Am J Perinatol
DOI: 10.1055/a-2257-3992
Short Communication

Early-Pregnancy Resilience Characteristics Before Versus During the COVID-19 Pandemic

1   Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, Rhode Island
Audra C. Fain
2   Department of Obstetrics and Gynecology, David Geffen School of Medicine UCLA, Los Angeles, California
Tess E.K. Cersonsky
3   Department of Obstetrics, Gynecology, and Reproductive Sciences, Icahn School of Medicine at Mount Sinai Hospital, New York, New York
Erika F. Werner
4   Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, Massachusetts
Emily S. Miller
1   Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, Rhode Island
Melissa A. Clark
1   Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, Rhode Island
5   Department of Health Services, Policy and Practice, Brown School of Public Health, Providence, Rhode Island
1   Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, Rhode Island
› Author Affiliations
Funding This work was supported by the National Institutes of Health (K23 HD103961, P20GM139767) and the Robert A. Winn Diversity in Clinical Trials Award Career Development Award (N.K.A.).


Objective Resilience is associated with mental and somatic health benefits. Given the social, physical, and mental health toll of the coronavirus disease 2019 (COVID-19) pandemic, we examined whether the COVID-19 pandemic was associated with population-level changes in resilience among pregnant people.

Study Design Secondary analysis of a prospective cohort of nulliparous pregnant people <20 weeks' gestation from a single hospital. Participants completed baseline assessments of resilience characteristics, including dispositional optimism (DO), mindfulness, and proactive coping. For this analysis, participants recruited before the COVID-19 pandemic were compared with those recruited during the pandemic. The primary outcome was DO, assessed as a continuous score on the validated Revised Life Orientation Test. Secondary outcomes included continuous scores on mindfulness and proactive coping assessments. Bivariable analyses were completed using chi-squared and Mann–Whitney U tests. Multivariable linear regression compared resilience scores by recruitment time frame, controlling for confounders selected a priori: maternal age, education, and marital status.

Results Of the 300 participants, 152 (50.7%) were recruited prior to the pandemic. Demographic and pregnancy characteristics differed between groups: the during-pandemic group was older, had higher levels of education, and were more likely to be married/partnered. There were no significant differences in any of the resilience characteristics before versus during the pandemic in bivariable or multivariable analyses.

Conclusion In this cohort, there were no differences in early pregnancy resilience characteristics before versus during the COVID-19 pandemic. This affirms that on a population level, resilience is a stable metric, even in the setting of a global pandemic.

Key Points

  • Resilience is associated with mental and somatic health benefits.

  • No difference in early-pregnancy resilience in those recruited before versus during the pandemic.

  • Consistent with conceptualization of resilience as an innate characteristic.

Publication History

Received: 16 June 2023

Accepted: 28 January 2024

Accepted Manuscript online:
30 January 2024

Article published online:
19 February 2024

© 2024. Thieme. All rights reserved.

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