Children and COVID-19 Research Library

Based on available reported data from UNFPA and the Short Term Fertility Fluctuation (STFF) study to date, there are no signs of dramatic increases or decreases in fertility due to the COVID-19 pandemic. Short term effects were observed in a range of highly developed countries but these reverted to pre-pandemic levels and trends shortly after. Data from low and middle income countries suggest similarities to those of many developed countries, with short term declines in births and subsequent recoveries. In this report, data from 15 countries sheds light on how the Covid-19 pandemic may affect births.

An aspect of the Covid-19 pandemic that merits attention is its effects on marriage and childbirth. Although the direct fertility effects of people getting the virus may be minor, the impact of delayed marriages due to the first preventive lockdown, such as that imposed in Pakistan from March 14 to May 8 2020, and the closure of marriage halls that lasted till September 14 may be non-negligible. These demographic consequences are of particular import to developing countries such as Pakistan where birth rates remain high, marriage is nearly universal, and almost all child-bearing takes place within marriage. Based on historic marriage patterns, this study estimates that the delay in nuptiality during the first wave of the coronavirus outbreak may affect about half of the marriages that were to take place during the year. In Pakistan, childbearing begins soon after marriage, and about 37% of Pakistani married women give birth to their first child within twelve months of marriage. A sizeable number out of these, around 400,000 annual births that occur within twelve months of the marriage, may consequently be delayed. Postponement of marriages due to the accompanying difficult economic situation and employment precariousness will accentuate this fertility effect. The net fertility impact of the Covid-19 outbreak will ultimately depend not only on the delay in marriages but also on the reproductive behavior of existing couples.

Rates of opioid use and opioid agonist maintenance treatment have increased substantially in recent years, particularly among women. Trends and outcomes of opioids use on fertility, pregnancy and breastfeeding, and longer‐term child developmental outcomes have not been well‐described. This paper reviews the existing literature on the health effects of opioid use on female fertility, pregnancy, breastmilk and the exposed infant. It finds that the current literature is primarily concentrated on the impact of opioid use in pregnancy and neonatal outcomes, with little exploration of effects on fertility. Studies are limited in number, some with small sample sizes, and many are hampered by methodological challenges related to confounding and other potential biases. Opioid use is becoming more prevalent due to environmental pressures such as COVID‐19.