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. 2024 Jul 1;34(Supplement_1):i58-i66.
doi: 10.1093/eurpub/ckad186.

Socioeconomic disparities in changes to preterm birth and stillbirth rates during the first year of the COVID-19 pandemic: a study of 21 European countries

Jennifer Zeitlin  1 , Marianne Philibert  1 , Henrique Barros  2 , Lisa Broeders  3 , Jan Cap  4 , Željka Draušnik  5 , Hilde Engjom  6 , Alex Farr  7 , Jeanne Fresson  8 , Miriam Gatt  9 , Mika Gissler  10   11 , Günther Heller  12 , Jelena Isakova  13 , Karin Källén  14 , Theopisti Kyprianou  15 , Marzia Loghi  16 , Kirsten Monteath  17   18 , Laust Mortensen  19   20 , Tonia Rihs  21 , Luule Sakkeus  22 , Izabela Sikora  23 , Katarzyna Szamotulska  24 , Petr Velebil  25   26 , Ivan Verdenik  27 , Guy Weber  28 , Irisa Zile  29 , Oscar Zurriaga  30   31   32 , Lucy Smith  33 ; Euro-Peristat Research Group and the Population Health Information Research Infrastructure
Collaborators, Affiliations

Socioeconomic disparities in changes to preterm birth and stillbirth rates during the first year of the COVID-19 pandemic: a study of 21 European countries

Jennifer Zeitlin et al. Eur J Public Health. .

Abstract

Background: Despite concerns about worsening pregnancy outcomes resulting from healthcare restrictions, economic difficulties and increased stress during the COVID-19 pandemic, preterm birth (PTB) rates declined in some countries in 2020, while stillbirth rates appeared stable. Like other shocks, the pandemic may have exacerbated existing socioeconomic disparities in pregnancy, but this remains to be established. Our objective was to investigate changes in PTB and stillbirth by socioeconomic status (SES) in European countries.

Methods: The Euro-Peristat network implemented this study within the Population Health Information Research Infrastructure (PHIRI) project. A common data model was developed to collect aggregated tables from routine birth data for 2015-2020. SES was based on mother's educational level or area-level deprivation/maternal occupation if education was unavailable and harmonized into low, medium and high SES. Country-specific relative risks (RRs) of PTB and stillbirth for March to December 2020, adjusted for linear trends from 2015 to 2019, by SES group were pooled using random effects meta-analysis.

Results: Twenty-one countries provided data on perinatal outcomes by SES. PTB declined by an average 4% in 2020 {pooled RR: 0.96 [95% confidence intervals (CIs): 0.94-0.97]} with similar estimates across all SES groups. Stillbirths rose by 5% [RR: 1.05 (95% CI: 0.99-1.10)], with increases of between 3 and 6% across the three SES groups, with overlapping confidence limits.

Conclusions: PTB decreases were similar regardless of SES group, while stillbirth rates rose without marked differences between groups.

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Figures

Figure 1
Figure 1
Change in preterm birth rates in March to December 2020 as measured by observed over expected risks for high, middle and low socioeconomic groups
Figure 2
Figure 2
Change in stillbirth rates in March to December 2020 as measured by observed over expected risks for high, middle and low socioeconomic groups
Figure 3
Figure 3
Change in preterm birth (A) and stillbirth (B) rates in March to December 2020 as measured by observed over expected risks for high, middle and low socioeconomic groups in large countries with preterm birth rate reductions
See this image and copyright information in PMC

References

    1. Kramer MS, Seguin L, Lydon J, Goulet L.. Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol 2000;14:194–210. - PubMed
    1. Singh GK, Kogan MD.. Persistent socioeconomic disparities in infant, neonatal, and postneonatal mortality rates in the United States, 1969-2001. Pediatrics 2007;119:e928-39–e939. - PubMed
    1. Smith LK, Draper ES, Manktelow BN, et al.Socioeconomic inequalities in very preterm birth rates. Arch Dis Child Fetal Neonatal Ed 2007;92:F11–4. - PMC - PubMed
    1. Zeitlin J, Mortensen L, Prunet C, et al.; Euro-Peristat Scientific Committee. Socioeconomic inequalities in stillbirth rates in Europe: measuring the gap using routine data from the Euro-Peristat Project. BMC Pregnancy Childbirth 2016;16:15. - PMC - PubMed
    1. Lindquist A, Noor N, Sullivan E, Knight M.. The impact of socioeconomic position on severe maternal morbidity outcomes among women in Australia: a national case-control study. BJOG 2015;122:1601–9. - PubMed