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

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Pregnant women have an increased risk of infectious diseases, including respiratory infections such as influenza,1 and are included on the coronavirus disease 2019 (COVID-19) UK clinically vulnerable list.2 Little is known about the risk of COVID-19 to unborn children, with data limited to a case series of 3 stillbirth deliveries in pregnant women with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection3 and a single London hospital reporting a higher rate of stillbirth deliveries during the pandemic period compared with a prepandemic period.4 To provide more robust data, we used national and regional hospitalization data in England to assess the risk of stillbirths during the COVID-19 pandemic.

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Article Information

Corresponding Author: Julia Stowe, PhD, Immunisation and Countermeasures, Public Health England, 61 Colindale Ave, London NW9 5EQ, England (julia.stowe@phe.gov.uk).

Accepted for Publication: October 9, 2020.

Published Online: December 7, 2020. doi:10.1001/jama.2020.21369

Author Contributions: Dr Stowe 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: Stowe, Andrews, Ladhani.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Stowe, Smith, Thurland.

Critical revision of the manuscript for important intellectual content: Stowe, Ramsay, Andrews, Ladhani.

Statistical analysis: Stowe, Smith, Thurland, Andrews.

Administrative, technical, or material support: Stowe.

Supervision: Ramsay.

Conflict of Interest Disclosures: None reported.

Funding/Support: This work was funded by Public Health England.

Role of the Funder/Sponsor: Public Health England participated in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References
1.
Kourtis  AP , Read  JS , Jamieson  DJ .  Pregnancy and infection.   N Engl J Med. 2014;370(23):2211-2218. doi:10.1056/NEJMra1213566PubMedGoogle ScholarCrossref
2.
Pregnancy and coronavirus, 2020. NHS England. Published July 22, 2020. Accessed September 4, 2020. https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/pregnancy-and-coronavirus/
3.
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
4.
Khalil  A , von Dedelszan  P , Draycott  T , Ugwumadu  A , O’Brien  P , Magee  L .  Change in the incidence of stillbirth and preterm delivery during the COVID-19 pandemic.   JAMA. 2020;324(7):705-706. doi:10.1001/jama.2020.12746PubMedGoogle ScholarCrossref
5.
Coronavirus (COVID-19) in the UK. Public Health England. Accessed September 17, 2020. https://coronavirus.data.gov.uk/cases
6.
Coronavirus and pregnancy—preserving maternal health across the European Region. World Health Organisation Europe. Published June 30, 2020. Accessed August 14, 2020. https://www.euro.who.int/en/health-topics/Life-stages/maternal-and-newborn-health/news/news/2020/6/coronavirus-and-pregnancy-preserving-maternal-health-across-the-european-region
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