The Temporal Relationship Between the Coronavirus Disease 2019 (COVID-19) Pandemic and Preterm Birth

Grobman, William A.; Sandoval, Grecio; Metz, Torri D.; Manuck, Tracy A.; Clifton, Rebecca G.; Hughes, Brenna L.; Saade, George R.; Longo, Monica; Sowles, Amber; Clark, Kelly; Simhan, Hyagriv N.; Rouse, Dwight J.; Mendez‐Figueroa, Hector; Gyamfi-Bannerman, Cynthia; Bailit, Jennifer L.; Costantine, Maged M.; Sehdev, Harish M.; Tita, Alan; Macones, George A.

doi:10.1097/aog.0000000000005171

Cited by 3 publications

(1 citation statement)

References 40 publications

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“…[9][10][11] One unexpected effect observed early during the pandemic was a population decrease in preterm birth rates, with reductions in preterm birth reported from many, [12][13][14][15][16][17] but not all, 18 countries. Studies from the United States also showed conflicting findings, [19][20][21][22][23][24][25][26][27][28] although the studies were not comparable because of heterogeneity with regard to populations (hospital, multicenter, population-based), study period, and study design or analysis.…”

Section: Discussionmentioning

confidence: 99%

Obstetric Intervention and Perinatal Outcomes During the Coronavirus Disease 2019 (COVID-19) Pandemic

Simon,

John,

Lisonkova

et al. 2023

Obstetrics &Amp; Gynecology

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OBJECTIVE: To quantify pandemic-related changes in obstetric intervention and perinatal outcomes in the United States. METHODS: We carried out a retrospective study of all live births and fetal deaths in the United States, 2015–2021, with data obtained from the natality, fetal death, and linked live birth–infant death files of the National Center for Health Statistics. Analyses were carried out among all singletons; singletons of patients with prepregnancy diabetes, prepregnancy hypertension, and hypertensive disorders of pregnancy; and twins. Outcomes of interest included preterm birth, preterm labor induction or preterm cesarean delivery, macrosomia, postterm birth, and perinatal death. Interrupted time series analyses were used to estimate changes in the prepandemic period (January 2015–February 2020), at pandemic onset (March 2020), and in the pandemic period (March 2020–December 2021). RESULTS: The study population included 26,604,392 live births and 155,214 stillbirths. The prepandemic period was characterized by temporal increases in preterm birth and preterm labor induction or cesarean delivery rates and temporal reductions in macrosomia, postterm birth, and perinatal mortality. Pandemic onset was associated with absolute decreases in preterm birth (decrease of 0.322/100 live births, 95% CI 0.506–0.139) and preterm labor induction or cesarean delivery (decrease of 0.190/100 live births, 95% CI 0.334–0.047) and absolute increases in macrosomia (increase of 0.046/100 live births), postterm birth (increase of 0.015/100 live births), and perinatal death (increase of 0.501/1,000 total births, 95% CI 0.220–0.783). These changes were larger in subpopulations at high risk (eg, among singletons of patients with prepregnancy diabetes). Among singletons of patients with prepregnancy diabetes, pandemic onset was associated with a decrease in preterm birth (decrease of 1.634/100 live births) and preterm labor induction or cesarean delivery (decrease of 1.521/100 live births) and increases in macrosomia (increase of 0.328/100 live births) and perinatal death (increase of 9.840/1,000 total births, 95% CI 3.933–15.75). Most changes were reversed in the months after pandemic onset. CONCLUSION: The onset of the coronavirus disease 2019 (COVID-19) pandemic was associated with a transient decrease in obstetric intervention (especially preterm labor induction or cesarean delivery) and a transient increase in perinatal mortality.

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Section: Discussionmentioning

confidence: 99%

Obstetric Intervention and Perinatal Outcomes During the Coronavirus Disease 2019 (COVID-19) Pandemic

Simon,

John,

Lisonkova

et al. 2023

Obstetrics &Amp; Gynecology

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Pregnancy-related and Neonatal Outcomes during Omicron Variant-Dominant COVID-19 Pandemic among the Black-Dominant Population

Min,

Min

2024

Am J Perinatol

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Objective: This study aimed to determine the effect of the Omicron variant on pregnancy-related and neonatal outcomes among the Black-dominant population. Study design: We performed a single-center retrospective cohort study during the prepandemic period from December 1, 2019 to February 29, 2020 and the Omicron surging period from December 1, 2021 to February 28, 2022. A total of 518 pregnant women were admitted for delivery during the study periods. Multiple gestations (n=21) and deliveries at less than 20 weeks of gestation (n=5) were excluded. We analyzed and compared the sociodemographic and clinical data from mothers and their neonates between the two cohorts as well as between SARS-CoV-2 positive and negative mothers during the Omicron surge. Subgroup analyses were also conducted specifically among the Black-only population. Results: The cohorts were predominantly Black (88.6%), with smaller proportions of Hispanic (8.9%), Asian (0.8%), White (0.8%), and other ethnicities (0.8%). Of 492 singleton deliveries, 275 live births, 8 (2.8%) stillbirths, and 31 (11.3%) preterm births (PTB) occurred during the prepandemic period, and 207 live births, 2 (1%) stillbirths, and 33 (15.9%) PTB occurred during the Omicron wave. There was no statistically significant difference in the rates of PTB, stillbirths, medically indicated PTB, and cesarean delivery between the two cohorts. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive mothers were not at an increased risk of adverse outcomes. However, Neonatal Intensive Care Unit (NICU) admission rate significantly increased among neonates born to SARS-CoV-2 positive mothers compared with negative mothers (32.3% vs. 16.5%, p=0.038). In subgroup analyses among Black individuals, this difference was not observed. Conclusion: There was no significant difference in pregnancy-related or neonatal outcomes in the Black-dominant population between the two cohorts. SARS-CoV-2 infection did not alter these findings except an increased NICU admission rate among neonates born to SARS-CoV-2 positive mothers.

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COVID-19 in Pregnancy: An Update for Clinicians

Packer,

Prabhu

2024

Clinical Obstetrics &Amp; Gynecology

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The Temporal Relationship Between the Coronavirus Disease 2019 (COVID-19) Pandemic and Preterm Birth

Abstract: The onset of the coronavirus disease 2019 (COVID-19) pandemic was not associated with a change in the rate of preterm birth, regardless of socioeconomic status.

Cited by 3 publications

References 40 publications

Obstetric Intervention and Perinatal Outcomes During the Coronavirus Disease 2019 (COVID-19) Pandemic

Obstetric Intervention and Perinatal Outcomes During the Coronavirus Disease 2019 (COVID-19) Pandemic

Pregnancy-related and Neonatal Outcomes during Omicron Variant-Dominant COVID-19 Pandemic among the Black-Dominant Population

COVID-19 in Pregnancy: An Update for Clinicians

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