skip to main content
US FlagAn official website of the United States government
dot gov icon
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
https lock icon
Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

Explore Research Products in the PAR
It may take a few hours for recently added research products to appear in PAR search results.


Title: The Unequal Impact of the COVID-19 Pandemic on Infant Health
Abstract The COVID-19 pandemic has taken a large toll on population health and well-being. We examine the consequences of prenatal exposure for infant health, through which the pandemic may have lasting intergenerational effects. We examine multiple pathways by which the pandemic shaped birth outcomes and socioeconomic disparities in these consequences. Analysis of more than 3.5 million birth records in California with universal information on COVID infection among persons giving birth at the time of delivery reveals deep inequalities in infection by education, race/ethnicity, and place-based socioeconomic disadvantage. COVID infection during pregnancy, in turn, predicts a large increase in the probability of preterm birth, by approximately one third. At the population level, a surprising reduction in preterm births during the first months of the pandemic was followed by an increase in preterm births during the surge in COVID infections in the winter of 2021. Whereas the early-pandemic reduction in preterm births benefited primarily highly educated mothers, the increase in preterm births during the winter infection surge was entirely concentrated among mothers with low levels of schooling. The COVID-19 pandemic is expected to exacerbate U.S. inequality in multiple ways. Our findings highlight a particularly enduring pathway: the long-term legacy of prenatal exposure to an unequal pandemic environment.  more » « less
Award ID(s):
2049300 2049529
PAR ID:
10555609
Author(s) / Creator(s):
;
Publisher / Repository:
Duke University Press
Date Published:
Journal Name:
Demography
Volume:
59
Issue:
6
ISSN:
0070-3370
Page Range / eLocation ID:
2025 to 2051
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. ; (, Proceedings of the National Academy of Sciences)
    In utero exposure to COVID-19 infection may lead to large intergenerational health effects. The impact of infection exposure has likely evolved since the onset of the pandemic as new variants emerge, immunity from prior infection increases, vaccines become available, and vaccine hesitancy persists, such thatwheninfection is experienced is as important aswhetherit is experienced. We examine the changing impact of COVID-19 infection on preterm birth and the moderating role of vaccination. We offer the first plausibly causal estimate of the impact of maternal COVID-19 infection by using population data with no selectivity, universal information on maternal COVID-19 infection, and linked sibling data. We then assess change in this impact from 2020 to 2023 and evaluate the protective role of COVID-19 vaccination on infant health. We find a substantial adverse effect of prenatal COVID-19 infection on the probability of preterm birth. The impact was large during the first 2 y of the pandemic but had fully disappeared by 2022. The harmful impact of COVID-19 infection disappeared almost a year earlier in zip codes with high vaccination rates, suggesting that vaccines might have prevented thousands of preterm births. The findings highlight the need to monitor the changing consequences of emerging infectious diseases over time and the importance of mitigation strategies to reduce the burden of infection on vulnerable populations. 
    more » « less
  2. ; ; ; ; ; ; ; ; ; ; et al (, BMJ)
    Abstract Objective To assess whether exposure to high temperatures in pregnancy is associated with increased risk for preterm birth, low birth weight, and stillbirth. Design Systematic review and random effects meta-analysis. Data sources Medline and Web of Science searched up to September 2018, updated in August 2019. Eligibility criteria for selecting studies Clinical studies on associations between high environmental temperatures, and preterm birth, birth weight, and stillbirths. Results 14 880 records and 175 full text articles were screened. 70 studies were included, set in 27 countries, seven of which were countries with low or middle income. In 40 of 47 studies, preterm births were more common at higher than lower temperatures. Exposures were classified as heatwaves, 1°C increments, and temperature threshold cutoff points. In random effects meta-analysis, odds of a preterm birth rose 1.05-fold (95% confidence interval 1.03 to 1.07) per 1°C increase in temperature and 1.16-fold (1.10 to 1.23) during heatwaves. Higher temperature was associated with reduced birth weight in 18 of 28 studies, with considerable statistical heterogeneity. Eight studies on stillbirths all showed associations between temperature and stillbirth, with stillbirths increasing 1.05-fold (1.01 to 1.08) per 1°C rise in temperature. Associations between temperature and outcomes were largest among women in lower socioeconomic groups and at age extremes. The multiple temperature metrics and lag analyses limited comparison between studies and settings. Conclusions Although summary effect sizes are relatively small, heat exposures are common and the outcomes are important determinants of population health. Linkages between socioeconomic status and study outcomes suggest that risks might be largest in low and middle income countries. Temperature rises with global warming could have major implications for child health. Systematic review registration PROSPERO CRD 42019140136 and CRD 42018118113. 
    more » « less
  3. ; ; ; (, Population and Development Review)
    Abstract The COVID‐19 pandemic was accompanied by social and economic changes previously associated with fertility delay and reduction, sparking widespread discussion of a “baby bust” in the United States. We examine fertility trends using restricted vital statistics data from California, a diverse population of 40 million, contributing 12 percent of U.S. births. Using time series models that account for longer‐run fertility trends, we observe modest, short‐term reductions in births from mid‐2020 through early 2021. Birth counts in subsequent months matched or even eased the pace of fertility decline since the 2008 recession and are unlikely a function of the pandemic alone. Responses to the pandemic were heterogeneous. Fertility declined markedly among the foreign‐born population, largely driven by changes in net migration. Among the U.S.‐born population, the short‐term pandemic‐attributable reductions were largest among older, highly educated people, suggesting mechanisms of fertility reduction disparately accessible to those with the most resources. We find no evidence of a strong population fertility response to the pandemic's accompanying employment shock, providing additional evidence of a growing divide between macroeconomic conditions and fertility patterns in the United States. 
    more » « less
  4. ; ; (, Nature Communications)
    Abstract Early forecasts give people in a storm’s path time to prepare. Less is known about the cost to society when forecasts are incorrect. In this observational study, we examine over 700,000 births in the path of Hurricane Irene and find exposure was associated with impaired birth outcomes. Additional warning time was associated with decreased preterm birth rates for women who experienced intense storm exposures documenting a benefit of avoiding a type II forecasting error. A larger share of this at-risk population experienced a type I forecasting error where severe physical storm impacts were anticipated but not experienced. Disaster anticipation disrupted healthcare services by delaying and canceling prenatal care, which may contribute to storm-impacted birth outcomes. Recognizing storm damages depend on human responses to predicted storm paths is critical to supporting the next generation’s developmental potential with judicious forecasts that ensure public warning systems mitigate rather than exacerbate climate damages. 
    more » « less
  5. ; (, Society and Mental Health)
    Rising domestic burdens for mothers fueled concerns that the COVID-19 pandemic exacerbated gender inequalities in well-being. Yet, survey research has not considered whether and how cognitive labor—planning, organizing, and monitoring family needs—contributed to gendered health disparities during the pandemic. Using data from the Study on U.S. Parents’ Divisions of Labor during COVID-19 (SPDLC) and a stress process perspective, we examine the association between cognitive labor and parents’ psychological well-being, and whether this association (1) differs between mothers and fathers and (2) is moderated by employment status and telecommuting. Mothers performed more cognitive labor during the pandemic than fathers, and cognitive labor was negatively associated with mothers’ psychological well-being—particularly for mothers who never or exclusively telecommuted. Mothers’ psychological well-being was higher when fathers did more cognitive labor, especially among mothers who worked outside the home. Overall, cognitive labor appears to be another stressor that contributed to increased gender inequality. 
    more » « less
  • Citation Formats
  • MLA
  • APA
  • Chicago
  • BibTeX
  • Save / Share this Record
  • Send to Email