In 2020, then a sociology professor at the University of Texas at Austin and principal investigator of Decode Zika, Letícia Marteleto was leading a team interviewing 4,000 women in Pernambuco, the Brazilian state hit hardest by the Zika epidemic. When COVID-19 hit, the researchers began to interview women via phone instead of at their homes, and the project expanded into Decode Zika and Covid (DZC).
Marteleto is now the Presidential Penn Compact Professor of Sociology at the University of Pennsylvania, a role she began in July. On her desk in the McNeil Building is a name plate with “Fearless Leader” underneath her name, a gift from the DZC team in Texas.
“The team gave me this because of our ability to pivot a data collection that was so massive and international, and still be able to do it. I carry this to remember those times and that we have to do good research even in times of crisis,” Marteleto says. The team interviewed the women again in 2021 and 2022, as part of the first-ever panel on reproductive health and fertility in Brazil. They are getting ready to contact them in 2024 for nine more waves of data collection.
“The concept that we are working with now is the idea that these women lived through back-to-back novel infectious disease crises; COVID started less than three years from when Zika ended,” she says. “You can imagine the uncertainty right when a novel disease outbreak hits, the kinds of questions that women were asking themselves. Are we going to see something like Zika again? Is this going to have an effect on pregnant women, fetuses, or babies?”
Marteleto published two papers this summer, “Climate and fertility amid a public health crisis” —Zika being the public health crisis under study—and “Scars from a Previous Epidemic: Social Proximity to Zika and Fertility Intentions during the COVID-19 Pandemic.” The first paper shows that increases in temperature and precipitation are associated with declines in births and that the Zika epidemic heightened behavioral changes in response to climate conditions.
The latter paper looked at the impacts of women having close proximity to Zika, meaning they had or suspected they had Zika, knew people who had it, or knew kids with microcephaly, a condition when the baby’s head is smaller than expected due to the mother’s Zika infection. The authors asked women about their pregnancy intentions, including whether they would delay or forego pregnancy completely, and found that women with closer proximity to Zika were more likely to choose not to get pregnant during the COVID-19 pandemic or ever. Women who wanted to have children postponed childbearing because of their experiences with Zika and worry about COVID.
“Once one novel disease crisis starts, what we are seeing is that in a moment of extreme uncertainty, women use what they’ve learned from the past,” Marteleto says. This is an example of women stating their childbearing intentions not only based on their financial situation and relationship with their partner, but also based on their experiences with big-picture events in the world.
The work continues at Penn, with Marteleto making preparations for more waves of interviews.
“The excitement to be here is great because of how global Penn is. The amount of interest that this project has already gotten from graduate students, for example, is something that just tells me that I did the right thing coming,” Marteleto says. She sat down with Penn Today to talk about her work at the intersection of fertility, climate, Zika, COVID-19, urbanicity, and inequalities.
This research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grants R01HD091257, P2CHD042849 and T32HD007081.)