Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 10;21(4):465.
doi: 10.3390/ijerph21040465.

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

Kalyan J Chundru  1 , Jeffrey E Korte  1 , Chun-Che Wen  1 , Brian Neelon  1   2 , Dulaney A Wilson  1 , Julio Mateus  3 , John L Pearce  1 , Mallory Alkis  4 , Matthew Finneran  4 , Sarah Simpson  1 , Hermes Florez  1   2 , Kelly J Hunt  1   2 , Angela M Malek  1
Affiliations

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

Kalyan J Chundru et al. Int J Environ Res Public Health. .

Abstract

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.

Keywords: COVID-19 pandemic; South Carolina; USA; infant outcomes; maternal health; preterm; racial disparities; small for gestational age; trends.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Cohort selection consort diagram.
Figure 2
Figure 2
Preterm delivery (PTD) (a–c) and small for gestational age (SGA) (d) trends in South Carolina (SC) between 2015 and 2021. Figures are based on unadjusted model results for each outcome. The blue vertical solid line at the first quarter (Q1) of 2020 represents the change-point.
See this image and copyright information in PMC

References

    1. Katz J., Lee A.C., Kozuki N., Lawn J.E., Cousens S., Blencowe H., Ezzati M., Bhutta Z.A., Marchant T., Willey B.A., et al. Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: A pooled country analysis. Lancet. 2013;382:417–425. doi: 10.1016/S0140-6736(13)60993-9. - DOI - PMC - PubMed
    1. Perin J., Mulick A., Yeung D., Villavicencio F., Lopez G., Strong K.L., Prieto-Merino D., Cousens S., Black R.E., Liu L. Global, regional, and national causes of under-5 mortality in 2000–19: An updated systematic analysis with implications for the Sustainable Development Goals. Lancet Child Adolesc. Health. 2022;6:106–115. doi: 10.1016/S2352-4642(21)00311-4. - DOI - PMC - PubMed
    1. Jelliffe-Pawlowski L.L., Hansen R.L. Neurodevelopmental outcome at 8 months and 4 years among infants born full-term small-for-gestational-age. J. Perinatol. 2004;24:505–514. doi: 10.1038/sj.jp.7211111. - DOI - PubMed
    1. Khalil A., von Dadelszen P., Kalafat E., Sebghati M., Ladhani S., Ugwumadu A., Draycott T., O’Brien P., Magee L. Change in obstetric attendance and activities during the COVID-19 pandemic. Lancet Infect. Dis. 2021;21:e115. doi: 10.1016/S1473-3099(20)30779-9. - DOI - PMC - PubMed
    1. Kotlar B., Gerson E.M., Petrillo S., Langer A., Tiemeier H. The impact of the COVID-19 pandemic on maternal and perinatal health: A scoping review. Reprod. Health. 2021;18:10. doi: 10.1186/s12978-021-01070-6. - DOI - PMC - PubMed

Publication types