Individual-level determinants of COVID-19 vaccination in pregnant people in East Tennessee.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) infection during pregnancy increases the risk of severe illness and death. This study describes individual-level determinants of COVID-19 vaccination among pregnant people in East Tennessee. METHODS: Advertisements for the online Moms and Vaccines survey were placed in prenatal clinics in Knoxville, Tennessee. Determinants were compared between unvaccinated individuals and those partially or fully vaccinated for COVID-19. RESULTS: Wave 1 of the Moms and Vaccines study included 99 pregnant people: 21 (21.2%) were unvaccinated and 78 (78.8%) were partially or fully vaccinated. Compared with the unvaccinated individuals, the partially or fully vaccinated patients more often obtained information about COVID-19 from their prenatal care provider (8 [38.1%] vs. 55 [70.5%], P = 0.006) and indicated higher levels of trust in that information (4 [19.1] vs. 69 [88.5%], P < 0.0001). Misinformation was higher in the unvaccinated group overall, although there was no difference in concern for the severity of COVID-19 infection during pregnancy by vaccination status (1 [5.0%] of the unvaccinated vs. 16 [20.8%] of the partially or fully vaccinated, P = 0.183). CONCLUSION: Strategies to counter misinformation are of the utmost importance, particularly pregnancy- and reproductive health-related misinformation, because of the increased risk of severe disease faced by unvaccinated pregnant individuals.

To Be Active or to Stop? A Cross-Sectional Retrospective Study Exploring Provider Advice and Patient Fears Surrounding Physical Activity in Pregnancies Complicated by Fetal Growth Restriction.

Exercise guidance for women with pregnancies complicated by fetal growth restriction (FGR) is vague, despite the fact that physical activity during pregnancy improves placental development, placental blood flow, and encourages healthy fetal growth. The goal of this study is to test the hypothesis that women with pregnancies complicated by FGR are fearful of physical activity and are being given unclear or limited advice from healthcare providers. Participants (N = 78) (women who delivered an infant diagnosed with FGR within the past 5 years) took an electronic survey including demographic information, pregnancy information, provider advice recall, and other health-related information relevant to growth-restricted pregnancies. Quantitative and qualitative (post-positivism paradigm) methods were employed to analyze the data. When asked specifically about how the FGR diagnosis impacted their activity levels, nearly 50% of participants said the diagnosis led them to decrease their activity levels. Participants reported that healthcare providers who do discuss activity with pregnant patients with FGR suggest low-intensity activities or ceasing activity, although the majority of providers did not discuss activity at all. More fears surrounding physical activity were reported post-FGR diagnosis, including worrying about fetal growth and development and causing fetal harm when engaging in physical activity.