About Dr. Robert “Bob” Vadovic Dr. Robert "Bob" Vadovic is a Nurse Practitioner with a Ph.D. in Nursing Practice. He started as an Office Provider at Intermountain Healthcare and is currently the Medical Director for High Risk and APPs and Program Director for the APP...
Drop in Preterm Births During COVID has Doctors Confused
A baffling new phenomenon is emerging in labor and delivery wards across the globe, and it’s something of a pleasant surprise to medical professionals: Since COVID-19, the premature birth rate in many countries has sharply dropped, resulting in more full-term births and fewer costly and deadly complications.
Premature birth is defined as a live delivery that happens before 37 weeks of gestation. Most common is late preterm (34-36 weeks); then mid-preterm (32-34 weeks); while births earlier than 32 weeks are considered very preterm, and those are associated with the most dangerous and deadly risks.
During pregnancy, your due date is understood to be an estimate, and a full-term birth can happen anywhere between 37 and 42 weeks of gestation.
According to data from the March of Dimes, in 2018 the premature birth rate in the United States had risen to over 10% of total births, and is generally expected to continue to rise. Globally, the rate of preterm birth is about 11%, and over 1 million children under the age of 5 die annually from complications due to preterm birth.
The impact of premature birth affects both short-term and long-term development. These challenges include breathing and swallowing issues, digestive and circulatory problems, as well as complications involving the brain, metabolism, and immune system. With such a vast collection of serious complications, there has been ample study devoted to decreasing the prevalence of preterm birth – and new insights into the phenomena of preterm birth will be of significant importance to overall public health.
However, there is still much that the medical community does not understand regarding the issue of preterm birth. The most compelling risk factors for preterm birth include intrauterine infection or medical complications of pregnancy like diabetes and hypertension.
The recommendations for reducing your risk of giving birth prematurely include lowering your stress levels, eating a nourishing diet, avoiding known risk factors for infections and illness, and avoiding alcohol, tobacco, or illicit drug use.
Since COVID-19 has contributed to a massive spike in global stress and fear, doctors initially expected that rates of premature birth would be on the rise–but in many areas, the opposite has held true!
Interestingly, new reports from around the globe are showing rather drastic drops in premature birth rates beginning in April of this year, with independent news reports from NICUs in Canada, Australia, Ireland and Denmark, among other nations.
In fact, one hospital crunched the numbers and found that between March and June 2020, there had been less than one-quarter the number of “extremely premature” infants born – which is a baffling and significant drop, the likes of which have not been seen during the entire twenty years prior.
Many researchers are captivated by what other factors play into the potential for causing premature birth. They are currently designing studies around various hypotheses that may lend insight into our overall understanding of preterm birth, and therefore can be more proactive in its prevention.
Possible speculation is underway as to what may be influencing the preterm birth rate drop, including the increased vigilance around immune support and personal hygiene, thereby decreasing the prevalence of viral infections in expectant mothers. Another potential angle for research involves the increased incidence of working remotely or not working, which may lead to less stress in expectant mothers, thereby reducing their risk of premature birth.
Finally, expectant mothers are being exposed to significantly lower amounts of environmental pollutants due to less burning of fossil fuels during COVID, which is improving air quality in metro areas. Air pollution is one clearly defined risk factor in preterm birth.
These and many other scenarios could potentially be co-factors in the decrease of preterm birth that many hospitals and families are currently enjoying.
While the correlations between preterm birth rates and stress, environmental pollutants, and maternal infection are more clearly defined, there are many other potential contributing factors to the rate of preterm birth that are not as well-documented.
For example, COVID could be reducing access to addictive and toxic substances, especially illicit drugs, for the most at-risk populations. During COVID, many expectant mothers are spending more free time at home, and this may correlate with an increase in home cooking (and therefore, better nutrition in expectant mothers), or more time for personal care.
Perhaps they are spending more time with family members, and less time commuting and working – and this could be a key factor in improving expectant mothers’ overall wellbeing. Other factors include a reduction – or increase – in time spent outdoors, and telemedicine instead of in-person prenatal exams.
As the pandemic continues to unfold, new trends may emerge, and as lockdowns and restrictions expire, it’s possible that we may see a tragic reversal of this trend. Hopefully researchers will uncover some helpful correlations in the data so that medical care providers will be better equipped to prevent preterm birth in the future.
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