Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Oct 24, 2020
Date Accepted: Dec 8, 2020
Date Submitted to PubMed: Dec 9, 2020
Social Media Use, Unhealthy Lifestyles and the Risk of Miscarriage Among Pregnant Women in the COVID-19 Pandemic: Prospective Observational Study
ABSTRACT
Background:
The COVID-19 pandemic has resulted in dramatic changes to normal life and disrupted social and economic function globally. However, little is known about the impact of social media use and the risk of miscarriage among pregnant women.
Objective:
We aimed to assess the association between social media use and the risk of miscarriage among pregnant women in the early stage of COVID-19 pandemic in China.
Methods:
In this prospective cohort study, 456 singleton pregnant women in mainland China were recruited during January and February, 2020. Social media use, social-demographic characteristics, history of previous health and current lifestyles was collected at baseline and the occurrence of miscarriage was followed up. Log-binomial regression models were used to estimate the risk ratios (RRs) of miscarriage for women with different exposure of COVID-19-specipfic information.
Results:
Among all the 456 pregnant women included, the mean (SD) time spent on reading COVID-19 news was 1.8 (0.9) hours per day. Only 23 (5.0%) women spent < 0.5 hours on reading COVID-19 news per day, whereas 247 (54.2%) women spent 0.5-2 hours and 54 (11.8%) women spent ≥ 3 hours on reading COVID-19 news per day. Women with excessive media use (≥3h) were more likely to be previous pregnant, never taking physical activities, with inadequate dietary diversity, and poor sleep quality (all p<0.05). The prevalence of miscarriage was 16.0% (95% CI: 12.6%-19.4%). Compared with women who spent 0.5-1h (10.9%) or 1-2h (9.9%) on reading COVID-19 news, miscarriage prevalence in women who spent 2-3h (19.7%) and ≥3h (31.5%) were both significantly higher (p<0.05). We observed a U-shape relationship between media use about COVID-19 and the risk of miscarriage. In the multivariable model, compared with 0.5-2h media use group, the risk of miscarriage was significantly higher in the 2-3h media use group (adjusted RR, 2.18; 95% CI: 1.20-3.95) and ≥ 3h media use group (adjusted RR, 4.08; 95% CI: 2.01-8.28), after adjusted for potential confounders (all p<0.05). In the sensitivity analysis, results were still stable. In the subgroup analysis, the risk of miscarriage was significantly higher in the <0.5h media use group among women living in urban areas, having history of miscarriage, and advanced maternal age (p<0.05), while significantly higher in the >3h media use group among women living in rural areas, without history of miscarriage, and younger age (p<0.05).
Conclusions:
Pregnant women spent about 2 hours a day on reading COVID-19 news in the early stage of COVID-19 pandemic in China. Pregnant women with excessive media use were more likely to be previous pregnant, never taking physical activities, with inadequate dietary diversity, and poor sleep quality. Excessive or inadequate media use was associated with the higher risk of miscarriage. Our findings highlighted the importance of getting moderate amount of COVID-19 related information from social media during the COVID-19 pandemic.
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