Pandemic lockdown triggered sharp drop in preterm births, Georgia Tech study finds

ATLANTA - In the spring of 2020, as the US went into a pandemic lockdown, the data shows preterm births, especially caesarian section deliveries and induced births suddenly dropped, too. 

Daniel Dench, an assistant professor of Economics at Georgia Tech, compared birth trends over the last decade, and says in March of 2020, there was a sudden drop in early deliveries.

"Preterm births that involved c-section or induced delivery drops by 6.9%," Dench says.

The numbers stayed down throughout the rest of 2020, and Dench says access to prenatal care may have been a driving factor.

"Women weren't spending as much time in the care of the doctor, and not as many tests were run that would have led a doctor to be concerned and want to take the baby early," he says.

Emory's Woodruff School of Nursing assistant professor Alexis Dunn Amore, a certified nurse midwife by training, says the drop in preterm births came at the same time prenatal visits decreased by about a third.

"Just because providers were trying to protect pregnant families from COVID, because we know that the mortality and the risks of a pregnant woman having COVID were significant," Dunn Amore says.  "So, there were a lot less prenatal visits during that time."

What is not yet clear, and what Dench is still studying, is how the drop in preterm births affected health outcomes for babies and their mothers.

"So, it could be when we analyze the data further, it could be that fetal deaths rise, as a result," Dench says. "Because a baby dies because they weren't taken early."

Dunn Amore agrees that lack of access may have caused some pre-birth complications to be missed.

"When you have an induction or caesarian, when you're preterm, that's kind of a proxy for there was something going on medically that necessitated the need to be delivered," she says. "So, I think some of that may not have been caught.

Early data shows maternal deaths rose in 2020, although it is not yet clear why.

Dunn Amore says more data could help them better understand how the lockdown affected women and their babies.

"Could it that those babies that would have been born preterm, if they'd had interventions, actually died because they did not have the intervention," she asks. "Because, just because you see a drop in the rate doesn't mean there has been too much intervention in the past.  That could be, but it's hard to arrive at that conclusion without knowing what happened to those babies that would have normally be born preterm."

Dench is now working on another study looking at how the drop in preterm births affected health outcomes for women and their babies.