Daily Ards Research Analysis
Today's search yielded one population-based cohort study examining perinatal outcomes during the first year of the COVID-19 pandemic. It found no change in preterm birth rates but detected small increases in gestational diabetes and composite neonatal morbidity.
Summary
Today's search yielded one population-based cohort study examining perinatal outcomes during the first year of the COVID-19 pandemic. It found no change in preterm birth rates but detected small increases in gestational diabetes and composite neonatal morbidity.
Research Themes
- Perinatal outcomes during COVID-19
- Gestational diabetes risk
- Neonatal respiratory morbidity
Selected Articles
1. Health Care System Burden During the COVID-19 Pandemic and Pregnancy Outcomes: A Population-Based Study.
In a population-based cohort comparing 2020 births to 2017–2019 within a single-payer system (N=479,894), preterm birth before 37 weeks remained unchanged (7.57% vs 7.57%; aRR 1.00, 95% CI 0.98–1.02). However, gestational diabetes and composite neonatal morbidity (Apgar 5-min <5, respiratory distress syndrome, mechanical ventilation) increased slightly.
Impact: This study provides robust, population-level evidence disentangling pandemic-era perinatal risks by showing stable preterm birth rates but increased gestational diabetes and neonatal morbidity. The large sample and adjusted analyses support reliable inferences for health system planning.
Clinical Implications: No increase in preterm birth suggests resilience of obstetric care for this outcome, but the rise in gestational diabetes warrants enhanced screening, lifestyle support, and glycemic management during disruptions. Neonatal services should anticipate slightly higher morbidity and ensure adequate respiratory support capacity.
Key Findings
- Preterm birth <37 weeks was unchanged in 2020 vs 2017–2019 (7.57% vs 7.57%; aRR 1.00, 95% CI 0.98–1.02).
- No differences in very/early preterm thresholds (<34, <32, <28, <26 weeks).
- Gestational diabetes increased slightly (9.54% vs 8.67%; aRR 1.07, 95% CI 1.05–1.10).
- Composite neonatal morbidity increased slightly (11.65% vs 10.85%; aRR 1.06, 95% CI 1.04–1.08).
Methodological Strengths
- Large, population-based cohort using province-wide single-payer data (N=479,894).
- Adjusted relative risk estimates with clear comparator period (2017–2019 vs 2020).
Limitations
- Retrospective observational design with potential residual confounding; individual SARS-CoV-2 infection status not reported.
- Findings limited to the first pandemic year and one jurisdiction; causality cannot be inferred.
Future Directions: Link individual-level infection, care access metrics, and health system strain to outcomes; evaluate subsequent pandemic waves; investigate mechanisms for increased gestational diabetes and neonatal morbidity (e.g., screening changes, lifestyle shifts).
OBJECTIVES: We aimed to explore how the COVID-19 pandemic impacted the incidence of preterm birth (PTB) and other perinatal outcomes. METHODS: This is a population-based cohort study using provincial-level population data. The study population consisted of persons who gave birth in a setting of a single-payer insurer during the period from January 2020 to December 2020. The comparator group included persons who delivered in the same setting between January 2017 and December 2019. The main outcome measured was PTB before 37 weeks gestation. In addition, we analyzed several secondary outcomes, including PTB at different gestational ages, hypertensive disorders in pregnancy, and composite neonatal morbidity (5-minute Apgar score <5, respiratory distress syndrome, or need for mechanical ventilation). RESULTS: Between January 2020 and December 2020, 116 244 births were documented (study group) and were compared with 363 650 births that occurred between January 2017 and December 2019 (control group). There was no difference in the rate of PTB before 37 weeks (7.57% vs. 7.57%, adjusted relative risk [aRR] 1.00, 95% CI 0.98-1.02), nor were there differences in the rate of PTB before 34, 32, 28, or 26 weeks gestation. The risk for gestational diabetes was slightly higher (9.54% vs. 8.67%, aRR 1.07, 95% CI 1.05-1.10), as was the risk of composite neonatal morbidity (11.65% vs. 10.85%, aRR 1.06, 95% CI 1.04-1.08). CONCLUSIONS: During the first year of the COVID-19 pandemic, the rate of PTB was not higher than in previous years. However, a higher risk of gestational diabetes and composite neonatal morbidity was noted.