Preterm Singleton Birth Rate during the COVID-19 Lockdown: A Population-Based Study

Abstract

Objective The aim of the study is to evaluate the effect of the coronavirus disease 2019 (COVID-19) pandemic national lockdown period on the rate of singleton preterm births in Israel.

Study Design This is a population-based cohort study of 3,41,291 singleton infants born in the months of January to July 2017 to 2020. Multivariable logistic regression analyses were used to estimate the influence of period and year on the rates of preterm births during the lockdown period (11^th March − 5^th May 2020) compared with rates before (January 1^st 2020 − March 10^th 2020), and after the lockdown (May 6^th 2020–June 30^th 2020) and to the corresponding periods in 2017to 2019.

Results During the lockdown period the preterm birth rate (primary outcome) decreased by 9.7% from 5.05 to 4.56% in the pre-lockdown period (p = 0.006), an adjusted decrease of −0.52% (95% confidence interval −0.89%; −0.15%), odds ratio 0.898 (95% confidence interval 0.832; 0.970).

Conclusion The rate of singleton preterm births declined by 9.7% during the COVID-19 pandemic national lockdown period in Israel.

Key Points

• A 10% decline in all preterm deliveries was observed during the COVID-19 pandemic national lock-down period.

• The lock-down might influence environmental changes which contribute to the decrease in preterm deliveries.

• Changes in lifestyle, and societal behavior might contribute to the decrease in preterm deliveries.

Keywords

COVID-19 - prematurity - lockdown

• References

• 1 Hedermann G, Hedley PL, Bækvad-Hansen M. et al. Danish premature birth rates during the COVID-19 lockdown. Arch Dis Child Fetal Neonatal 2021; 106 (01) 93-95
• 2 Philip RK, Purtill H, Reidy E. et al. Unprecedented reduction in births of very low birthweight (VLBW) and extremely low birthweight (ELBW) infants during the COVID-19 lockdown in Ireland: a 'natural experiment' allowing analysis of data from the prior two decades. BMJ Glob Health 2020; 5 (09) e003075
• 3 Kc A, Gurung R, Kinney MV. et al. Effect of the COVID-19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: a prospective observational study. Lancet Glob Health 2020; 8 (10) e1273-e1281
• 4 Been JV, Burgos Ochoa L, Bertens LCM, Schoenmakers S, Steegers EAP, Reiss IKM. Impact of COVID-19 mitigation measures on the incidence of preterm birth: a national quasi-experimental study. Lancet Public Health 2020; 5 (11) e604-e611
• 5 De Curtis M, Villani L, Polo A. Increase of stillbirth and decrease of late preterm infants during the COVID-19 pandemic lockdown. Arch Dis Child Fetal Neonatal 2021; 106 (04) 456
• 6 McDonnell S, McNamee E, Lindow SW, O'Connell MP. The impact of the Covid-19 pandemic on maternity services: a review of maternal and neonatal outcomes before, during and after the pandemic. Eur J Obstet Gynecol Reprod Biol 2020; 255: 172-176
• 7 Rasmussen MI, Hansen ML, Pichler G, Dempsey E, Pellicer A, EL-Khuffash A. et al. Extremely preterm infant admissions within the SafeBoosC-III consortium during the COVID-19 lockdown. medRxiv 2020; https://doi.org/10.1101/2020.10.02.20204578
• 8 Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008; 371 (9606): 75-84
• 9 Chakraborty I, Maity P. COVID-19 outbreak: migration, effects on society, global environment and prevention. Sci Total Environ 2020; 728: 138882
• 10 Mimouni F, Lakshminrusimha S, Pearlman SA, Raju T, Gallagher PG, Mendlovic J. Perinatal aspects on the covid-19 pandemic: a practical resource for perinatal-neonatal specialists. J Perinatol 2020; 40 (05) 820-826
• 11 Pode-Shakked N, Blau A, Pode-Shakked B. et al. Combined gestational age- and birth weight-adjusted cutoffs for newborn screening of congenital adrenal hyperplasia. J Clin Endocrinol Metab 2019; 104 (08) 3172-3180
• 12 Woodworth KR, Olsen EO, Neelam V. et al. CDC COVID-19 response pregnancy and infant linked outcomes team; COVID-19 pregnancy and infant linked outcomes team (PILOT). Birth and infant outcomes following laboratory-confirmed SARS-COV-2 infection in pregnancy—SET-NET, 16 Jurisdictions, March 29-October 14, 2020. MMWR Morb Mortal Wkly Rep 2020; 69 (44) 1635-1640
• 13 Sosa CG, Althabe F, Belizán JM, Bergel E. Bed rest in singleton pregnancies for preventing preterm birth. Cochrane Database Syst Rev 2015; (03) CD003581
• 14 Crowther CA, Han S. Hospitalisation and bed rest for multiple pregnancy. Cochrane Database Syst Rev 2010; (07) CD000110
• 15 Bonzini M, Coggon D, Palmer KT. Risk of prematurity, low birthweight and pre-eclampsia in relation to working hours and physical activities: a systematic review. Occup Environ Med 2007; 64 (04) 228-243
• 16 Bonzini M, Palmer KT, Coggon D, Carugno M, Cromi A, Ferrario MM. Shift work and pregnancy outcomes: a systematic review with meta-analysis of currently available epidemiological studies. BJOG 2011; 118 (12) 1429-1437
• 17 Englund-Ögge L, Brantsæter AL, Juodakis J. et al. Associations between maternal dietary patterns and infant birth weight, small and large for gestational age in the Norwegian Mother and Child Cohort Study. Eur J Clin Nutr 2019; 73 (09) 1270-1282
• 18 Shah NR, Bracken MB. A systematic review and meta-analysis of prospective studies on the association between maternal cigarette smoking and preterm delivery. Am J Obstet Gynecol 2000; 182 (02) 465-472
• 19 Hernandez M. This is the effect coronavirus has had on air pollution all across the world. Accessed November 11, 2020 at: https://www.weforum.org/agenda/2020/04/coronavirus-covid19-air-pollution-enviroment-nature-lockdown/
• 20 Levy I, Drori R, Zaltsberg A, Mazah E, Cordoba-Bijoner L, Galin T. Effect of the Corona epidemics on air pollution. Accessed November 11, 2020 at: www.magazine.isees.org.il/ArticlePage.aspx?ArticleID=933
• 21 Kloog I. Air pollution, ambient temperature, green space and preterm birth. Curr Opin Pediatr 2019; 31 (02) 237-243
• 22 Kumari V, Mehta K, Choudhary R. COVID-19 outbreak and decreased hospitalization of pregnant women in labour. Lancet Glob Health 2020; 8 (09) e1116-e1117