Neonatal outcomes during the COVID-19 pandemic in New York City

Richter, Felix; Strasser, Arielle S; Suárez‐Fariñas, Mayte; Zhao, Shan; Nadkarni, Girish N.; Jabs, Ethylin Wang; Guttmann, Katherine; Glicksberg, Benjamin S.

doi:10.1101/2020.12.20.20248583

Cited by 5 publications

(12 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the evidence for NICU admissions is mixed. Two other studies, one from Japan and the other from the US, reported a significant decline in NICU admissions during the pandemic compared with a prepandemic period, 46,47 but other studies found no changes 26,48,49 . Although there were documented changes in NICU entry and staffing policies that could affect admissions, 50 given the decrease in low Apgar scores among multiparas in our study, it is conceivable that the decline in term NICU admissions could be related to lower newborn complication rates.…”

Section: Discussioncontrasting

confidence: 46%

Impact of the COVID‐19 pandemic on perinatal care and outcomes in the United States: An interrupted time series analysis

Riley

Nethery

Chung

et al. 2021

Birth

View full text Add to dashboard Cite

Background Hospitals quickly adapted perinatal care to mitigate SARS‐CoV‐2 transmission at the onset of the COVID‐19 pandemic. The objective of this study was to estimate the impact of pandemic‐related hospital policy changes on perinatal care and outcomes in one region of the United States. Methods This interrupted time series analysis used retrospective data from consecutive singleton births at 15 hospitals in the Pacific Northwest from 2017 to 2020. The primary outcomes were those hypothesized to be affected by pandemic‐related hospital policies and included labor induction, epidural use, oxytocin augmentation, mode of delivery, and early discharge (<48 hours after cesarean and <24 hours after vaginal births). Secondary outcomes included preterm birth, severe maternal morbidity, low 5‐minute Apgar score, neonatal intensive care unit (NICU) admission, and 30‐day readmission. Segmented Poisson regression models estimated the outcome level shift changes after the pandemic onset, controlling for underlying trends, seasonality, and stratifying by parity. Results No statistically significant changes were detected in intrapartum interventions or mode of delivery after onset of the pandemic. Early discharge increased for all births following cesarean and vaginal birth. Newborn readmission rates increased but only among nulliparas (aRR: 1.49, 95%CI: 1.17, 1.91). Among multiparas, decreases were observed in preterm birth (aRR: 0.90, 95%CI: 0.84, 0.96), low 5‐minute Apgar score (aRR: 0.75, 95%CI: 0.68, 0.81), and term NICU admission rates (aRR: 0.85, 95%CI: 0.80, 0.91). Conclusions Increases in early discharge and newborn readmission rates among nulliparas suggest a need for more postpartum support during the pandemic. Decreases in preterm birth and term NICU admission among multiparas may have implications beyond the pandemic and deserve further study.

show abstract

Section: Discussioncontrasting

confidence: 46%

Impact of the COVID‐19 pandemic on perinatal care and outcomes in the United States: An interrupted time series analysis

Riley

Nethery

Chung

et al. 2021

Birth

View full text Add to dashboard Cite

show abstract

“…Provisional monthly data from California from April to July 2020, found no reduction in the overall rate of preterm births by payer, region or race/ethnicity; the study did, however, find a slight increase in births occurring between 28 to 32 weeks’ gestation 4 . In a study of neonatal outcomes from a large hospital in New York City—one of the hardest hit areas at the onset of the pandemic—there was no evidence of changes in preterm birth in the first months of the pandemic 5 . Similarly, there were no significant changes in preterm birth or stillbirth rates in a racially diverse urban cohort from two Philadelphia hospitals between March and June 2020 6 .…”

Section: Introductionmentioning

confidence: 92%

“…To date, perinatal epidemiology studies in the United States have primarily focussed on the initial stage of the pandemic, when most populous states mandated strict sheltering in place 4–7 …”

Section: Commentmentioning

confidence: 99%

Changes in preterm birth and caesarean deliveries in the United States during the SARS‐CoV‐2 pandemic

Gemmill

Casey

Catalano

et al. 2021

Paediatric Perinatal Epid

View full text Add to dashboard Cite

Background Preliminary studies suggest that the SARS‐CoV‐2 pandemic and associated social, economic and clinical disruptions have affected pregnancy decision‐making and outcomes. Whilst a few US‐based studies have examined regional changes in birth outcomes during the pandemic's first months, much remains unknown of how the pandemic impacted perinatal health indicators at the national‐level throughout 2020, including during the ‘second wave’ of infections that occurred later in the year. Objectives To describe changes in monthly rates of perinatal health indicators during the 2020 pandemic for the entire US. Methods For the years 2015 to 2020, we obtained national monthly rates (per 100 births) for four perinatal indicators: preterm (<37 weeks’ gestation), early preterm (<34 weeks’ gestation), late preterm (34–36 weeks’ gestation) and caesarean delivery. We used an interrupted time‐series approach to compare the outcomes observed after the pandemic began (March 2020) to those expected had the pandemic not occurred for March through December of 2020. Results Observed rates of preterm birth fell below expectation across several months of the 2020 pandemic. These declines were largest in magnitude in early and late 2020, with a 5%–6% relative difference between observed and expected occurring in March and November. For example, in March 2020, the observed preterm birth rate of 9.8 per 100 live births fell below the 95% prediction interval (PI) of the rate predicted from history, which was 10.5 preterm births per 100 live births (95% PI 10.2, 10.7). We detected no changes from expectation in the rate of caesarean deliveries. Conclusions Our findings provide nationwide evidence of unexpected reductions in preterm delivery during the 2020 SARS‐CoV‐2 pandemic in the US. Observed declines below expectation were differed by both timing of delivery and birth month, suggesting that several mechanisms, which require further study, may explain these patterns.

show abstract

“…There have been reports of a decline in preterm births after the onset of the COVID-19 pandemic in HICs 8 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , although findings are inconsistent. 37 , 38 , 39 , 40 , 41 , 42 Pooled estimates from a recent meta-analysis suggest a modest decrease in overall preterm birth in HICs only and also a reduction in spontaneous preterm birth but not medically indicated preterm birth, 8 although the latter finding rests on the results from only 2 hospital-based studies. 25 , 37 Notably, an earlier analysis of Danish data comparing births in the month following lockdown to births in the same interval in earlier years concluded that there was a decrease in extremely preterm birth after lockdown but no similar trend for later preterm births.…”

Section: Commentmentioning

confidence: 99%

Preterm birth after the introduction of COVID-19 mitigation measures in Norway, Sweden, and Denmark: a registry-based difference-in-differences study

Oakley

Örtqvist

Kinge

et al. 2022

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

Background Although some studies have reported a decrease in preterm birth following the start of the COVID-19 pandemic, the findings are inconsistent. Objective This study aimed to compare the incidences of preterm birth before and after the introduction of COVID-19 mitigation measures in Scandinavian countries using robust population-based registry data. Study Design This was a registry-based difference-in-differences study using births from January 2014 through December 2020 in Norway, Sweden, and Denmark. The changes in the preterm birth (<37 weeks) rates before and after the introduction of COVID-19 mitigation measures (set to March 12, 2020) were compared with the changes in preterm birth before and after March 12 from 2014 to 2019. The differences per 1000 births were calculated for 2-, 4-, 8-, 12-, and 16-week intervals before and after March 12. The secondary analyses included medically indicated preterm birth, spontaneous preterm birth, and very preterm (<32 weeks) birth. Results A total of 1,519,521 births were included in this study. During the study period, 5.6% of the births were preterm in Norway and Sweden, and 5.7% were preterm in Denmark. There was a seasonal variation in the incidence of preterm birth, with the highest incidence during winter. In all the 3 countries, there was a slight overall decline in preterm births from 2014 to 2020. There was no consistent evidence of a change in the preterm birth rates following the introduction of COVID-19 mitigation measures, with difference-in-differences estimates ranging from 3.7 per 1000 births (95% confidence interval, −3.8 to 11.1) for the first 2 weeks after March 12, 2020, to −1.8 per 1000 births (95% confidence interval, −4.6 to 1.1) in the 16 weeks after March 12, 2020. Similarly, there was no evidence of an impact on medically indicated preterm birth, spontaneous preterm birth, or very preterm birth. Conclusion Using high-quality national data on births in 3 Scandinavian countries, each of which implemented different approaches to address the pandemic, there was no evidence of a decline in preterm births following the introduction of COVID-19 mitigation measures.

show abstract

Neonatal outcomes during the COVID-19 pandemic in New York City

Cited by 5 publications

References 7 publications

Impact of the COVID‐19 pandemic on perinatal care and outcomes in the United States: An interrupted time series analysis

Impact of the COVID‐19 pandemic on perinatal care and outcomes in the United States: An interrupted time series analysis

Changes in preterm birth and caesarean deliveries in the United States during the SARS‐CoV‐2 pandemic

Preterm birth after the introduction of COVID-19 mitigation measures in Norway, Sweden, and Denmark: a registry-based difference-in-differences study

Contact Info

Product

Resources

About