Changes and geographic variation in rates of preterm birth and stillbirth during the prepandemic period and COVID-19 pandemic, according to health insurance claims in the United States, April–June 2019 and April–June 2020

Chen, Jiajia; Ferré, Cynthia; Ouyang, Lijing; Mohamoud, Yousra A.; Barfield, Wanda D.; Cox, Shanna

doi:10.1016/j.ajogmf.2021.100508

Cited by 12 publications

(3 citation statements)

References 4 publications

(3 reference statements)

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“…A meta-analysis of non-US studies [29], some hospital and population-based studies in the United Kingdom (UK) [7,30] and Canada [31,32], one hospital-based study in Philadelphia [33], and a population-based study in California [34] spanning different time periods in 2020, found no changes in PTD rates at the onset of the pandemic. In contrast, several studies in different countries [35][36][37][38], one of which was among privately insured women [39], a population-based study in Tennessee [40], and another meta-analysis within this time period [41], also reported a decrease in overall PTD rates or in specific subgroups [42]. Furthermore, only a limited number of studies indicated an overall increase in PTD [43,44].…”

Section: Discussionmentioning

confidence: 97%

Increasing Preterm Delivery and Small for Gestational Age Trends in South Carolina during the COVID-19 Pandemic

Chundru,

Korte,

Wen

et al. 2024

IJERPH

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Preterm delivery (PTD) complications are a major cause of childhood morbidity and mortality. We aimed to assess trends in PTD and small for gestational age (SGA) and whether trends varied between race–ethnic groups in South Carolina (SC). We utilized 2015–2021 SC vital records linked to hospitalization and emergency department records. PTD was defined as clinically estimated gestation less than (<) 37 weeks (wks.) with subgroup analyses of PTD < 34 wks. and < 28 wks. SGA was defined as infants weighing below the 10th percentile for gestational age. This retrospective study included 338,532 (243,010 before the COVID-19 pandemic and 95,522 during the pandemic) live singleton births of gestational age ≥ 20 wks. born to 260,276 mothers in SC. Generalized estimating equations and a change-point during the first quarter of 2020 helped to assess trends. In unadjusted analyses, pre-pandemic PTD showed an increasing trend that continued during the pandemic (relative risk (RR) = 1.04, 95% CI: 1.02–1.06). PTD < 34 wks. rose during the pandemic (RR = 1.07, 95% CI: 1.02–1.12) with a significant change in the slope. Trends in SGA varied by race and ethnicity, increasing only in Hispanics (RR = 1.02, 95% CI: 1.00–1.04) before the pandemic. Our study reveals an increasing prevalence of PTD and a rise in PTD < 34 wks. during the pandemic, as well as an increasing prevalence of SGA in Hispanics during the study period.

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Section: Discussionmentioning

confidence: 97%

Increasing Preterm Delivery and Small for Gestational Age Trends in South Carolina during the COVID-19 Pandemic

Chundru,

Korte,

Wen

et al. 2024

IJERPH

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“…Given the numerous potential variables and retrospective nature of this study, it is difficult to determine whether the preterm birth rate was due to maternal stress, illness, or overall health; specific drug use; or other factors. However, when looking at literature, studies show a decrease in preterm birth rates during the pandemic [ 29 , 30 ]. In a study looking at association of preterm birth rate during the 2020 stay-at-home order in our state, they reported significantly lower rates compared to previous years [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Comparing maternal substance use and perinatal outcomes before and during the COVID-19 pandemic

et al. 2023

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Objective To examine the effect of the COVID-19 pandemic on maternal substance abuse and neonatal outcomes. Study design Cross-sectional observational study of neonates admitted to the NICU and born to mothers with evidence of substance abuse pre-pandemic compared to during the COVID-19 pandemic. Result We noted a significant increase in fentanyl (12% vs. 0.6%, p < 0.001) and tobacco use (64% vs. 33%, p < 0.001) during the pandemic compared to pre-pandemic, including an increase in fentanyl use among mothers enrolled in opioid maintenance therapy (OMT) during the pandemic (32.3% vs. 1.5%, p < 0.001). There was a significant increase in preterm births (58% vs. 48%, p = 0.022) and lower birth weight (2315 ± 815 vs. 2455 ± 861 g, p = 0.049) during pandemic. Conclusion There was a significant increase in maternal fentanyl use during the pandemic, even with OMT enrollment, with an increase in preterm births and lower birth weights among infants born to mothers with substance use.

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“…Multiple population-based studies from Europe, South Korea, and Israel have demonstrated a reduction in the preterm birth (PTB) rate during the height of the pandemic and lockdown restrictions [1][2][3][4][5][6]; however, several studies found no difference in PTBs during the pandemic, including studies from Norway, Sweden, Denmark, and Canada [7][8][9]. Studies from the United States have also examined the effects of the pandemic on birth outcomes, although the majority have taken place in either a single hospital or hospital system [10][11][12][13] and included only a portion of hospitals from across the country [14][15][16] or included only commercially insured births [16], thereby limiting their generalizability to understand changes at the population level. Of the four population-based studies in the United States, all found a significant reduction in the PTB rate [17][18][19][20]; however, only one of these studies further investigated whether changes in PTB rates differed across socioeconomic characteristics such as race/ethnicity or payment source.…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 on Perinatal Outcomes and Birth Locations in a Large US Metropolitan Area

Lee,

Perez,

Patel

et al. 2024

Healthcare

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This was a population-based study to determine the impact of COVID-19 on birth outcomes in the Chicago metropolitan area, comparing pre-pandemic (April–September 2019) versus pandemic (April–September 2020) births. Multivariable regression models that adjusted for demographic and neighborhood characteristics were used to estimate the marginal effects of COVID-19 on intrauterine fetal demise (IUFD)/stillbirth, preterm birth, birth hospital designation, and maternal and infant hospital length of stay (LOS). There were no differences in IUFD/stillbirths or preterm births between eras. Commercially insured preterm and term infants were 4.8 percentage points (2.3, 7.4) and 3.4 percentage points (2.5, 4.2) more likely to be born in an academic medical center during the pandemic, while Medicaid-insured preterm and term infants were 3.6 percentage points less likely (−6.5, −0.7) and 1.8 percentage points less likely (−2.8, −0.9) to be born in an academic medical center compared to the pre-pandemic era. Infant LOS decreased from 2.4 to 2.2 days (−0.35, −0.20), maternal LOS for indicated PTBs decreased from 5.6 to 5.0 days (−0.94, −0.19), and term births decreased from 2.5 to 2.3 days (−0.21, −0.17). The pandemic had a significant effect on the location of births that may have exacerbated health inequities that continue into childhood.

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Changes and geographic variation in rates of preterm birth and stillbirth during the prepandemic period and COVID-19 pandemic, according to health insurance claims in the United States, April–June 2019 and April–June 2020

Cited by 12 publications

References 4 publications

Increasing Preterm Delivery and Small for Gestational Age Trends in South Carolina during the COVID-19 Pandemic

Increasing Preterm Delivery and Small for Gestational Age Trends in South Carolina during the COVID-19 Pandemic

Comparing maternal substance use and perinatal outcomes before and during the COVID-19 pandemic

Impact of COVID-19 on Perinatal Outcomes and Birth Locations in a Large US Metropolitan Area

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