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Change in the Incidence of Stillbirth and Preterm Delivery During the COVID-19 Pandemic

Educational Objective
To understand how COVID-19 may contribute to increased rates or stillbirth and preterm deliveries
1 Credit CME

High rates of preterm birth and cesarean delivery have been reported in women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.1 However, studies have inadequate power to assess uncommon outcomes like stillbirth (fetal death ≥24 weeks’ gestation). The UK Obstetric Surveillance System reported 3 stillbirths among 247 completed pregnancies in women with confirmed coronavirus disease 2019 (COVID-19) vs the national rate (12.1 per 1000 births vs 4-5 per 1000 births).2 We assessed the change in stillbirth and preterm delivery rates during the pandemic.

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Article Information

Corresponding Author: Asma Khalil, MD, Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George’s University Hospitals, NHS Foundation Trust, Blackshaw Road, London SW17 0QT, United Kingdom (akhalil@sgul.ac.uk).

Accepted for Publication: June 29, 2020.

Published Online: July 10, 2020. doi:10.1001/jama.2020.12746

Author Contributions: Dr Khalil had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Khalil, von Dadelszen, O’Brien, Magee.

Acquisition, analysis, or interpretation of data: Khalil, Draycott, Ugwumadu, O’Brien, Magee.

Drafting of the manuscript: Khalil, Draycott, Ugwumadu, O’Brien.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Khalil.

Administrative, technical, or material support: Khalil, von Dadelszen, Ugwumadu, Magee.

Conflict of Interest Disclosures: Dr Draycott reported receipt of grants from Tommy’s Centre for Maternity Improvement outside the submitted work. No other disclosures were reported.

References
1.
Khalil  A , Kalafat  E , Benlioglu  C ,  et al  SARS-CoV-2 infection in pregnancy: a systematic review and meta-analysis of clinical features and pregnancy outcomes.   EClinical Medicine. Published online July 3, 2020. doi:10.1016/j.eclinm.2020.100446Google Scholar
2.
Knight  M , Bunch  K , Vousden  N ,  et al; UK Obstetric Surveillance System SARS-CoV-2 Infection in Pregnancy Collaborative Group.  Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study.   BMJ. 2020;369:m2107. doi:10.1136/bmj.m2107PubMedGoogle ScholarCrossref
3.
Campbell  KH , Tornatore  JM , Lawrence  KE ,  et al.  Prevalence of SARS-CoV-2 among patients admitted for childbirth in Southern Connecticut.   JAMA. Published online May 26, 2020. doi:10.1001/jama.2020.8904PubMedGoogle Scholar
4.
Sutton  D , Fuchs  K , D’Alton  M , Goffman  D .  Universal screening for SARS-CoV-2 in women admitted for delivery.   N Engl J Med. 2020;382(22):2163-2164. doi:10.1056/NEJMc2009316PubMedGoogle ScholarCrossref
5.
Khalil  A , Hill  R , Ladhani  S , Pattisson  K , O’Brien  P .  Severe acute respiratory syndrome coronavirus 2 in pregnancy: symptomatic pregnant women are only the tip of the iceberg.   Am J Obstet Gynecol. Published online May 7, 2020. doi:10.1016/j.ajog.2020.05.005PubMedGoogle Scholar
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