Depressive symptoms hopelessness self-efficacy and COVID-19-related stressors among pregnant women in Hungary across two pandemic waves

Depression and hopelessness during pregnancy may be intensified by public health crises, yet less is known about how pregnancy- and pandemic-related stressors differ across successive COVID-19 waves. This study examined depressive symptoms, hopelessness, self-efficacy, and COVID-19-related concerns among pregnant women in Hungary during two independent cross-sectional pandemic waves. A total of 692 pregnant women participated in Wave 1 and 459 in Wave 2. Participants completed the Edinburgh Postnatal Depression Scale, Beck Hopelessness Scale, General Self-Efficacy Scale, and the study-specific „Pregnancy during the coronavirus” questionnaire. EPDS categories did not differ significantly between waves; 11.8% of participants in Wave 1 and 10.5% in Wave 2 fell into the major depressive symptom range. Mild hopelessness was reported by 31.1% and 26.4%, and moderate/severe hopelessness by 3.2% and 3.3%, respectively. Confinement-related difficulties and daily disruption, as well as perceived support and positive reappraisal, were higher in Wave 1 than Wave 2, both p < 0.001. In Wave 2, unplanned or unwanted pregnancy was associated with higher depressive symptoms, hopelessness, and financial/housing concerns. Emotional distress and impaired coping was the strongest predictor of EPDS and BHS scores, while self-efficacy was a consistent negative predictor. These findings support pregnancy-sensitive mental health screening during public health crises.