Pregnant Women's Concerns Regarding COVID-19 and Their Willingness to Be Vaccinated.

Objectives: We investigated coronavirus disease 2019 (COVID-19) opinions, experiences, and willingness to accept COVID-19 vaccination during pregnancy at two prenatal clinics in early 2021 and early 2022. Materials and Methods: Paper questionnaires were distributed to pregnant women at prenatal care facilities in Virginia and Florida between January and April 2021 and January and April 2022. Questions regarding acceptance and opinions of the influenza vaccine served as a baseline to assess COVID-19 vaccine opinions. Associations between demographic parameters and vaccine opinions and acceptance were examined using Chi-square. A COVID-19 concern score was constructed by principal component analysis with differences between groups assessed by analysis of variance (ANOVA) and analysis of covariance (ANCOVA). Results: Many participants (40.6%) reported that the COVID pandemic had affected their pregnancy. Main themes were problems with social networks, increased stress/anxiety, and being more cautious. In 2021, 19.5% reported they would accept a COVID-19 vaccination during their pregnancy, which increased to 45.8% in 2022. Vaccine hesitancy did not vary by race or between sites, but educational attainment was significant (p < 0.001). Women with a higher concern score were more likely to report they would accept a COVID-19 vaccine. Women who would accept COVID vaccination had a positive opinion regarding the influenza vaccine. Main themes for refusing COVID-19 vaccination were concerns about side effects, lack of research/data, and mistrust of vaccines. Conclusions: The proportion of women willing to accept COVID-19 vaccination increased but remained below 50%. Willingness to accept vaccination during pregnancy was associated with higher education, higher concern about COVID-19, and a positive opinion of the influenza vaccine.

Pregnant Women's Opinions and Acceptance of Influenza and Tdap Vaccines.

Background: Influenza and tetanus, diphtheria, and pertussis (Tdap) vaccinations during pregnancy protect mother and infant. However, acceptance of these vaccines during pregnancy is suboptimal, especially among Black women in the United States. We characterize vaccine intentions and opinions of pregnant patients at two prenatal care clinics before and after reading informational text. Methods: A survey was distributed to pregnant patients at prenatal clinics in Winchester, Virginia, and Jacksonville, Florida. The survey assessed patient demographics and vaccine opinions and acceptance before and after patients read informational text about the vaccines. Associations between demographics and vaccine opinions and acceptance were assessed using Chi-square; Principal Component Analysis was used to produce an influenza vaccine opinion score. Differences in the opinion score between groups were assessed by ANOVA and ANCOVA. Results: Respondents (n = 654) who identified as Black and with lower educational attainment reported lower receipt of the influenza vaccine outside of pregnancy and receipt of or plans to receive the influenza and Tdap vaccines during pregnancy (p < 0.001). Respondents' influenza vaccine practices outside of pregnancy were associated with their likelihood of getting the vaccine while pregnant. Most respondents found the informational text useful; among women not yet vaccinated, 26% reported they were more likely to receive the influenza vaccine and 49.9% more likely to receive the Tdap vaccine after reading the text. Conclusions: Women have varying opinions and make different decisions about immunization, with race and educational level being significant correlates. Participants generally welcomed information about vaccines, and many were influenced positively, especially for Tdap.

A Survey of Women and Their Providers Regarding Gestational Weight Gain.

Background: Inappropriate gestational weight gain (GWG) is prevalent in the United States. About 20% of women gain below Institute of Medicine (IOM) recommendations; more than 50% gain above. GWG outside of recommendations is linked to poor birth outcomes and health issues for mother and baby. Counseling by health care providers is important to encourage appropriate GWG. Methods: Assess patient recall of counseling regarding GWG, provider knowledge, and opinions about IOM GWG guidance, and GWG outcomes in a subset of women. Cross-sectional, with questionnaires distributed by 8 medical centers across the United States to patients. Questionnaires were distributed to providers and data on maternal body mass index (BMI) and GWG collected at seven sites. Results: A total of 1,157 women returned questionnaires (1,820 maximum possible). A majority at all sites reported a provider discussed their expected GWG with them. Close to half reported that a provider had discussed potential harms from inappropriate GWG. Most of the women (71.2%) considered their obstetrician to be a helpful resource for GWG advice. Most providers (87.5%) reported they were aware of IOM guidelines. As many providers disagreed (18.8%) as agreed (20.8%) that they were successful helping their patients attain appropriate GWG (58.3% were neutral). Physician self-reported confidence was associated with whether they believed they could help their patients avoid excessive GWG. The most common outcome was GWG above recommendations (51.4%). Overweight and obese women were more likely to gain above recommendations. Providers underestimated the proportion of their patients that gained below IOM recommendations (8.5% vs. 18.6%). Conclusions: Providers are aware of the dangers of excessive GWG and a majority of patients report receiving counseling. Providers appear more cognizant of excessive GWG and underestimate inadequate GWG. Most women are not achieving an appropriate GWG, with overweight and obese women especially likely to gain above recommendations.