, treatments that focus on cognitions about the self and the environment may help to alleviate depressive symptoms in pregnant women.

孕妇可能特别容易受到与 2019 年冠状病毒病 (COVID-19) 大流行相关的负面事件（即逆境）以及对这些事件的负面情感反应（即压力）的影响。我们研究了孕妇中与 COVID-19 大流行相关的压力和逆境的潜在结构、该人群中与 COVID-19 相关的压力和逆境的潜在前因，以及与产前抑郁症状的关联。

我们于 2020 年 3 月至 5 月对居住在旧金山湾区的 725 名孕妇进行了调查，其中 343 名孕妇提供了经过地理编码的地址，并通过人口普查区与社区层面的风险衡量标准进行了匹配。我们将她们自我报告的抑郁症状与大流行前怀孕的人口统计学因素和心理健康困难史相匹配的女性进行了比较。

在大流行期间怀孕的女性患抑郁症的可能性几乎是大流行前怀孕的女性的两倍。与社会经济不平等相关的个人和社区层面的因素与 COVID-19 相关压力和逆境的潜在因素有关。除了客观的逆境之外，主观压力反应与大流行期间的抑郁症状密切相关。

这些发现强调了主观反应在产前抑郁症脆弱性中的作用以及影响对 COVID-19 相关压力的易感性的因素，为支持从这次大流行和未来疾病爆发中恢复的资源分配提供了信息。除了减轻大流行对环境造成破坏的政策外，注重自我和环境认知的治疗方法可能有助于缓解孕妇的抑郁症状。