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, unhealthy lifestyles and the risk of miscarriage among pregnant women during the COVID-19 pandemic. OBJECTIVE: We aimed to assess the association between social media use, unhealthy lifestyles 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-demographic characteristics, history of previous health, social media use, 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, there were 82 (18.0%) without any physical activities, 82 (18.0%) with inadequate dietary diversity, 174 (38.2%) with poor sleep quality, and 54 (11.8%) spending &#8805; 3 hours on reading COVID-19 news per day. Women with excessive media use (&#8805;3h) were more likely to be previous pregnant, never taking physical activities, with inadequate dietary diversity, and poor sleep quality (all P<.05). The prevalence of miscarriage was 16.0% (95% CI: 12.6%-19.4%). Compared with women who spent 0.5-2h (10.1%) on reading COVID-19 news per day, miscarriage prevalence in women who spent <0.5h (21.7%), 2-3h (19.7%) and &#8805;3h (31.5%) were higher (P<.05). Miscarriage prevalence was also higher in pregnant women with poor sleep quality (22.4% vs 12.1%, P<.05) and high educational level (17.9% vs 8.0%, P<.05). In the multivariable model, poor sleep quality (adjusted RR, 2.06; 95% CI: 1.24-3.44), 2-3h media use daily (adjusted RR, 1.74; 95% CI: 1.02-2.97), and &#8805; 3h media use daily (adjusted RR, 2.56; 95% CI: 1.43-4.59) were associated with miscarriage (all P<.05) (all P<.05). In the sensitivity analysis, results were still stable. CONCLUSIONS: Pregnant women with excessive media use were more likely to be never taking physical activities, with inadequate dietary diversity, and poor sleep quality. Excessive media use and poor sleep quality was associated with the higher risk of miscarriage. Our findings highlighted the importance of healthy lifestyles during the COVID-19 pandemic.
Social Media Use, Unhealthy Lifestyles and the Risk of Miscarriage Among Pregnant Women in the COVID-19 Pandemic: Prospective Observational Study