Evidence map›Paper›PMID 35568191›Full record

ArticleAmerican journal of obstetrics and gynecology2022

Attempts to conceive and the COVID-19 pandemic: data from the Apple Women's Health Study.

Victoria Fruh, Genevieve Lyons, Ariel L Scalise, Nicola J Gallagher, Anne-Marie Jukic, Donna D Baird, Uvika Chaturvedi, Sanaa Suharwardy, Jukka-Pekka Onnela, Michelle A Williams and 3 more

Abstract read
In one paragraph

Article in American journal of obstetrics and gynecology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Victoria FruhDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA.
Genevieve LyonsDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA.
Ariel L ScaliseDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA.
Nicola J GallagherDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA.
Anne-Marie JukicEpidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.
Donna D BairdEpidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.
Uvika ChaturvediHealth, Apple Inc, Cupertino, CA.
Sanaa SuharwardyHealth, Apple Inc, Cupertino, CA.
Jukka-Pekka OnnelaDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA.
Michelle A WilliamsDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA.
Russ HauserDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA.
Brent A CoullDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA.
Shruthi MahalingaiahDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA. Electronic address: shruthi@hsph.harvard.edu.

Funding

Environmental influences on fertility and reproductive healthZIAES103333 · NIEHS · NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES · PI JUKIC, ANNE MARIE · 2019 to 2025
$7.3M
Environmental Effects On FertilityZIAES049003 · NIEHS · NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES · PI BAIRD, DONNA D. · 2009 to 2023
$3.3M
6 · The paper itself

Abstract

backgroundPrevious studies have suggested that emergent events may affect pregnancy planning decisions. However, few have investigated the effect of factors related to the COVID-19 pandemic on pregnancy planning, measured by attempting conception, and how attempting conception status may differ by individual-level factors, such as social status or educational level.

objectiveThis study aimed to examine the effects of factors related to the COVID-19 pandemic, until March 2021, on attempting conception status and to assess the effect measure modification by educational level and subjective social status. STUDY

designWe conducted a longitudinal analysis within a subgroup of 21,616 participants in the Apple Women's Health Study who enrolled from November 2019 to March 2021, who met the inclusion criteria, and who responded to the monthly status menstrual update question on attempting conception status (yes or no). Participants reporting hysterectomy, pregnancy, lactation, or menopause were excluded. We used generalized estimating equation methodology to fit logistic regression models that estimate odds ratios and 95% confidence intervals for the association between the proportion of participants attempting conception and the month of response (compared with a prepandemic reference month of February 2020) while accounting for longitudinal correlation and adjusting for age, race and ethnicity, and marital status. We stratified the analysis by social status and educational level.

resultsWe observed a trend of reduced odds of attempting conception, with an 18% reduction in the odds of attempting conception in August 2020 and October 2020 compared with the prepandemic month of February 2020 (August odds ratio: 0.82 [95% confidence interval, 0.70-0.97]; October odds ratio: 0.82 [95% confidence interval, 0.69-0.97). The participants with lower educational level (no college education) experienced a sustained reduction in the odds of attempting to conceive from June 2020 to March 2021 compared with February 2020, with up to a 24% reduction in the odds of attempting to conceive in October 2020 (odds ratio, 0.76; 95% confidence interval, 0.59-0.96). Among participants that were college educated, we observed an initial reduction in the odds of attempting to conceive starting in July 2020 (odds ratio 0.73; 95% confidence interval, 0.54-0.99) that returned near prepandemic odds. Moreover, we observed a reduction in the odds of attempting to conceive among those with low subjective social status, with a decline in the odds of attempting to conceive beginning in July 2020 (odds ratio, 0.83; 95% confidence interval, 0.63-1.10) and continuing until March 2021 (odds ratio, 0.79; 95% confidence interval, 0.59-1.06), with the greatest reduction in odds in October 2020 (odds ratio, 0.67; 95% confidence interval, 0.50-0.91).

conclusionAmong women in the Apple Women's Health Study cohort, our findings suggested a reduction in the odds of attempting to conceive during the COVID-19 pandemic, until March 2021, particularly among women of lower educational level and lower perceived social status.

Indexed as

COVID-19FemaleFertilizationHumansPandemicsPregnancyWomen's Healthdesire to conceiveeducational levelhealth-related decision-makingpandemic social and environmental factorsperceived social statuspregnancy planningwomen’s health

Identifiers

PMID35568191
PMCPMC9093060

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.