Abstract
BACKGROUND: Despite benefits of prenatal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation, less than half of eligible individuals receive WIC benefits during pregnancy. By exacerbating barriers to participating in this program, the pandemic could have reduced prenatal WIC participation especially among certain vulnerable groups. OBJECTIVES: The objective was to examine the association of the pandemic with prenatal WIC participation among eligible individuals. An additional objective is to examine this association by key demographic characteristics, including income and education, and health care access. METHODS: Using Pregnancy Risk Assessment Monitoring System 2017-2022 from 23 states, WIC-eligible pregnant individuals with data on WIC receipt were included. Those who had given birth from 2017 through February 2020 and from July 2020 through 2022 were classified as having pregnancies during prepandemic and postpandemic periods, respectively. An interrupted time series model using logistic regression examined association of pandemic with WIC participation. RESULTS: Compared with prepandemic, the postpandemic period was associated with lower odds of WIC participation in the overall sample (odds ratio [OR]: 0.84; 95% confidence interval [CI]: 0.74, 0.96). The postpandemic period also was significantly associated with lower odds of WIC participation in some subgroups, such as those with an education level of high school or less (OR: 0.77; 95% CI: 0.65, 0.92), family income of poverty ratio <1 (OR: 0.77; 95% CI: 0.61, 0.97), inadequate prenatal care (OR: 0.62; 95% CI: 0.40, 0.96), and no health insurance during pregnancy (OR: 0.28; 95% CI: 0.11, 0.72). CONCLUSIONS: Findings suggest a decline in prenatal WIC participation after the pandemic. Additionally, the association of the pandemic with lower odds of WIC participation among those from lower socioeconomic status and poorer health care access suggests exacerbation of health disparities and underscores the need to improve participation in these groups.