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Factors Associated With Changes in Pregnancy Intention Among Women Who Were Mothers of Young Children in New York City Following the COVID-19 Outbreak.
Kahn, Linda G; Trasande, Leonardo; Liu, Mengling; Mehta-Lee, Shilpi S; Brubaker, Sara G; Jacobson, Melanie H.
  • Kahn LG; Division of Environmental Pediatrics, Department of Pediatrics, NYU Langone Medical Center, New York, New York.
  • Trasande L; Department of Population Health, NYU Langone Medical Center, New York, New York.
  • Liu M; Division of Environmental Pediatrics, Department of Pediatrics, NYU Langone Medical Center, New York, New York.
  • Mehta-Lee SS; Department of Population Health, NYU Langone Medical Center, New York, New York.
  • Brubaker SG; Department of Environmental Medicine, NYU Langone Medical Center, New York, New York.
  • Jacobson MH; NYU Wagner School of Public Service, New York, New York.
JAMA Netw Open ; 4(9): e2124273, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1409779
ABSTRACT
Importance Early evidence shows a decrease in the number of US births during the COVID-19 pandemic, yet few studies have examined individual-level factors associated with pregnancy intention changes, especially among diverse study populations or in areas highly affected by COVID-19 in the US.

Objective:

To study changes in pregnancy intention following the outbreak of the COVID-19 pandemic and identify factors possibly associated with these changes. Design, Setting, and

Participants:

A cross-sectional, population-based study was conducted among women who were currently pregnant or had delivered a live infant and responded to a survey emailed to 2603 women (n = 1560). Women who were mothers of young children enrolled in the prospective New York University Children's Health and Environment Study birth cohort were included; women who were not currently pregnant or recently postpartum were excluded. Exposures Demographic, COVID-19-related, stress-related, and financial/occupational factors were assessed via a survey administered from April 20 to August 31, 2020. Main Outcomes and

Measures:

Pregnancy intentions before the COVID-19 pandemic and change in pregnancy intentions following the outbreak.

Results:

Of the 2603 women who were sent the survey, 1560 (59.9%) who were currently pregnant or had delivered a live infant responded, and 1179 women (75.6%) answered the pregnancy intention questions. Mean (SD) age was 32.2 (5.6) years. Following the outbreak, 30 of 61 (49.2%) women who had been actively trying to become pregnant had ceased trying, 71 of 191 (37.2%) women who had been planning to become pregnant were no longer planning, and 42 of 927 (4.5%) women who were neither planning nor trying were newly considering pregnancy. Among those who ceased trying, fewer than half (13 [43.3%]) thought they would resume after the pandemic. Of those pre-COVID-19 planners/triers who stopped considering or attempting pregnancy, a greater proportion had lower educational levels, although the difference was not statistically significant on multivariable analysis (odds ratio [OR], 2.14; 95% CI, 0.92-4.96). The same was true for those with higher stress levels (OR, 1.09; 95% CI, 0.99-1.20) and those with greater financial insecurity (OR, 1.37; 95% CI, 0.97-1.92. Those who stopped considering or attempting pregnancy were more likely to respond to the questionnaire during the peak of the outbreak (OR, 2.04; 95% CI, 1.01-4.11). Of those pre-COVID-19 nonplanners/nontriers who reported newly thinking about becoming pregnant, a smaller proportion responded during the peak, although the finding was not statistically significant on multivariable analysis (OR, 0.52; 95% CI, 0.26-1.03). Likewise, fewer respondents who were financially insecure reported newly considering pregnancy, although the finding was not statistically significant (OR, 0.69; 95% CI, 0.46-1.03). They were significantly less likely to be of Hispanic ethnicity (OR, 0.27; 955 CI, 0.10-0.71) and more likely to have fewer children in the home (OR, 0.62; 95% CI, 0.40-0.98) or self-report a COVID-19 diagnosis (OR, 2.70; 95% CI, 1.31-5.55). Conclusions and Relevance In this cross-sectional study of 1179 women who were mothers of young children in New York City, increased stress and financial insecurity owing to the COVID-19 pandemic paralleled a reduction in pregnancy intention in the early months of the pandemic, potentially exacerbating long-term decreases in the fertility rate.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy / Quarantine / Intention / COVID-19 / Mothers Type of study: Cohort study / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy / Quarantine / Intention / COVID-19 / Mothers Type of study: Cohort study / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article