{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:56:52Z","timestamp":1785250612946,"version":"3.55.0"},"reference-count":60,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Perinatal health was profoundly affected as a result of the socioeconomic hardships and public health measures during the COVID\u201019 pandemic. Few studies have evaluated changes and disparities in perinatal health using population\u2010based data and rigorous methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine changes related to the COVID\u201019 pandemic in perinatal health and healthcare utilisation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using population\u2010based data from the 2016\u20132021 Pregnancy Risk Assessment Monitoring System (<jats:italic>N<\/jats:italic>\u2009=\u2009116,170), we employed a Bayesian structural time\u2010series approach to examine deviations in perinatal health and healthcare utilisation outcomes from predicted trends following the onset of the COVID\u201019 pandemic in March 2020, adjusting for covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The onset of the COVID\u201019 pandemic was associated with delayed prenatal care initiation (1.1%, 95% confidence interval [CI] 0.2, 2.0), reduced prenatal care (\u22122.8%, 95% CI \u22123.6, \u22121.7), reduced postpartum visits (\u22121.0%, 95% CI \u22121.5, \u22120.4), and increased gestational hypertension (11.1%, 95% CI 5.4, 16.7), gestational diabetes mellitus (GDM), (17.6%, 95% CI 10.1, 26.2), and prenatal depression (7.3%, 95% CI 1.9, 13.0). Stratified models showed that Black participants experienced earlier prenatal care initiation; Native American participants experienced lower prenatal care visits and greater increases in gestational hypertension and GDM; Asian\/Pacific Islander participants experienced delayed prenatal care initiation and heightened prenatal depression and postnatal depressive symptoms; and Hispanic participants experienced higher GWG and reduced postpartum visits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>As perinatal health imparts enduring impacts for pregnant people and infants, this study provides insight into the pandemic's potentially long\u2010lasting population health effects. Future work should examine longer\u2010term trends and how pandemic\u2010related policies contributed to disparate impacts.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.70000","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:39:02Z","timestamp":1741826342000},"page":"375-386","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Perinatal Health and Healthcare Utilisation During the <scp>COVID<\/scp>\u201019 Pandemic: A Nationwide Interrupted Time Series Analysis"],"prefix":"10.1111","volume":"39","author":[{"given":"Deborah","family":"Karasek","sequence":"first","affiliation":[{"name":"School of Public Health at Oregon Health &amp; Science University and Portland State University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel F.","family":"Collin","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences Harvard School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0730-4077","authenticated-orcid":false,"given":"Rita","family":"Hamad","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences Harvard School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences Harvard School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5879-9730","authenticated-orcid":false,"given":"Alison","family":"Gemmill","sequence":"additional","affiliation":[{"name":"Department of Population, Family and Reproductive Health Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2021.100027"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1739357"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2020-320682"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2020-319990"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(20)30223-1"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.20991"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.10.033"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-021-01513-7"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwac110"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.24011"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005014"},{"key":"e_1_2_10_13_1","first-page":"1","article-title":"Assessing the Quality of Medical and Health Data From the 2003 Birth Certificate Revision: Results From Two States","volume":"62","author":"Martin J. 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