The Geographical Correlation Between Historical Preterm Birth Disparities and COVID-19 Burden

Abstract

Similar to obstetric outcomes, rates of SARS-CoV-2 (COVID-19) infection are not homogeneously distributed among populations; risk factors accumulate in discrete locations. This study aimed to investigate the geographical correlation between pre-COVID-19 regional preterm birth (PTB) disparities and subsequent COVID-19 disease burden. We performed a retrospective, ecological cohort study of an upstate New York birth certificate database from 2004 to 2018, merged with publicly available community resource data. COVID-19 rates from 2020 were used to allocate ZIP codes to “low-,” “moderate-,” and “high-prevalence” groups, defined by median COVID-19 diagnosis rates. COVID-19 cohorts were associated with poverty and educational attainment data from the US Census Bureau. The dataset was analyzed for the primary outcome of PTB using ANOVA. GIS mapping visualized PTB rates and COVID-19 disease rates by ZIP code. Within 38 ZIP codes, 123,909 births were included. The median COVID-19 infection rate was 616.5 (per 100 K). PTB (all) and COVID-19 were positively correlated, with high- prevalence COVID-19 ZIP codes also being the areas with the highest prevalence of PTB ( F = 11.06, P = .0002); significance was also reached for PTB < 28 weeks ( F = 15.87, P < .0001) and periviable birth ( F = 16.28, P < .0001). Odds of PTB < 28 weeks were significantly higher in the “high-prevalence” COVID-19 cohort compared to the “low-prevalence” COVID 19 cohort (OR 3.27 (95% CI 2.42–4.42)). COVID-19 prevalence was directly associated with number of individuals below poverty level and indirectly associated with median household income and educational attainment. GIS mapping demonstrated ZIP code clustering in the urban center with the highest rates of PTB < 28 weeks overlapping with high COVID-19 disease burden. Historical disparities in social determinants of health, exemplified by PTB outcomes, map community distribution of COVID-19 disease burden. These data should inspire socioeconomic policies supporting economic vibrancy to promote optimal health outcomes across all communities. Supplementary Information The online version contains supplementary material available at 10.1007/s43032-022-01076-w.

Parto prematuro durante el primer año de la pandemia por COVID 19 en la Región de la Araucanía, Chile

“…Estudios de tipo poblacional reportan en Dinamarca reducciones en las tasas globales de parto prematuro, en las tasas de nacimientos de prematuros extremos (OR 0.27, IC al 95% 0.07 a 0.86) y mortinatos (OR 0.69, IC al 95% 0.50 a 0.95), especialmente asociados a los periodos de confinamiento más prolongados 12 . Otro estudio de cohorte poblacional en Italia reportó también una disminución en las tasas de parto prematuro en todas las categorías de parto prematuro durante el 2020, comparado con el periodo 2017 -2019, tasa global de parto prematuro (RR= 0.91, IC al 95% 0.88 a 0.93), pretérmino tardío (RR= 0.91, IC al 95% 0.88 a 0.94), muy prematuro (RR= 0.88, IC al 95% 0.84 a 0.91) y prematuros extremos (RR= 0.88, IC al 95% 0.82 a 0.95) 13 . Resultados similares se reportan en estudio poblacional de Korea del Sur 14 .…”