"What we have done is an unintended increase in stillbirths as we seek to protect (pregnant women) from COVID-19."
For example, Jane Warland, a midwifery nurse and researcher at the University of South Australia, says in a story for nature about a chronic increase in stillbirths that researchers have begun to observe in some parts of the world.
Results from all over the world
A large study of 9 hospitals in Nepal found that stillbirth rates rose in the first month of the COVID-19-induced lockdown. After the lockdown, researchers noted an increase in premature births and caesarean sections. The stillbirth rate rose from 14 per 1,000 births to 21 per 1,000 births. The researchers did not see an increase in the total number of stillbirths, but this could be due to an apparently large decrease in the number of babies born in a hospital.
"Institutional births decreased by more than half during lockdown," the authors say. "With an increase in the institutional stillbirth rate and newborn mortality as well as a decrease in the quality of care." Fewer babies were born in a hospital and more died of those who were. And everyone was looked after less than before the lockdown. There have been no reports that pregnant women were infected with the coronavirus.
Why is this happening?
The authors have several theories: pregnant women in worse situations may have gone to hospital, while women who could be delivered at home skew the statistics. They also theorized that there could have been delays in care due to lockdowns.
The Centers for Disease Control and Prevention define stillbirth as the death of a fetus or baby before or during delivery. The pregnancy lasts about 40 weeks. The loss of the fetus in the first 20 weeks is called a miscarriage. After that it is called stillbirth. According to data from 2014, the stillbirth rate in the US is 1 in 160 births.
The increase in stillbirths appears to be happening around the world. A report from St. George & # 39; s Hospital in London, England found that the stillbirth rate rose from just over 2 per 1,000 in mid-2019 to just over 9 per 1,000 in the first half of 2020. Only 1 pregnant woman tested positive for SARS -CoV-2. Asma Khalil, MD, professor of obstetrics at St. George & # 39; s and the study author, wrote in a tweet: “(T) He observed an increase in stillbirths during the Covid-19 pandemic which is alarming but confirms that anecdotal reports of excessive cases of inexplicable stillbirths from a number of clinicians. "
Some reports contradict these statistics, or at least show that premature births are falling.
More research is needed to consider women who had babies at home or in smaller facilities.
One theory put forward in the Nature story is that due to limitations on face-to-face appointments, healthcare providers may have overlooked the evolution of conditions and potential problems. Additionally, expectant parents who are unsure of the rules about appointments and are concerned about the virus may have delayed care or missed appointments.
On the flip side, the apparent drop in premature births may be due to the fact that home-stuck mothers are less stressed, rested and less exposed to other germs and viruses.
COVID-19 and expectant mothers
It seems that the coronavirus itself may not be to blame. Several studies 1,2,3,4 have found similar health results for infected and uninfected women. However, the lack of access to health care caused by pandemic shutdowns may have had an impact.
What can you do about it? As of mid-September, many US states lifted restrictions or started lifting them. Expectant parents should keep in touch with their health care providers and raise any concerns with them.
1. Trippella, G., Ciarcià, M., Ferrari, M., Buzzatti, C., Maccora, I., Azzari, C., Dani, C., Galli, L. & Chiappini, E. (2020). COVID-19 in Pregnant Women and Newborns: A Systematic Review of the Literature with Quality Assessment of the Studies. Pathogens (Basel, Switzerland), 9 (6), 485. https://doi.org/10.3390/pathogens9060485
2. S. Hayakawa, S. Komine-Aizawa & G. G. Mor (2020). Covid-19 pandemic and pregnancy. The Journal of Obstetrics and Gynecology, 10.1111 / jog.14384. Online pre-release. https://doi.org/10.1111/jog.14384
3. Elshafeey, F., Magdi, R., Hindi, N., Elshebiny, M., Farrag, N., Mahdy, S., Sabbour, M., Gebril, S., Nasser, M., Kamel, M .., Amir, A., Maher Emara, M. & Nabhan, A. (2020). A systematic scoping review of COVID-19 during pregnancy and childbirth. International Journal of Gynecology and Obstetrics: the official organ of the International Federation of Gynecology and Obstetrics, 150 (1), 47–52. https://doi.org/10.1002/ijgo.13182
4. Yang, Z., Wang, M., Zhu, Z. & Liu, Y. (2020). Coronavirus Disease 2019 (COVID-19) and Pregnancy: A Systematic Review. The Journal of Maternal-Fetal and Neonatal Medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Perinatal Societies in Asia and Oceania, the International Society of Perinatal Obstetricians, 1–4. Online pre-release. https://doi.org/10.1080/14767058.2020.1759541