{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T07:00:49Z","timestamp":1785481249377,"version":"3.56.0"},"reference-count":47,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To examine the immediate and long-term effect of the pandemic on clinical encounters in predominantly low-income, racially and ethnically diverse mothers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This is a longitudinal study of 3,073 predominantly low-income, racially, and ethnically diverse mothers in the Boston Birth Cohort. We conducted descriptive and random-effects negative binomial regression to examine the impact of the COVID-19 pandemic on medical and mental health care encounters of the study mothers, using comprehensive electronic health record data before and during the pandemic (January 2019\u2013December 2021). We also conducted a qualitative survey in a subsample (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u223c200) to assess pandemic-related stressors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Compared with 2019 (prepandemic), mental health encounter incidence increased by 56% in 2020 (incidence rate ratio [IRR]: 1.56, 95% confidence interval [CI]: 1.29\u20131.88) and 37% in 2021 (IRR: 1.37, CI: 1.14\u20131.64). In contrast, primary care and non-mental health subspecialty care decreased in 2020 (IRRs: 0.91 and 0.73, CIs: 0.85\u20130.97 and 0.67\u20130.8) and recovered in 2021 (IRRs: 1.24 and 1.48, CIs: 1.17\u20131.32 and 1.37\u20131.61), whereas emergency department encounters decreased in both 2020 (IRR: 0.64, CI: 0.57\u20130.71) and 2021 (IRR: 0.74, CI: 0.67\u20130.82). Telemedicine was utilized the most for mental health. Consistently, 38.4% of the mothers reported higher levels of stress during the pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>COVID-19 imposed significant mental distress on this sample of racially and ethnically diverse mothers, with an increase in mental health encounters. Telemedicine was a major modality for mental health services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Policy Implications:<\/jats:title>\n                    <jats:p>The study findings draw attention to the profound adverse impact of the pandemic on mental health in racially and ethnically diverse mothers and highlights the need to develop current and long-term strategies for addressing mental distress in this population and for future preparedness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15409996261428521","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:34:43Z","timestamp":1773286483000},"page":"755-767","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A Longitudinal Study of the COVID-19 Pandemic\u2019s Impact on Medical and Mental Health Care Encounters in the Boston Birth Cohort"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1847-3397","authenticated-orcid":false,"given":"Serena A.","family":"Rusk","sequence":"first","affiliation":[{"name":"Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengmeng","family":"Li","sequence":"additional","affiliation":[{"name":"Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selena P.","family":"Anjur-Dietrich","sequence":"additional","affiliation":[{"name":"Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Magalona","sequence":"additional","affiliation":[{"name":"Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoying","family":"Wang","sequence":"additional","affiliation":[{"name":"Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiumei","family":"Hong","sequence":"additional","affiliation":[{"name":"Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle","family":"Mirolli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Pearson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Zuckerman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobin","family":"Wang","sequence":"additional","affiliation":[{"name":"Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA."},{"name":"Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.4016"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.2395"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/cars.12288"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-021-01110-8"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.8598"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2020.05.003"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.3982"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.3978"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-045343"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6923e1"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.2196\/26558"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2021.1529"},{"key":"e_1_3_3_14_1","unstructured":"13. 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