Background: Pregnancy can be a stressful time and the COVID 19 pandemic has affected all aspects of life. This study aims to investigate the impact of the pandemic on population birth outcomes in Wales, rates of primary immunisations and examine expectant mothers experiences of pregnancy including self reported levels of stress and anxiety.
Methods: Population level birth outcomes in Wales: Stillbirths, prematurity, birth weight and Caesarean section births before (2016 to 2019) and during (2020) the pandemic were compared using national level routine anonymised data held in the Secure Anonymised Information Linkage (SAIL) Databank. The first three scheduled primary immunisations were compared between 2019 and 2020. Self reported pregnancy experience: 215 expectant mothers (aged 16+) in Wales completed an online survey about their experiences of pregnancy during the pandemic. The qualitative survey data was analysed using codebook thematic analysis.
Findings: There was no significant difference between annual outcomes including gestation and birth weight, stillbirths, and Caesarean sections for infants born in 2020 compared to years 2016 to 2019. There was an increase in late term births (>42 weeks gestation) during the first lockdown (OR: 1.28, p=0.019) and a decrease in moderate to late preterm births (32 to 36 weeks gestation) during the second lockdown (OR: 0.74, p=0.001). Fewer babies were born in 2020 (N=29,031) compared to years 2016 to 2019 (average N=32,582). All babies received their immunisations in 2020, but there were minor delays in the timings of vaccines. Those due at 8 weeks were 8% less likely to be on time (within 28 days) and at 16 weeks, they were 19% less likely to be on time. The pandemic had a negative impact on the mental health of 71% of survey respondents, who reported anxiety, stress and loneliness; this was associated with attending scans without their partner, giving birth alone, and minimal contact with midwives.
Interpretation: The pandemic had a negative impact on mothers experiences of pregnancy; however, population level data suggests that this did not translate to adverse birth outcomes for babies born during the pandemic.