To describe the impact of COVID-19 on the neonatology workforce, focusing on professional and domestic workloads.
We surveyed US neonatologists in December 2020 regarding the impact on professional and domestic work during the pandemic. We estimated associations between changes in time spent on types of professional and domestic work and demographic variables with multivariable logistic regression analyses.
Of 758 participants, 67.6% were women. A higher proportion of women than men were in the younger age group (63.3%, 29.3%), held no leadership position (61.4%, 46.3%), had dependents at home (68.8%, 56.3%), did not have a partner or other adult at home (10.6%, 3.2%), and had an employed partner (88.1%, 64.6%; P<.01 for all). A higher proportion of women than men reported a decrease in time spent on scholarly work (35.0%, 29.0%, P=.02) and career development (44.2%, 34.9%, P<.01). A higher proportion of women than men reported spending more time caring for children (74.2%, 55.8%, P<0.01). Reduced time spent on career development was associated with younger age (aOR=2.21; 95% CI, 1.20, 4.08) and number of dependents (aOR=1.21; 95% CI, 1.01, 1.45). Women were more likely to report an increase in time spent time doing domestic work (aOR=1.53; 95% CI, 1.07, 2.19) and a reduction in time on self-care (aOR=0.49; 95% CI, 0.29, 0.81).
COVID-19 impacts the neonatology workforce significantly, disproportionately affecting younger, parent, and women physicians. Targeted interventions are needed to support post-pandemic career recovery and advance physician contributions to the field.

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