had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Objective: To evaluate fertility intensions among couples in Shanghai under the novel coronavirus infection (COVID-19) pandemic against the backdrop of persistently low fertility. Methods: A cross-sectional study was carried out using data from studies conducted before the COVID-19 pandemic. Data were collected regarding sociodemographic characteristics, history of reproduction and gynecology, fertility intention before and after the COVID-19 pandemic, female psychological state, and the impact of the COVID-19 pandemic on daily life. Results: Under the influence of COVID-19, 296/447 (66.2%) participants did not change their original fertility intention to have children, while 151/447 (33.8%) of participants were affected by the outbreak. Participants who believed in government and hospital control policies were less likely to change their intention to become pregnant (P < 10-3 , P < 10-3). In contrast, concerns about the impact of COVID-19 on female and fetal health led participants to cancel their original pregnancy plans (P < 10 −3). Conclusion: Three in ten couples of childbearing age, who originally expressed their intention of becoming pregnant, canceled their pregnancy plans after the COVID-19 outbreak. The COVID-19 outbreak has brought new challenges to people's physical and mental health. Effective policies and measures can help to improve people's fertility intentions with respect to having children.

No abstract