Factors Associated With Changes in Pregnancy Intention Among Women Who Were Mothers of Young Children in New York City Following the COVID-19 Outbreak.
Factors Associated With Changes in Pregnancy Intention Among Women Who Were Mothers of Young Children in New York City Following the COVID-19 Outbreak.
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DOI：
10.1001/jamanetworkopen.2021.24273
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发表时间：
2021-09-01
影响因子：
13.8
通讯作者：
Jacobson MH
中科院分区：
文献类型：
--
作者：
Kahn LG;Trasande L;Liu M;Mehta-Lee SS;Brubaker SG;Jacobson MH
在纽约市第一波新冠肺炎的高峰期，有年幼孩子的女性的怀孕意愿是否发生了变化？在这项横断面研究中，纽约市有1,179名年幼子女的母亲，其中近一半一直试图怀孕，超过三分之一的人在新冠肺炎疫情爆发的头几个月停止之前一直在考虑尝试怀孕。在封锁期间回答调查的女性更有可能停止怀孕的尝试或计划。这项研究的结果表明，新冠肺炎疫情的爆发与计划或试图怀孕的女性减少有关；这些发现可能对生育率产生长期影响。早期证据显示，在新冠肺炎大流行期间，美国出生人口数量有所下降，但很少有研究考察与怀孕意愿变化相关的个人层面因素，特别是在不同的研究人群中，或在美国受新冠肺炎影响较高的地区。研究新冠肺炎疫情爆发后怀孕意向的变化，并确定可能与这些变化相关的因素。一项以人口为基础的横断面研究在目前怀孕或生下活婴儿的妇女中进行，并回复了通过电子邮件发送给2,603名妇女的调查(n = 1560)。在纽约大学儿童健康和环境研究未来出生队列中登记的年幼孩子的母亲被包括在内；目前没有怀孕或最近产后的妇女被排除在外。通过一项于2020年4月20日至8月31日进行的调查，评估了人口统计学、新冠肺炎相关、压力相关以及财务/职业因素。新冠肺炎大流行前的怀孕意向和疫情爆发后怀孕意向的变化。在向2603名女性发送的调查中，1560名(59.9%)目前怀孕或已生下活婴的女性做出了回应，1179名女性(75.6%)回答了怀孕意向问题。平均年龄32.2岁(5.6岁)。疫情爆发后，61名积极尝试怀孕的妇女中有30名(49.2%)已经停止尝试，191名计划怀孕的妇女中有71名(37.2%)不再计划怀孕，927名既没有计划也没有尝试怀孕的妇女中有42名(4.5%)新考虑怀孕。在那些停止尝试的人中，不到一半(13[43.3%])的人认为他们会在大流行后恢复。在那些停止考虑或尝试怀孕的新冠肺炎前规划者/试管者中，更大比例的人教育水平较低，尽管经多因素分析，差异并不具有统计学意义(优势比[OR]，2.14；95%CI，0.92-4.96)。压力水平较高的人(OR，1.09；95%CI，0.99-1.20)和财务不安全感较大的人(OR，1.37；95%CI，0.97-1.92)也是如此。那些停止考虑或尝试怀孕的人更有可能在疫情爆发高峰期回答调查问卷(OR，2.04；95%CI，1.01-4.11)。在那些报告了新考虑怀孕的新冠肺炎前无计划者/非计划者中，在高峰期做出反应的比例较小，尽管这一发现在多变量分析中没有统计学意义(OR，0.52；95%CI，0.26-1.03)。同样，经济上不安全的受访者报告新考虑怀孕的人较少，尽管这一发现在统计学上没有显著意义(OR，0.69；95%CI，0.46-1.03)。他们明显不太可能是西班牙裔(OR，0.27；955CI，0.10-0.71)，更有可能家里孩子较少(OR，0.62；95%CI，0.40-0.98)或自我报告患有新冠肺炎(OR，2.70；95%CI，1.31-5.55)。在这项对纽约市1,179名有年幼子女的母亲进行的横断面研究中，新冠肺炎疫情造成的压力增加和经济不安全感增加的同时，怀孕意愿在疫情爆发的头几个月减少，有可能加剧生育率的长期下降。这项横断面研究调查了在第一波新冠肺炎疫情期间，纽约市有年幼孩子的母亲的怀孕意向。
Were there changes in pregnancy intentions among women who were mothers of young children around the peak of the first wave of COVID-19 in New York City? In this cross-sectional study of 1179 women in New York City who were mothers of young children, nearly half of those who had been attempting to become pregnant and more than a third who had been thinking about trying before the COVID-19 pandemic stopped in the first few months of the outbreak. Women who responded to a survey during the lockdown were more likely to cease attempts or plans to become pregnant. The results of this study suggest that the outbreak of the COVID-19 pandemic was associated with fewer women planning or attempting to become pregnant; these findings may have long-term effects on fertility rates. 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. To study changes in pregnancy intention following the outbreak of the COVID-19 pandemic and identify factors possibly associated with these changes. 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. Demographic, COVID-19–related, stress-related, and financial/occupational factors were assessed via a survey administered from April 20 to August 31, 2020. Pregnancy intentions before the COVID-19 pandemic and change in pregnancy intentions following the outbreak. 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). 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. This cross-sectional study examines the intentions on becoming pregnant of women in New York City who were mothers of young children during the first wave of the COVID-19 pandemic.
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