title: Psychological responses of pregnant women to an infectious outbreak: a case-control study of the 2003 SARS outbreak in Hong Kong.
abstract: OBJECTIVE
  The aim of the present study was to examine the behavioral and psychological responses of pregnant women during the 2003 severe acute respiratory syndrome (SARS) outbreak in Hong Kong.
  
  
  METHODS
  Ethnographic interviews were first conducted to identify the common psychological and behavioral responses to the outbreak. This was followed by a case-control study of 235 consecutive pregnant women recruited during the SARS epidemic, and a historical cohort of 939 pregnant women recruited a year before the outbreak. Both cohorts completed standardized rating scales on depression, anxiety, and social support.
  
  
  RESULTS
  Women in the SARS cohort adopted behavioral strategies to mitigate their risk of contracting infection. However, pregnant women tended to overestimate the risk of contracting SARS and nearly a third of the women were homebound. The anxiety level of the SARS cohort was slightly higher than that of the pre-SARS control. No statistical difference was found between the depression levels of the two cohorts.
  
  
  CONCLUSIONS
  The improved social support experienced by pregnant women during SARS might have buffered the stress associated with an outbreak. However, clinicians should monitor for overestimation of infectious risk among pregnant women.
authors.affiliation: Department of Psychiatry, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, People's Republic of China. dominic.lee@mac.com
authors.forename: Dominic T S
authors.initials: DT
authors.lastname: Lee
authors.forename: Daljit
authors.initials: D
authors.lastname: Sahota
authors.forename: Tse N
authors.initials: TN
authors.lastname: Leung
authors.forename: Alexander S K
authors.initials: AS
authors.lastname: Yip
authors.forename: Fiona F Y
authors.initials: FF
authors.lastname: Lee
authors.forename: Tony K H
authors.initials: TK
authors.lastname: Chung
mesh_terms: D000328:Adult; D001294:Attitude to Health; D016022:Case-Control Studies; D015331:Cohort Studies; D004196:Disease Outbreaks; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D018577:Homebound Persons / Q000523:psychology / Q000706:statistics & numerical data; D006723:Hong Kong; D006801:Humans; D007406:Interview, Psychological; D011247:Pregnancy / Q000523:psychology*; D012306:Risk; D012307:Risk Factors; D045169:Severe Acute Respiratory Syndrome / Q000517:prevention & control / Q000523:psychology* / Q000635:transmission; D012944:Social Support