Healthcare system burden during COVID-19 pandemic and pregnancy outcomes: a population-based study.

Abstract

Objective: We aimed explore how the COVID-19 pandemic impacted the incidence of preterm birth and other perinatal outcomes.

Methods: A population-based cohort study, using provincial-level population data. The study population consisted of individuals who gave birth in a setting of a single-payer insurer during the period from January 2020 to December 2020. The comparator group included individuals who delivered in the same setting between January 2017 and December 2019. The main outcome measured was preterm birth (PTB) before 37 weeks of gestation. Additionally, we analyzed several secondary outcomes, including PTB at different gestational ages, hypertensive disorders in pregnancy, and composite neonatal morbidity (5-minute Apgar score <5, respiratory distress syndrome, or need for mechanical ventilation).

Results: Between January 2020 and December 2020, 116 244 births were documented (study group) and were compared with 363 650 births that occurred between January 2017 and December 2019 (control group). There was no difference in the rate of PTB prior to 37 weeks (7.57% vs. 7.57%, aRR 1.00, 95% CI 0.98-1.02), nor were there differences in the rate of PTB prior to 34, 32, 28 or 26 weeks of gestation. The risk for gestational diabetes was slightly higher (9.54% vs. 8.67%, aRR 1.07, 95% CI 1.05-1.10), as was the risk of composite neonatal morbidity (11.65% vs. 10.85%, aRR 1.06, 95% CI 1.04-1.08).

Conclusion: During the first year of the COVID-19 pandemic, the rate of preterm birth was not higher than in previous years. But, a higher risk of gestational diabetes and composite neonatal morbidity was noted.