BACKGROUND: As the coronavirus disease pandemic spread across the United States and protective measures to mitigate its impact were enacted, parents and children experienced widespread disruptions in daily life. Our objective with this national survey was to determine how the pandemic and mitigation efforts affected the physical and emotional well-being of parents and children in the United States through early June 2020. METHODS: In June 2020, we conducted a national survey of parents with children age ,18 to measure changes in health status, insurance status, food security, use of public food assistance resources, child care, and use of health care services since the pandemic began. RESULTS: Since March 2020, 27% of parents reported worsening mental health for themselves, and 14% reported worsening behavioral health for their children. The proportion of families with moderate or severe food insecurity increased from 6% before March 2020 to 8% after, employer-sponsored insurance coverage of children decreased from 63% to 60%, and 24% of parents reported a loss of regular child care. Worsening mental health for parents occurred alongside worsening behavioral health for children in nearly 1 in 10 families, among whom 48% reported loss of regular child care, 16% reported change in insurance status, and 11% reported worsening food security. CONCLUSIONS: The coronavirus disease pandemic has had a substantial tandem impact on parents and children in the United States. As policy makers consider additional measures to mitigate the health and economic effects of the pandemic, they should consider the unique needs of families with children. WHAT'S KNOWN ON THIS SUBJECT: The coronavirus disease 2019 (COVID-19) pandemic and protective measures associated with it created widespread disruptions in daily life of US parents and children. Families with children disproportionately live in poverty, potentially increasing their risk to COVID-19-related economic distress and difficulties sustaining basic needs. WHAT THIS STUDY ADDS: COVID-19 has had a substantial impact on the well-being of parents and children. As policy makers consider additional measures to mitigate the health and economic effects of the pandemic, they should consider the unique needs of families with children.

The purpose of this study was to evaluate risk factors for antepartum depressive symptoms that can be assessed in routine obstetric care. We evaluated articles in the Englishlanguage literature from 1980 through 2008. Studies were selected if they evaluated the association between antepartum depressive symptoms and ≥1 risk factors. For each risk factor, 2 blinded, independent reviewers evaluated the overall trend of evidence. In total, 57 studies met eligibility criteria. Maternal anxiety, life stress, history of depression, lack of social support, unintended pregnancy, Medicaid insurance, domestic violence, lower income, lower education, smoking, single status, and poor relationship quality were associated with a greater likelihood of antepartum depressive symptoms in bivariate analyses. Life stress, lack of social support, and domestic violence continued to demonstrate a significant association in multivariate analyses. Our results demonstrate several correlates that are consistently related to an increased risk of depressive symptoms during pregnancy. Keywords depression; pregnancy; risk factorDepression is one of the most common complications in pregnancy. As many as 12.7% of pregnant women experience a major depressive disorder. 1 Several professional organizations now recommend routine screening for antepartum depression. 2,3 In fact, the American College of Obstetricians and Gynecologists (ACOG) recommends screening for depression during each trimester of pregnancy. 2 Prenatal care providers are uniquely suited to address antepartum depression. First of all, providers have already captured their target population, because most women will use obstetric services at some point during their pregnancies. Providers also have multiple opportunities to assess, treat, and follow-up with patients, as obstetric visits are recurring during a severalmonth span. Despite these qualifications, prenatal care providers are constrained by a lack of © 2010 Mosby, Inc. All rights reserved. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript education in the evaluation and treatment of depression. Less than half of obstetricians report that residency prepared them to diagnose depression. 4 Although several metaanalyses have summarized risk factors for postpartum depression, [5][6][7][8] there has beennosystematic synthesis of the literature regarding risk factors for depressive symptoms during pregnancy, when obstetric providers will have their most frequent contact with patients. We cannot assume that the risk factors during pregnancy are the same as those postpartum, because certain factors, such as pregnancy intention and social support, may operate differently before and after the arrival of a baby.If providers know the clinical significance of risk factors for depression in pregnancy, they may be able to more easily identify women with the highest chance for developing this condition. Therefore, the purpose of our study was to examine risk factors for antepartum depression that can be assess...

RECENT NATIONAL STUDY indicated that illicit drug use is 16.2% among pregnant teens and 7.4% among pregnant women aged 18 to 25 years. 1 Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome in newborns following birth. The syndrome most commonly occurs in the context of antepartum opiate use, although other drugs have also been implicated. [2][3][4][5] In addition to NAS, illicit drug use (specifically opioid dependence) during pregnancy is associated with a significantly increased risk of adverse neonatal outcomes such as low birthweight (Ͻ2500 g) and mortality. [6][7][8][9] Neonatal abstinence syndrome is characterized by a wide array of signs and symptoms including increased irritability, hypertonia, tremors, feeding intolerance, emesis, watery stools, seizures, and respiratory distress. 10 Symptoms of withdrawal associated with NAS have been described in 60% to 80% of newborns exposed to heroin or methadone in utero. 11 Recently, analyses from Australia 12 and the Florida Medicaid program (D. Aronberg, JD, written communication, November 30, 2011) found that the incidence of NAS has been increasing. To date, there are no national es-Author Affiliations are listed at the end of this article.

This survey study provides nationally representative estimates of the distribution, severity, and factors associated with adult food allergy in the United States.