Married women’s decision to delay childbearing, and loneliness, severe psychological distress, and suicidal ideation under crisis: Online survey data analysis from 2020 and 2021 (preprint)

Background The COVID-19 pandemic has affected every aspect of our lives, including the decision to become pregnant. Existing literature suggests that infertility and the decision to delay childbearing at a younger age are associated with a lower level of well-being and regrets when women start to desire a baby. Thus, the decision to delay childbearing due to the pandemic could negatively affect the well-being of women. This study focuses on how pregnancy decisions affect the well-being of women during the COVID-19 pandemic.Methods From the Japan COVID-19 and Society Internet Survey, a nationally representative web-based survey, 768 observations of married women aged 18 to 50 years who had the intention of getting pregnant during the pre-pandemic period (conducted in 2020 and 2021) were used. Loneliness, severe psychological distress, and suicidal ideation were used as well-being indicators. For pooled data, a generalised estimated equation (GEE) model was used to estimate how pregnancy decision related to well-being indicators. For a sub-analysis, the sample was divided by the survey year and a Poisson regression model was used.Results Approximately 20% of married women reported that their decision to postpone childbearing was due to the pandemic. The GEE analysis showed an association between delaying childbearing and severe psychological distress, with the prevalence ratio (PR) being 2.06 [95% CI (1.40–3.03)]. Furthermore, loneliness and suicidal ideation that occurred after the beginning of the pandemic were significantly related to the decision to delay childbearing—1.55 [95% CI (1.03,2.34)] and 2.55 [95% CI (1.45–4.51)], respectively. Moreover, these PRs were larger for 2021 compared to 2020.Conclusion During the COVID-19 pandemic, approximately one-fifth of married women who had childbearing intentions before the pandemic decided to postpone pregnancy. They exhibited a deteriorated mental health state. Furthermore, the negative associations were larger in 2021 compared to 2020. Loneliness has negative consequences for both mental and physical health, as well as elevated severe psychological distress and suicidal ideation among those who decided to postpone pregnancy. Therefore, the current results should not be overlooked by society.

How well does societal mobility restriction help control the COVID-19 pandemic? Evidence from real-time evaluation (preprint)

Objectives To determine the impact of restrictions on mobility on reducing transmission of COVID-19. Design Daily incidence rates lagged by 14 days were regressed on mobility changes using LOESS regression and logit regression between the day of the 100th case in each country to August 31, 2020. Setting 34 OECD countries plus Singapore and Taiwan. Participants Google mobility data were obtained from people who turned on mobile device-based global positioning system (GPS) and agreed to share their anonymized position information with Google. Interventions We examined the association of COVID-19 incidence rates with mobility changes, defined as changes in categories of domestic location, against a pre-pandemic baseline, using country-specific daily incidence data on newly confirmed COVID-19 cases and mobility data. Results In two thirds of examined countries, reductions of up to 40% in commuting mobility (to workplaces, transit stations, retailers, and recreation) were associated with decreased COVID-19 incidence, more so early in the pandemic. However, these decreases plateaued as mobility remained low or decreased further. We found smaller or negligible associations between mobility restriction and incidence rates in the late phase in most countries. Conclusion Mild to moderate degrees of mobility restriction in most countries were associated with reduced incidence rates of COVID-19 that appear to attenuate over time, while some countries exhibited no effect of such restrictions. More detailed research is needed to precisely understand the benefits and limitations of mobility restrictions as part of the public health response to the COVID-19 pandemic.

Working from Home and Dietary Changes during the COVID-19 Pandemic: A Longitudinal Study of Health App (CALO Mama) Users (preprint)

It is plausible that the coronavirus disease 2019 pandemic and related lifestyle changes affected dietary patterns, but existing studies have limitations owing to a cross-sectional design. Using longitudinal data, we examined dietary changes in people due to the pandemic and related lifestyles. We conducted an online survey on lifestyle changes during the pandemic from April 30 to May 8, 2020, among users of a health app called CALO mama provided in Japan. We retrieved and linked the dietary data for 5,929 participants from January 1 to May 13, 2020. Generalized linear mixed models were used to estimate the frequencies of food intake associated with the pandemic and lifestyles. During the governmental declaration of a state of emergency, the frequency of intake of self-made meals (incidence rate ratio [IRR] = 1.05), vegetables (IRR = 1.06), and snacks increased (IRR = 1.04). Similarly, working from home was associated with increased rates of intake of self-made meals (IRR = 1.02), vegetables (IRR = 1.02), fruits (IRR = 1.06), and snacks (IRR = 1.04). In contrast, working hours (self-made meals: IRR = 0.997, fruits: IRR = 0.99, snacks: IRR = 0.99 [per hour]), time spent on childcare (self-made meals: IRR = 0.99, vegetables: IRR = 0.99, fruits: IRR = 0.98 [per hour]), and depressive symptoms (self-made meals: IRR = 0.93, vegetables: IRR = 0.92, fruits: IRR = 0.90) tended to be negatively associated with the frequency of food intake. This study showed that the pandemic affected dietary patterns in various ways. It is important to record and notice such changes and modify them to the recommended balance during a prolonged pandemic to ensure healthy eating habits.

Working From Home and Lifestyle Changes Associated With Risk of Depression During the COVID-19 Pandemic: An Observational Study of Health App (CALO Mama) Users (preprint)

Background: During the corona-virus disease 2019 pandemic, many people refrained from going out, started working from home (WFH), and suspended work or lost their jobs, and these lifestyle changes could affect their mental health. This study examines how such pandemic-related lifestyle changes were associated with the risk of depression.Methods: An online survey among participants who use a health app called CALO mama was conducted from April 30 to May 8, 2020 in Japan. Depressive symptoms were assessed using the two-question screen. Participants consisted of 1,238 men (mean age = 51.0) and 2,086 women (mean age = 43.2), and their number of daily steps from January 1 to May 13, recorded by an accelerometer in their mobile devices, was linked to their responses.Results: On average, participants took 900 fewer weekday steps during the governmental declaration of a state of emergency. Depressive symptoms were more prevalent among women than men (45.9% vs. 32.4%). Among women, a decrease in walking and increased time spent on childcare were associated with an increased risk of depression. Conversely, starting WFH was negatively associated with risk for women. Among men, more weekday steps in the pre-declaration period were protective against depression. Men who worked longer during the declaration period, however, had an increased risk for depression, but WFH mitigated their risk.Conclusions: Prevention of social isolation and physical inactivity due to home-bound lifestyles, the promotion of WFH, and gender-specific measures such as prevention of longer working hours and more support for home childcare are needed.