Examining the Relative Importance of Factors Influencing Perinatal Anxiety in Different Perinatal Periods During the Covid-19 Pandemic: A Random Forest-Based Approach.

Perinatal anxiety disorders are associated with adverse outcomes for mothers and children. However, most studies investigating perinatal anxiety, especially during the Covid-19 pandemic, have focused on pregnancy symptoms at a certain time. This study aimed to describe the prevalence of anxiety in four perinatal periods and to determine the relative importance of factors influencing anxiety in different perinatal periods during the Covid-19 pandemic. This cross-sectional study recruited 2030 women from February 28 to April 26, 2020, in Wuhan, Beijing, and Lanzhou, China. A random forest model was used to identify factors affecting anxiety during four perinatal periods, and the Shapley Additive explanation (SHAP) method was used to further interpret the results. The results show that during the Covid-19 pandemic, the prevalence of anxiety in the four trimesters of pregnancy was 21.5%, 19.2%, 21.6%, and 27.2%, respectively. Depression, insomnia, and worries or fears during childbirth are all important factors affecting maternal anxiety, among which depression is the most important factor. However, the relative importance of factors in different stages of pregnancy is different, so precise intervention should be implemented in time to alleviate the occurrence of maternal anxiety.