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Observational Study
. 2023 Jun 1;141(6):1171-1180.
doi: 10.1097/AOG.0000000000005171. Epub 2023 May 3.

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

William A Grobman  1 , Grecio J Sandoval, Torri D Metz, Tracy A Manuck, Rebecca G Clifton, Brenna L Hughes, George R Saade, Monica Longo, Amber Sowles, Kelly Clark, Hyagriv N Simhan, Dwight J Rouse, Hector Mendez-Figueroa, Cynthia Gyamfi-Bannerman, Jennifer L Bailit, Maged M Costantine, Harish M Sehdev, Alan T N Tita, George A Macones; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network*
Affiliations
Observational Study

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

William A Grobman et al. Obstet Gynecol. .

Abstract

Objective: To evaluate whether preterm birth rates changed in relation to the onset of the coronavirus disease 2019 (COVID-19) pandemic and whether any change depended on socioeconomic status.

Methods: This is an observational cohort study of pregnant individuals with a singleton gestation who delivered in the years 2019 and 2020 at 1 of 16 U.S. hospitals of the Maternal-Fetal Medicine Units Network. The frequency of preterm birth for those who delivered before the onset of the COVID-19 pandemic (ie, in 2019) was compared with that of those who delivered after its onset (ie, in 2020). Interaction analyses were performed for people of different individual- and community-level socioeconomic characteristics (ie, race and ethnicity, insurance status, Social Vulnerability Index (SVI) of a person's residence).

Results: During 2019 and 2020, 18,526 individuals met inclusion criteria. The chance of preterm birth before the COVID-19 pandemic was similar to that after the onset of the pandemic (11.7% vs 12.5%, adjusted relative risk 0.94, 95% CI 0.86-1.03). In interaction analyses, race and ethnicity, insurance status, and the SVI did not modify the association between the epoch and the chance of preterm birth before 37 weeks of gestation (all interaction P >.05).

Conclusion: There was no statistically significant difference in preterm birth rates in relation to the COVID-19 pandemic onset. This lack of association was largely independent of socioeconomic indicators such as race and ethnicity, insurance status, or SVI of the residential community in which an individual lived.

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Conflict of interest statement

Financial Disclosure: Torri D. Metz disclosed receiving payment from UpToDate (royalties for two topics on trial of labor after cesarean). Money was paid to her institution from Gestvision (site PI for preeclampsia point-of-care test; institution received money to conduct study [ended August 2020])and Pfizer (site PI for Phase III respiratory syncytial virus [RSV] vaccine trial, institution received money to conduct study). She is a member of medical advisory board for Pfizer and site PI for a COVID-19 vaccination trial in pregnancy Society for Maternal-Fetal Medicine Board of Directors (unpaid). Brenna L. Hughes disclosed receiving payment from Merck, UpToDate, and Johns Hopkins. The other authors did not report any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Flowchart for the composition of the study population. MFMU, Maternal Fetal Medicine Units Network.
Figure 2.
Figure 2.
Subgroup analysis for preterm birth <32 weeks of gestation and social vulnerability index: socioeconomic status subtheme. RD, risk difference; RR, relative risk; aRR, adjusted relative risk.
See this image and copyright information in PMC

References

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