Preterm birth, stillbirth rates did not increase during pandemic
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There were no increases in preterm births or stillbirths during the first year of the COVID-19 pandemic, according to a study published in the Canadian Medical Association Journal.
These findings potentially alleviate concerns about the impact of COVID-19 on pregnancy.
According to the researchers, infection, inflammation, stress, medical or pregnancy-induced disorders, genetic predisposition and environmental factors can contribute to stillbirth and preterm birth, although their causes remain unknown in many cases.
Various reports indicated decreases in preterm birth rates in the Netherlands, Ireland and the United States during the pandemic, while the United Kingdom, Italy, India and other countries saw increases in stillbirths and some preterm birth rate variability. However, most of these studies were small, the researchers said.
In a population-based, retrospective cohort study, the researchers compared trends among more than 2.4 million births in Ontario between the pre-pandemic period of 2002 to 2019 with the pandemic period of January to December 2020.
The overall cohort saw a mean preterm birthrate of 7.96%, with a range of 7.32% to 8.59%. The preterm birth rate specifically for January to December 2020 was 7.87%, with no unusual change.
Also, the overall cohort had a mean stillbirth rate of 0.56%, with a range of 0.48% to 0.70%. But from January to December 2020, the stillbirth rate was 0.53%, again with no unusual change.
“We found no unusual changes in rates of preterm birth or stillbirth during the pandemic, which is reassuring,” author Prakesh S. Shah, MD, MSc, MBBS, pediatrician-in-chief at Sinai Health and professor at the University of Toronto, said in a press release.
The researchers said that compliance with pandemic-related measures could affect preterm birth rates in different settings, so they examined birth outcomes in public health units where SARS-CoV-2 positivity rates were higher, such as in Toronto, the Peel Region, the York Region and Ottawa, as well as urban and rural births and those in neighborhoods with different average income levels.
“In some areas and in certain people, the restrictions could be beneficial, and in other settings or individuals, restrictions could have the opposite effect,” said Shah.
The researchers also noted the limitations of their study, including a lack of case-level medical details and potential registration errors, although they reported that the database they used is well curated.
However, they said, they identified no unusual change in preterm birth or stillbirth incidences or in their subgroups during the first year of the pandemic period compared with the previous 17.5 years.
International studies now are underway to help understand the impact of COVID-19 on pregnancy and childbirth around the globe, the researchers said.
Reference:
Shah PS, et al. CMAJ. 2021;doi:10.1503/cmaj.210081.