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. 2025 Aug 6;20(8):e0329683.
doi: 10.1371/journal.pone.0329683. eCollection 2025.

Impact of the COVID-19 pandemic on pregnancy complications and conceptions resulting in births following spontaneous conception and in-vitro fertilization in British Columbia: A population-based study

Rebecca Eckler  1 , Bahi Fayek  1   2 , Erica Won  1 , Sabina Dobrer  2 , Sarka Lisonkova  1   2   3 , Paul J Yong  1   2 , K S Joseph  1   2   3 , Mohamed A Bedaiwy  1   2
Affiliations

Impact of the COVID-19 pandemic on pregnancy complications and conceptions resulting in births following spontaneous conception and in-vitro fertilization in British Columbia: A population-based study

Rebecca Eckler et al. PLoS One. .

Abstract

Objectives: To investigate the impact of the COVID-19 pandemic's onset on clinical and demographic characteristics, pregnancy complications, and monthly conception rates resulting in births through spontaneous conceptions and in-vitro fertilization (IVF) in British Columbia (BC), Canada.

Materials and methods: This retrospective population-based cohort study examined individuals who gave birth (both live births and stillbirths) in BC between June 1, 2010, and March 31, 2021, with estimated conception dates from January 1, 2010 to June 30, 2020. Data were obtained from the BC Perinatal Data Registry. Two groups were identified based on the estimated conception date: the pre-pandemic conception group (conception from January-1-2010 to February-29-2020) and the pandemic conception group (conception from March-1-2020 to June-30-2020). A time series forecasting method (ARIMA) was employed to observe trends in conception rates during the study period.

Results: 304,244 individuals with pregnancies resulting in live births or stillbirths during the study period were evaluated. A total of 429,843 such conceptions were included in the study: 417,753 (97.2%) occurring before the onset of the pandemic and 12,090 (2.8%) in the pandemic period. In June 2020, conceptions resulting in births decreased by 26.6% compared with June 2019. Trends in conceptions resulting in live births were similar, with a conception rate of 235.2 per 100,000 women of reproductive age in June 2020, compared with the expected rate of 305.0 per 100,000. In March 2020, 0.5% of conceptions that resulted in births ended in stillbirths, compared to 1.7% in March 2019. IVF conceptions ending in births declined during the pandemic, dropping to 2.5 and 2.8 per 100,000 in March and April 2020, respectively, compared with the expected 13.1 per 100,000. However, by June 2020, these rates began to recover toward the expected levels. Rates of gestational diabetes mellites (GDM), gestational hypertension (GHTN), and postpartum intensive care unit (ICU) admissions were similar before and during the COVID-19 pandemic.

Conclusions: During the challenging period of the COVID-19 pandemic in BC, couples may have chosen to delay conception. Rates of conceptions resulting in stillbirths remained relatively unchanged. IVF conception rates were impacted by the suspension of elective procedures. Preterm birth rates slightly exceeded expected levels but remained within normal fluctuations, and small increases in GDM and GHTN prevalence were also observed.

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Conflict of interest statement

P.J.Y: Research grants from Canadian Institutes of Health Research (CIHR) and a Michael Smith Foundation for Health Research Grant. - M.A.B: Research grants from Canadian Institutes of Health Research (CIHR) and Ferring Pharmaceutical. He is on the advisory board for AbbVie, Pfizer, and Baxter. - Other authors do not have any declarations of interest. These competing interests do not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Flow chart of the studied population.
(A) Flow chart of the included individuals; (B) Summary of conceptions resulting in birth during the study period (January 2010-June 2020). Abbreviation: IVF, In-vitro fertilization.
Fig 2
Fig 2. Conception rates resulted in births (live births and stillbirths) throughout the study period.
(A): Conception rates throughout the study period (January 2010-June 2020). (B): Monthly conception rate trends from March to June across years (2010–2020).
Fig 3
Fig 3. Observed and expected conceptions rates resulting in births (live births and stillbirths) during the study period.
Fig 4
Fig 4. Observed and expected IVF conceptions rates resulting in births during the study period.
See this image and copyright information in PMC

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