Perinatal & Pediatric
Paid Family Leave and Prevention of Acute Respiratory Infections in Young Infants Katherine Ahrens* Katherine Ahrens Teresa Janevic Erin C. Strumpf Arijit Nandi Justin R. Ortiz Jennifer A. Hutcheon
Introduction: Acute respiratory tract infections are the leading cause of emergency department (ED) visits and hospitalizations in US children, with highest risks in the first two months after birth. Group childcare settings can increase the frequency and spread of respiratory tract infections. Our aim was to determine if New York State’s 2018 paid family leave policy, which provided eligible workers with ≤8 weeks of paid time off, lowered acute care encounters for respiratory infections in young infants.
Methods: We used acute care encounters (hospitalizations and ED visits) in New York State and New England control states (Massachusetts, New Hampshire, Vermont, Maine), Oct 2015- Feb 2020. We conducted a controlled time series analysis using Poisson regression to estimate the impact of the paid family leave policy on acute care encounters for respiratory infections in infants aged ≤8 weeks, comparing observed counts during respiratory virus season (Oct-Mar) to those predicted in the absence of the policy. Our primary outcome was encounters for upper or lower respiratory tract infections or associated symptoms (fever, cough). Our secondary outcome was acute care encounters for respiratory syncytial virus (RSV) bronchiolitis. Acute care encounters for respiratory infections in one-year olds (who would not be expected to benefit from the policy) was modelled as a placebo test.
Results: There were 52 943 acute care encounters for respiratory infection among infants aged ≤8 weeks. Encounters were 18% lower than predicted (relative percentage change= -17.9 [95% CI: -20.3 to -15.7]) after the introduction of paid family leave. RSV encounters were 27% lower [95% CI: -31 to -24] than predicted. No such reductions were observed in one-year olds after the introduction of paid family leave (relative percentage change= -1.5 [95% CI: -2.5 to -0.6]).
Conclusions: New York’s paid family leave policy reduced acute care encounters for respiratory tract infections in young infants.
