Published onNeonatology Update
Despite early reports suggesting a decline in preterm births during the COVID-19 pandemic period, an analysis by our team and researchers at the Perelman School of Medicine at the University of Pennsylvania found no change in preterm births or stillbirths at 2 Philadelphia hospitals in the first 4 months of the pandemic. The findings, which were recently published in the Journal of the American Medical Association, resulted from the examination of an ongoing, racially diverse pregnancy cohort that assesses both spontaneous and medically indicated preterm birth.
The cohort, known as GeoBirth, includes more than 100,000 births at 2 Penn Medicine hospitals in Philadelphia since 2008. Each preterm birth, characterized as any birth occurring before 37 weeks’ gestation, is manually classified by 2 independent, blinded reviewers as either a spontaneous preterm birth or a medically indicated preterm birth. The former includes preterm labor or early rupture of the membranes, and the latter includes conditions that necessitate an early delivery for the health of the mother or baby, such as preeclampsia or intrauterine growth restriction.
We analyzed 2,992 live births from March 2020 through the end of June 2020 and compared those births to 5 875 over the same 4-month period in 2018 and 2019. Making use of the robust GeoBirth data set, we compared rates of overall preterm birth, spontaneous preterm birth, medically indicated preterm birth, and stillbirth, defined as intrauterine demise after 20 weeks.
The data did not show any significant change in preterm or stillbirth rates during the COVID-19 pandemic. Even when breaking down the preterm birth data by spontaneous and medically indicated preterm births, we still did not detect differences between the pre-pandemic and pandemic period. These findings differ from European studies that have reported a decrease in preterm birth and increase in stillbirth during the first few months of the pandemic.
The GeoBirth cohort will allow us the opportunity to query how individual, societal, and environmental factors affect pregnant women and how those factors may be heightened by the varying effects of a pandemic. It is imperative that we have rigorous tools to study how these different factors may harm pregnant people and how the pandemic may exacerbate those factors so we can target appropriate strategies to improve the lives of women and their babies.
Handley SC, et al. Changes in preterm birth phenotypes and stillbirth at two Philadelphia hospitals during the SARS-CoV-2 pandemic from March-June 2020. JAMA. 2021;325(1):87-89.
Contributed by: Sara Handley, MD, MSCE