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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

JAMA

Published Online: July 10, 2020

Research Letter

Article Information and Disclosures

Asma Khalil, MD¹;

Peter von Dadelszen, PhD²;

Tim Draycott, MD³;

et al

Austin Ugwumadu, PhD¹;

Pat O’Brien, MBBCh, MRCOG, MFFP⁴;

Laura Magee, PhD²

Author Affiliations

¹Fetal Medicine Unit, St George’s University of London, London, United Kingdom
²School of Life Course Sciences, King’s College London, London, United Kingdom
³Department of Women’s Health, North Bristol NHS Trust, Westbury on Trym, United Kingdom
⁴Department of Women’s Health, University College London Hospitals, London, United Kingdom

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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

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. EClinicalMedicine. Published online July 3, 2020. doi:10.1016/j.eclinm.2020.100446 Google Scholar

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.m2107 PubMed Google Scholar Crossref

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.2020.8904 PubMed Google Scholar

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/NEJMc2009316 PubMed Google Scholar Crossref

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.2020.05.005 PubMed Google Scholar

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

Second-Trimester Miscarriage in a Pregnant Woman With COVID-19

Labor and Delivery Visitor Policies During the COVID-19 Pandemic

Prevalence of SARS-CoV-2 Among Patients Admitted for Childbirth in Southern Connecticut

Caring for Women Who Are Planning Pregnancy, Pregnant, or Postpartum During the COVID-19 Pandemic

Mode of Delivery Among Pregnant Women With COVID-19 and Maternal and Neonatal Outcomes in Spain

Associations Between Built Environment, Neighborhood SES, and SARS-CoV-2 Infection

Clarifying Consequences of COVID-19 in Pregnant Women, Newborns, and Children With Existing Cohorts

Association of SARS-CoV-2 Test Status and Pregnancy Outcomes

Changes in Preterm Birth and Stillbirth at 2 Philadelphia Hospitals During the SARS-CoV-2 Pandemic

Stillbirths During the COVID-19 Pandemic in England, April-June 2020

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