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1. A prospective cohort study of preconception COVID-19 vaccination and miscarriage

   https://doi.org/10.1093/humrep/dead211  

   Yland, Jennifer J. ; Wesselink, Amelia K. ; Regan, Annette K. ; Hatch, Elizabeth E. ; Rothman, Kenneth J. ; Savitz, David A. ; Wang, Tanran R. ; Huybrechts, Krista F. ; Hernández-Díaz, Sonia ; Eisenberg, Michael L. ; et al ( October 2023 , Human Reproduction)

   To what extent is preconception maternal or paternal coronavirus disease 2019 (COVID-19) vaccination associated with miscarriage incidence?

   COVID-19 vaccination in either partner at any time before conception is not associated with an increased rate of miscarriage.

   Several observational studies have evaluated the safety of COVID-19 vaccination during pregnancy and found no association with miscarriage, though no study prospectively evaluated the risk of early miscarriage (gestational weeks [GW] <8) in relation to COVID-19 vaccination. Moreover, no study has evaluated the role of preconception vaccination in both male and female partners.

   An Internet-based, prospective preconception cohort study of couples residing in the USA and Canada. We analyzed data from 1815 female participants who conceived during December 2020–November 2022, including 1570 couples with data on male partner vaccination.

   Eligible female participants were aged 21–45 years and were trying to conceive without use of fertility treatment at enrollment. Female participants completed questionnaires at baseline, every 8 weeks until pregnancy, and during early and late pregnancy; they could also invite their male partners to complete a baseline questionnaire. We collected data on COVID-19 vaccination (brand and date of doses), history of SARS-CoV-2 infection (yes/no and date of positive test), potential confounders (demographic, reproductive, and lifestyle characteristics), and pregnancy status on all questionnaires. Vaccination status was categorized as never (0 doses before conception), ever (≥1 dose before conception), having a full primary sequence before conception, and completing the full primary sequence ≤3 months before conception. These categories were not mutually exclusive. Participants were followed up from their first positive pregnancy test until miscarriage or a censoring event (induced abortion, ectopic pregnancy, loss to follow-up, 20 weeks’ gestation), whichever occurred first. We estimated incidence rate ratios (IRRs) for miscarriage and corresponding 95% CIs using Cox proportional hazards models with GW as the time scale. We used propensity score fine stratification weights to adjust for confounding.

   Among 1815 eligible female participants, 75% had received at least one dose of a COVID-19 vaccine by the time of conception. Almost one-quarter of pregnancies resulted in miscarriage, and 75% of miscarriages occurred <8 weeks’ gestation. The propensity score-weighted IRR comparing female participants who received at least one dose any time before conception versus those who had not been vaccinated was 0.85 (95% CI: 0.63, 1.14). COVID-19 vaccination was not associated with increased risk of either early miscarriage (GW: <8) or late miscarriage (GW: 8–19). There was no indication of an increased risk of miscarriage associated with male partner vaccination (IRR = 0.90; 95% CI: 0.56, 1.44).

   The present study relied on self-reported vaccination status and infection history. Thus, there may be some non-differential misclassification of exposure status. While misclassification of miscarriage is also possible, the preconception cohort design and high prevalence of home pregnancy testing in this cohort reduced the potential for under-ascertainment of miscarriage. As in all observational studies, residual or unmeasured confounding is possible.

   This is the first study to evaluate prospectively the relation between preconception COVID-19 vaccination in both partners and miscarriage, with more complete ascertainment of early miscarriages than earlier studies of vaccination. The findings are informative for individuals planning a pregnancy and their healthcare providers.

   This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Health [R01-HD086742 (PI: L.A.W.); R01-HD105863S1 (PI: L.A.W. and M.L.E.)], the National Institute of Allergy and Infectious Diseases (R03-AI154544; PI: A.K.R.), and the National Science Foundation (NSF-1914792; PI: L.A.W.). The funders had no role in the study design, data collection, analysis and interpretation of data, writing of the report, or the decision to submit the paper for publication. L.A.W. is a fibroid consultant for AbbVie, Inc. She also receives in-kind donations from Swiss Precision Diagnostics (Clearblue home pregnancy tests) and Kindara.com (fertility apps). M.L.E. received consulting fees from Ro, Hannah, Dadi, VSeat, and Underdog, holds stock in Ro, Hannah, Dadi, and Underdog, is a past president of SSMR, and is a board member of SMRU. K.F.H. reports being an investigator on grants to her institution from UCB and Takeda, unrelated to this study. S.H.-D. reports being an investigator on grants to her institution from Takeda, unrelated to this study, and a methods consultant for UCB and Roche for unrelated drugs. The authors report no other relationships or activities that could appear to have influenced the submitted work.

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2. Cognitive Symptoms of Post–COVID-19 Condition and Daily Functioning

   https://doi.org/10.1001/jamanetworkopen.2023.56098  

   Jaywant, Abhishek ; Gunning, Faith M. ; Oberlin, Lauren E. ; Santillana, Mauricio ; Ognyanova, Katherine ; Druckman, James N. ; Baum, Matthew A. ; Lazer, David ; Perlis, Roy H. ( February 2024 , JAMA Network Open)

   The frequent occurrence of cognitive symptoms in post–COVID-19 condition has been described, but the nature of these symptoms and their demographic and functional factors are not well characterized in generalizable populations.

   To investigate the prevalence of self-reported cognitive symptoms in post–COVID-19 condition, in comparison with individuals with prior acute SARS-CoV-2 infection who did not develop post–COVID-19 condition, and their association with other individual features, including depressive symptoms and functional status.

   Two waves of a 50-state nonprobability population-based internet survey conducted between December 22, 2022, and May 5, 2023. Participants included survey respondents aged 18 years and older.

   Post–COVID-19 condition, defined as self-report of symptoms attributed to COVID-19 beyond 2 months after the initial month of illness.

   Seven items from the Neuro-QoL cognition battery assessing the frequency of cognitive symptoms in the past week and patient Health Questionnaire-9.

   The 14 767 individuals reporting test-confirmed COVID-19 illness at least 2 months before the survey had a mean (SD) age of 44.6 (16.3) years; 568 (3.8%) were Asian, 1484 (10.0%) were Black, 1408 (9.5%) were Hispanic, and 10 811 (73.2%) were White. A total of 10 037 respondents (68.0%) were women and 4730 (32.0%) were men. Of the 1683 individuals reporting post–COVID-19 condition, 955 (56.7%) reported at least 1 cognitive symptom experienced daily, compared with 3552 of 13 084 (27.1%) of those who did not report post–COVID-19 condition. More daily cognitive symptoms were associated with a greater likelihood of reporting at least moderate interference with functioning (unadjusted odds ratio [OR], 1.31 [95% CI, 1.25-1.36]; adjusted [AOR], 1.30 [95% CI, 1.25-1.36]), lesser likelihood of full-time employment (unadjusted OR, 0.95 [95% CI, 0.91-0.99]; AOR, 0.92 [95% CI, 0.88-0.96]) and greater severity of depressive symptoms (unadjusted coefficient, 1.40 [95% CI, 1.29-1.51]; adjusted coefficient 1.27 [95% CI, 1.17-1.38). After including depressive symptoms in regression models, associations were also found between cognitive symptoms and at least moderate interference with everyday functioning (AOR, 1.27 [95% CI, 1.21-1.33]) and between cognitive symptoms and lower odds of full-time employment (AOR, 0.92 [95% CI, 0.88-0.97]).

   The findings of this survey study of US adults suggest that cognitive symptoms are common among individuals with post–COVID-19 condition and associated with greater self-reported functional impairment, lesser likelihood of full-time employment, and greater depressive symptom severity. Screening for and addressing cognitive symptoms is an important component of the public health response to post–COVID-19 condition.

    

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3. Study on U.S. Parents' Divisions of Labor During COVID-19, Waves 1-2

   https://doi.org/10.3886/E183142V2  

   Carlson, Daniel L. ; Petts, Richard J. ( January 2022 , ICPSR - Interuniversity Consortium for Political and Social Research)

   The COVID-19 pandemic has dramatically altered family life in the United States. Over the long duration of the pandemic, parents had to adapt to shifting work conditions, virtual schooling, the closure of daycare facilities, and the stress of not only managing households without domestic and care supports but also worrying that family members may contract the novel coronavirus. Reports early in the pandemic suggest that these burdens have fallen disproportionately on mothers, creating concerns about the long-term implications of the pandemic for gender inequality and mothers’ well-being. Nevertheless, less is known about how parents’ engagement in domestic labor and paid work has changed throughout the pandemic, what factors may be driving these changes, and what the long-term consequences of the pandemic may be for the gendered division of labor and gender inequality more generally.
   
   The Study on U.S. Parents’ Divisions of Labor During COVID-19 (SPDLC) collects longitudinal survey data from partnered U.S. parents that can be used to assess changes in parents’ divisions of domestic labor, divisions of paid labor, and well-being throughout and after the COVID-19 pandemic. The goal of SPDLC is to understand both the short- and long-term impacts of the pandemic for the gendered division of labor, work-family issues, and broader patterns of gender inequality.
   
   Survey data for this study is collected using Prolifc (www.prolific.co), an opt-in online platform designed to facilitate scientific research. The sample is comprised U.S. adults who were residing with a romantic partner and at least one biological child (at the time of entry into the study). In each survey, parents answer questions about both themselves and their partners. Wave 1 of SPDLC was conducted in April 2020, and parents who participated in Wave 1 were asked about their division of labor both prior to (i.e., early March 2020) and one month after the pandemic began. Wave 2 of SPDLC was collected in November 2020. Parents who participated in Wave 1 were invited to participate again in Wave 2, and a new cohort of parents was also recruited to participate in the Wave 2 survey. Wave 3 of SPDLC was collected in October 2021. Parents who participated in either of the first two waves were invited to participate again in Wave 3, and another new cohort of parents was also recruited to participate in the Wave 3 survey. This research design (follow-up survey of panelists and new cross-section of parents at each wave) will continue through 2024, culminating in six waves of data spanning the period from March 2020 through October 2024. An estimated total of approximately 6,500 parents will be surveyed at least once throughout the duration of the study.
   
   SPDLC data will be released to the public two years after data is collected; Waves 1 and 2 are currently publicly available. Wave 3 will be publicly available in October 2023, with subsequent waves becoming available yearly. Data will be available to download in both SPSS (.sav) and Stata (.dta) formats, and the following data files will be available: (1) a data file for each individual wave, which contains responses from all participants in that wave of data collection, (2) a longitudinal panel data file, which contains longitudinal follow-up data from all available waves, and (3) a repeated cross-section data file, which contains the repeated cross-section data (from new respondents at each wave) from all available waves. Codebooks for each survey wave and a detailed user guide describing the data are also available. Response Rates: Of the 1,157 parents who participated in Wave 1, 828 (72%) also participated in the Wave 2 study. Presence of Common Scales: The following established scales are included in the survey:
   

   • Self-Efficacy, adapted from Pearlin's mastery scale (Pearlin et al., 1981) and the Rosenberg self-esteem scale (Rosenberg, 2015) and taken from the American Changing Lives Survey
   • Communication with Partner, taken from the Marriage and Relationship Survey (Lichter & Carmalt, 2009)
     
   • Gender Attitudes, taken from the National Survey of Families and Households (Sweet & Bumpass, 1996)
     
   • Depressive Symptoms (CES-D-10)
   • Stress, measured using Cohen's Perceived Stress Scale (Cohen, Kamarck, & Mermelstein, 1983)
     

   Full details about these scales and all other items included in the survey can be found in the user guide and codebook
   The second wave of the SPDLC was fielded in November 2020 in two stages. In the first stage, all parents who participated in W1 of the SPDLC and who continued to reside in the United States were re-contacted and asked to participate in a follow-up survey. The W2 survey was posted on Prolific, and messages were sent via Prolific’s messaging system to all previous participants. Multiple follow-up messages were sent in an attempt to increase response rates to the follow-up survey. Of the 1,157 respondents who completed the W1 survey, 873 at least started the W2 survey. Data quality checks were employed in line with best practices for online surveys (e.g., removing respondents who did not complete most of the survey or who did not pass the attention filters). After data quality checks, 5.2% of respondents were removed from the sample, resulting in a final sample size of 828 parents (a response rate of 72%).
   
   In the second stage, a new sample of parents was recruited. New parents had to meet the same sampling criteria as in W1 (be at least 18 years old, reside in the United States, reside with a romantic partner, and be a parent living with at least one biological child). Also similar to the W1 procedures, we oversampled men, Black individuals, individuals who did not complete college, and individuals who identified as politically conservative to increase sample diversity. A total of 1,207 parents participated in the W2 survey. Data quality checks led to the removal of 5.7% of the respondents, resulting in a final sample size of new respondents at Wave 2 of 1,138 parents.
   
   In both stages, participants were informed that the survey would take approximately 20 minutes to complete. All panelists were provided monetary compensation in line with Prolific’s compensation guidelines, which require that all participants earn above minimum wage for their time participating in studies.
   To be included in SPDLC, respondents had to meet the following sampling criteria at the time they enter the study: (a) be at least 18 years old, (b) reside in the United States, (c) reside with a romantic partner (i.e., be married or cohabiting), and (d) be a parent living with at least one biological child. Follow-up respondents must be at least 18 years old and reside in the United States, but may experience changes in relationship and resident parent statuses. Smallest Geographic Unit: U.S. State

   This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. In accordance with this license, all users of these data must give appropriate credit to the authors in any papers, presentations, books, or other works that use the data. A suggested citation to provide attribution for these data is included below:            
   
   Carlson, Daniel L. and Richard J. Petts. 2022. Study on U.S. Parents’ Divisions of Labor During COVID-19 User Guide: Waves 1-2.  

   To help provide estimates that are more representative of U.S. partnered parents, the SPDLC includes sampling weights. Weights can be included in statistical analyses to make estimates from the SPDLC sample representative of U.S. parents who reside with a romantic partner (married or cohabiting) and a child aged 18 or younger based on age, race/ethnicity, and gender. National estimates for the age, racial/ethnic, and gender profile of U.S. partnered parents were obtained using data from the 2020 Current Population Survey (CPS). Weights were calculated using an iterative raking method, such that the full sample in each data file matches the nationally representative CPS data in regard to the gender, age, and racial/ethnic distributions within the data. This variable is labeled CPSweightW2 in the Wave 2 dataset, and CPSweightLW2 in the longitudinal dataset (which includes Waves 1 and 2). There is not a weight variable included in the W1-W2 repeated cross-section data file.
    

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4. Disparities in bone density across contemporary Amazonian forager‐horticulturalists: Cross‐population comparison of the Tsimane and Shuar

   https://doi.org/10.1002/ajpa.23949  

   Madimenos, Felicia C. ; Liebert, Melissa A. ; Cepon‐Robins, Tara J. ; Urlacher, Samuel S. ; Josh Snodgrass, J. ; Sugiyama, Lawrence S. ; Stieglitz, Jonathan ( October 2019 , American Journal of Physical Anthropology)

   This study investigates bone density across the life course among Bolivian Tsimane and Ecuadorian Shuar of Amazonia. Both groups are rural, high‐fertility forager‐horticulturalists, with high lifetime physical activity levels. We test whether Tsimane and Shuar bone density patterns are different from each other, and if both groups are characterized by lower osteoporosis risk compared to U.S. references.

   Anthropometric and calcaneal bone density data, obtained via quantitative ultrasonometry (QUS), were collected from 678 Tsimane and 235 Shuar (13–92 years old). Population and sex differences in QUS values (estimated bone mineral density, speed of sound, broadband ultrasound attenuation) by age group were assessed using Mann–WhitneyUtests. Age‐related change and age at peak QUS value were determined using polynomial regressions. One‐way analyses of covariance assessed population‐level differences in QUS values by age group adjusting for body mass index. Participants aged 50+ years at elevated osteoporosis risk were identified using aTscore < −1.8; binomial tests assessed risk compared to U.S. references.

   Shuar males and females <50 years old have QUS values 3–36% higher than Tsimane, with differences evident in adolescence. Among Tsimane and Shuar, 49 and 23% of participants aged 50+ years old, respectively, are at high risk for osteoporosis, compared to 34% of Americans; Shuar osteoporosis risk is comparable to Americans, while Tsimane risk is elevated.

   Disparate patterns in QUS values are documented for Tsimane and Shuar, with pronounced differences early in life. Potential explanations for differences include gene–environment interactions and/or degree of market integration, which influences diet, activity profiles, pathogen exposures, and other lifestyle covariates. As Tsimane osteoporosis risk is greater than in the United States, findings point to alternative risk factors for low bone density that are not readily discernible in industrialized populations.

    

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5. Association of Post–COVID-19 Condition Symptoms and Employment Status

   https://doi.org/10.1001/jamanetworkopen.2022.56152  

   Perlis, Roy H. ; Lunz Trujillo, Kristin ; Safarpour, Alauna ; Santillana, Mauricio ; Ognyanova, Katherine ; Druckman, James ; Lazer, David ( February 2023 , JAMA Network Open)

   Little is known about the functional correlates of post–COVID-19 condition (PCC), also known as long COVID, particularly the relevance of neurocognitive symptoms.

   To characterize prevalence of unemployment among individuals who did, or did not, develop PCC after acute infection.

   This survey study used data from 8 waves of a 50-state US nonprobability internet population-based survey of respondents aged 18 to 69 years conducted between February 2021 and July 2022.

   The primary outcomes were self-reported current employment status and the presence of PCC, defined as report of continued symptoms at least 2 months beyond initial month of symptoms confirmed by a positive COVID-19 test.

   The cohort included 15 308 survey respondents with test-confirmed COVID-19 at least 2 months prior, of whom 2236 (14.6%) reported PCC symptoms, including 1027 of 2236 (45.9%) reporting either brain fog or impaired memory. The mean (SD) age was 38.8 (13.5) years; 9679 respondents (63.2%) identified as women and 10 720 (70.0%) were White. Overall, 1418 of 15 308 respondents (9.3%) reported being unemployed, including 276 of 2236 (12.3%) of those with PCC and 1142 of 13 071 (8.7%) of those without PCC; 8229 respondents (53.8%) worked full-time, including 1017 (45.5%) of those with PCC and 7212 (55.2%) without PCC. In survey-weighted regression models excluding retired respondents, the presence of PCC was associated with a lower likelihood of working full-time (odds ratio [OR], 0.71 [95% CI, 0.63-0.80]; adjusted OR, 0.84 [95% CI, 0.74-0.96]) and with a higher likelihood of being unemployed (OR, 1.45 [95% CI, 1.22-1.73]; adjusted OR, 1.23 [95% CI, 1.02-1.48]). The presence of any cognitive symptom was associated with lower likelihood of working full time (OR, 0.70 [95% CI, 0.56-0.88]; adjusted OR, 0.75 [95% CI, 0.59-0.84]).

   PCC was associated with a greater likelihood of unemployment and lesser likelihood of working full time in adjusted models. The presence of cognitive symptoms was associated with diminished likelihood of working full time. These results underscore the importance of developing strategies to treat and manage PCC symptoms.

    

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