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Objectives. To describe prevalence of breast milk feeding among people with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy and examine associations between breast milk feeding, timing of maternal infection before delivery, and rooming-in status during delivery hospitalization. Methods. We performed a retrospective cohort study using data from Massachusetts, Minnesota, Nebraska, Pennsylvania, and Tennessee of whether people with confirmed SARS-CoV-2 infection during pregnancy in 2020 initiated breast milk feeding at birth. Results. Among 11 114 (weighted number) people with SARS-CoV-2 infection in pregnancy, 86.5% (95% confidence interval [CI] = 82.4%, 87.6%) initiated breast milk feeding during birth hospitalization. People with infection within 14 days before delivery had significantly lower prevalence of breast milk feeding (adjusted prevalence ratio [APR] = 0.88; 95% CI = 0.83, 0.94) than did those with infection at least 14 days before delivery. When stratified by rooming-in status, the association between timing of infection and breast milk feeding remained only among infants who did not room in with their mother (APR = 0.77; 95% CI = 0.68, 0.88). Conclusions. Pregnant and postpartum people with SARS-CoV-2 infection should have access to lactation support and be advised about the importance of breast milk feeding and how to safely feed their infants in the same room. (Am J Public Health. 2022;112(S8):S787–S796. https://doi.org/10.2105/AJPH.2022.307023 )

Objective To describe prevalence of breastmilk feeding among people with SARS-CoV-2 infection during pregnancy and examine associations between breastmilk feeding, timing of maternal infection before delivery, and rooming-in status during delivery hospitalization. Methods Retrospective cohort using data from five states reporting initiation of breastmilk feeding of infants at birth among people with confirmed SARS-CoV-2 infection during pregnancy in 2020. Results Among 9760 (weighted N) people with SARS-CoV-2 infection in pregnancy, 86.0% (95% confidence interval [CI]: 83.3%-88.7%) initiated breastmilk feeding during birth hospitalization. People with infection ≤ 14 days before delivery had significantly lower prevalence of breastmilk feeding (adjusted prevalence ratio [aPR] 0.90, 95% CI: 0.82, 0.97) compared to those with infection > 14 days before delivery. When stratified by rooming-in status, the association between timing of infection and breastmilk feeding remained only among infants who did not room-in with their mother (aPR 0.78, 95% CI: 0.66, 0.92). Conclusion Pregnant and postpartum people with SARS-CoV-2 infection should be advised about the importance of breastmilk feeding, how to safely feed their infants in the same room, and have access to lactation support.

Background In collaboration with state, tribal, local, and territorial health departments, CDC established the U.S. Zika Pregnancy Registry (USZPR) in early 2016 to monitor pregnant women with laboratory evidence of possible recent Zika virus infection and their infants. Methods This report includes an analysis of completed pregnancies (which include live births and pregnancy losses, regardless of gestational age) in the 50 U.S. states and the District of Columbia (DC) with laboratory evidence of possible recent Zika virus infection reported to the USZPR from January 15 to December 27, 2016. Birth defects potentially associated with Zika virus infection during pregnancy include brain abnormalities and/or microcephaly, eye abnormalities, other consequences of central nervous system dysfunction, and neural tube defects and other early brain malformations. Results During the analysis period, 1,297 pregnant women in 44 states were reported to the USZPR. Zika virus-associated birth defects were reported for 51 (5%) of the 972 fetuses/infants from completed pregnancies with laboratory evidence of possible recent Zika virus infection (95% confidence interval [CI] = 4%-7%); the proportion was higher when restricted to pregnancies with laboratory-confirmed Zika virus infection (24/250 completed pregnancies [10%, 95% CI = 7%-14%]). Birth defects were reported in 15% (95% CI = 8%-26%) of fetuses/infants of completed pregnancies with confirmed Zika virus infection in the first trimester. Among 895 liveborn infants from pregnancies with possible recent Zika virus infection, postnatal neuroimaging was reported for 221 (25%), and Zika virus testing of at least one infant specimen was reported for 585 (65%). Conclusions and implications for public health practice These findings highlight why pregnant women should avoid Zika virus exposure. Because the full clinical spectrum of congenital Zika virus infection is not yet known, all infants born to women with laboratory evidence of possible recent Zika virus infection during pregnancy should receive postnatal neuroimaging and Zika virus testing in addition to a comprehensive newborn physical exam and hearing screen. Identification and follow-up care of infants born to women with laboratory evidence of possible recent Zika virus infection during pregnancy and infants with possible congenital Zika virus infection can ensure that appropriate clinical services are available.

PURPOSE: Studies suggest exposure to ambient particulate matter less than 2.5 μg/m(3) in aerodynamic diameter (PM(2.5)) may be associated with preterm birth (PTB), but few have evaluated how this is modified by ambient temperature. We investigated the relationship between PM(2.5) exposure during pregnancy and PTB in infants without birth defects (1999–2006) and enrolled in the National Birth Defects Prevention Study and how it is modified by concurrent temperature. METHODS: PTB was defined as spontaneous or iatrogenic delivery before 37 weeks. Exposure was assigned using inverse distance weighting with up to four monitors within 50 kilometers of maternal residence. To account for state-level variations, a Bayesian two-level hierarchal model was developed. RESULTS: PTB was associated with PM(2.5) during the third and fourth months of pregnancy (range: (odds ratio (95% confidence interval) = 1.00 (0.35, 2.15) to 1.49 (0.82, 2.68) and 1.31 (0.56, 2.91) to 1.62 (0.7, 3.32), respectively); no week of exposure conveyed greater risk. Temperature may modify this relationship; higher local average temperatures during pregnancy yielded stronger positive relationships between PM(2.5) and PTB compared to nonstratified results. CONCLUSIONS: Results add to literature on associations between PM(2.5) and PTB, underscoring the importance of considering co-exposures when estimating effects of PM(2.5) exposure during pregnancy.