University of Texas at Austin, Austin, U.S.A.
Universidade Estadual de Campinas, Campinas, Brasil.
Cad Saude Publica. 2022 Apr 29;38(4):EN230621. doi: 10.1590/0102-311XEN230621. eCollection 2022.
This study aims to estimate fertility trends in Brazil in the 2010s and early 2020s during a period of back-to-back novel infectious disease outbreaks - Zika virus and COVID-19. We use Brazilian Ministry of Health and Association of Civil Registrar data from 2011-2021 to measure general fertility rates at the national and state levels. We also used seasonal ARIMA model to forecast fertility rates by month and state in 2021 and compared these forecasts with observed fertility rates. We find that fertility rates were steady over 2011-2015 with no statistically significant variation, followed by a sharp decline during the Zika outbreak in 2016 followed by a return to pre-Zika levels after the end of the epidemic. Furthermore, to evaluate the effect of the COVID-19 pandemic, we make comparisons with observed and forecast rates from 2020-2021, showing that declines were generally larger for observed than for forecast rates, yet statistically insignificant. We argue that the resurgence of the COVID-19 pandemic in 2021 might lead to further declines, as women might have not had enough time to adjust rebound from either the effects of the Zika epidemic. We also discuss the importance of timely availability of live births data during a public health crisis with immediate consequences for fertility rates.
这项研究旨在估计 21 世纪 10 年代和 2020 年代初期巴西的生育趋势，这一时期接连爆发了新型传染病——寨卡病毒和 COVID-19。我们使用巴西卫生部和民事登记协会的数据，从 2011 年至 2021 年，在国家和州两级衡量一般生育率。我们还使用季节性 ARIMA 模型按月和按州预测 2021 年的生育率，并将这些预测与实际生育率进行比较。我们发现，2011 年至 2015 年期间，生育率保持稳定，没有明显的变化，随后在寨卡病毒爆发期间急剧下降，疫情结束后恢复到寨卡病毒爆发前的水平。此外，为了评估 COVID-19 大流行的影响，我们将 2020 年至 2021 年的实际和预测生育率进行比较，结果表明，实际生育率的降幅通常大于预测生育率，但没有统计学意义。我们认为，2021 年 COVID-19 疫情的再次爆发可能导致进一步下降，因为女性可能还没有足够的时间从寨卡疫情的影响中恢复过来。我们还讨论了在公共卫生危机期间及时获得活产数据的重要性，因为这对生育率有直接影响。
