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. 2022 Oct;42(10):1346-1352.
doi: 10.1038/s41372-022-01488-1. Epub 2022 Aug 16.

Changes in preterm birth during the COVID-19 pandemic by duration of exposure and race and ethnicity

Anne M Mullin  1 , Sara C Handley  2   3   4 , Lisbet Lundsberg  5 , Michal A Elovitz  6 , Scott A Lorch  2   3   4 , Elias J McComb  6 , Diana Montoya-Williams  2   3 , Nancy Yang  2   3 , Kevin Dysart  2   3 , Moeun Son  5 , Jay Greenspan  7   8   9 , Jennifer F Culhane  5 , Heather H Burris  10   11   12
Affiliations

Changes in preterm birth during the COVID-19 pandemic by duration of exposure and race and ethnicity

Anne M Mullin et al. J Perinatol. 2022 Oct.

Abstract

Objective: We aimed to determine whether coronavirus-disease-2019 (COVID-19) pandemic exposure duration was associated with PTB and if the pandemic modified racial disparities.

Study design: We analyzed Philadelphia births and replicated in New Haven. Compared to matched months in two prior years, we analyzed overall PTB, specific PTB phenotypes, and stillbirth.

Results: Overall, PTB was similar between periods with the following exceptions. Compared to pre-pandemic, early pregnancy (<14 weeks') pandemic exposure was associated with lower risk of PTB < 28 weeks' (aRR 0.60 [0.30-1.10]) and later exposure with higher risk (aRR 1.77 [0.78-3.97]) (interaction p = 0.04). PTB < 32 weeks' among White patients decreased during the pandemic, resulting in non-significant widening of the Black-White disparity from aRR 2.51 (95%CI: 1.53-4.16) to aRR 4.07 (95%CI: 1.56-12.01) (interaction P = 0.41). No findings replicated in New Haven.

Conclusion: We detected no overall pandemic effects on PTB, but potential indirect benefits for some patients which could widen disparities remains possible.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Dates of the best obstetric estimate of last menstrual period (LMP), pandemic onset, and delivery.
LMP last menstrual period, GA gestational age.
Fig. 2
Fig. 2. Risk of adverse preterm birth during the pandemic compared to matched months in two prior years in Philadelphia and New Haven.
P values test for interaction between duration of pandemic exposure and risk of each outcome during the pandemic compared to pre-pandemic. PTB preterm birth, sPTB spontaneous preterm birth, mPTB medically indicated preterm birth, GA gestational age.
Fig. 3
Fig. 3. Adjusted ratios of relative risk of preterm birth outcomes during the pandemic compared to pre-pandemic and interaction p-values in Philadelphia and New Haven.
Estimates >1 indicate increase in the disparity, whereas estimates <1 indicate decrease in the disparity compared to White individuals. PTB preterm birth, sPTB spontaneous preterm birth, mPTB medically indicated preterm birth.
See this image and copyright information in PMC

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