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. 2023 Sep 4;13(1):14580.
doi: 10.1038/s41598-023-37871-x.

Preterm births prevalence during the COVID-19 pandemic in Brazil: results from the national database

Charles M'poca Charles  1   2 , Luiz Alves Souza Neto  3   4 , Camila Ferreira Soares  5 , Tacildo Souza Araújo  3 , Cristiano Torezzan  6 , Everton Emanuel Campos Lima  5   6 , Aline Munezero  1 , Luis Bahamondes  1   7 , Renato Teixeira Souza  1 , Maria Laura Costa  1 , José Guilherme Cecatti  1 , Rodolfo Carvalho Pacagnella  8
Affiliations

Preterm births prevalence during the COVID-19 pandemic in Brazil: results from the national database

Charles M'poca Charles et al. Sci Rep. .

Abstract

The SARS-CoV-2 (COVID-19) pandemic impacted the health systems between and within countries, and in the course of the pandemic sexual and reproductive health services were the most disrupted. Findings from high-income settings have reported significant changes in preterm birth prevalence during the pandemic period. To understand the possible effects of the COVID-19 pandemic on preterm birth numbers at the Brazilian national level. We compare the number of preterm deliveries during the COVID-19 pandemic period (2020 and 2021) with previous years. We conducted a population-based cross-sectional study taking the period from January 2017 to December 2021 to account. We use individual-level live births data from the Brazilian Live Birth Information System (SINASC), and we estimate the odds ratio (OR) of preterm deliveries using propensity score weighting analysis in Brazil and its regions. During the study period (from 2017 to 2021), about 2.7 million live births were recorded per year, and the missing value for gestational age at delivery was less than 1.5%. The preterm birth prevalence slightly increased during the COVID-19 pandemic compared to the pre-pandemic period (11.32% in 2021 vs 11.09% in 2019, p-value < 0.0001). After adjusting for sociodemographic variables, the OR of preterm births in Brazil has significantly increased, 4% in 2020 (OR: 1.04 [1.03-1.05] 95% CI, p-value < 0.001), and 2% in 2021(OR: 1.02 [1.01-1.03] 95% CI, p-value < 0.001), compared to 2019. At the regional level, the preterm birth pattern in the South, Southeast and Northeast regions show a similar pattern. The highest odds ratio was observed in the South region (2020 vs 2019, OR: 1.07 [1.05-1.10] 95% CI; 2021 vs 2019, OR: 1.03 [1.01-1.06] 95% CI). However, we also observed a significant reduction in the ORs of preterm births in the northern region during the COVID-19 pandemic (2020 vs 2019, OR: 0.96 [0.94-0.98] 95% CI) and (2021 vs 2019, OR: 0.97 [0.95-0.99] 95% CI). Our analysis shows that the pandemic has increased regional variation in the number of preterm births in Brazil in 2020 and 2021 compared to the pre-pandemic years.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Example of Kernel density estimate (KDE) plot for the Propensity Score referring to births in Brazil in the years 2019 and 2020. Source Brazilian Live Birth Information System (SINASC) (2023).
Figure 2
Figure 2
Odds-ratios of preterm birth for Brazil and its regions 2017 to 2021. Source Brazilian Live Birth Information System (SINASC) (2023).
Figure 3
Figure 3
Caesarean delivery rate for categories of gestational ages in Brazil (2017 to 2021). Source Brazilian Live Birth Information System (SINASC) (2023).
Figure 4
Figure 4
Odds-ratio of caesarean delivery among preterm babies in Brazil and regions (2017 to 2020). Source Brazilian Live Birth Information System (SINASC) (2023).
See this image and copyright information in PMC

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