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Let's not ignore the possibility that the reduction in pre-term birth could be due to women receiving less pre-natal screening, leading to conditions that would

Let's not ignore the possibility that the reduction in pre-term birth could be due to women receiving less pre-natal screening, leading to conditions that would warrant immediate induction going undetected. In fact, data collected from a hospital in the UK indicates a 4X increase in the incidence of stillbirth. From: https://www.medscape.com/viewarticle/934056 https://www.medscape.com/viewarticle/934056 edit: Non-paywalled: https://outline.com/MZUPk3 https://outline.com/MZUPk3 > The incidence of stillbirth was significantly higher during the pandemic period (16 of 1,718 births; 9.31 per 1,000 births) than the prepandemic period (four of 1,681 births; 2.38 per 1,000), a difference of 6.93 stillbirths per 1,000 births. A hypothesis put forth by the authors on why this is: > they say the uptick in stillbirths may be due to indirect effects such as a reluctance to go to the hospital when needed (such as in the case of reduced fetal movements), fear of contracting COVID-19, or not wanting to further burden the National Health Service. Changes in obstetric services may also have played a role.

barbegal 6y ago
This is the most reasonable explanation I have heard and I'm surprised it was not discussed in https://www.medrxiv.org/content/10.1101/2020.06.03.20121442v1 https://www.medrxiv.org/content/10.1101/2020.06.03.20121442v... The increase in stillbirths roughly matches the reduction in pre-term births but the proof would be in the reduction in medically induced births during lockdown for which we don't seem to have the data.
irjustin 6y ago
Interesting, is the data there to show COVID infections of stillbirth? Can that account for at least some of them to offset?
- dahfizz 6y ago
  Considering only 0.4% of the UK population has gotten covid ( 300,000 cases / 68,000,000 population) I would say it's incredibly tenuous to blame the 400% stillbirths increase on covid infections.
throw57382 6y ago
Take that paper with a grain of salt. If you look at their stillbirth rate in the whole of 2017 (rather than an arbitrarily short period immediately before covid), you find their stillbirth rate was 4.21 per 1,000. They went from 4.21 in 2017, to 2.38 in a few months in 2019, then 9.31 in 2020? The UK hasn't really been improving in stillbirth rates, so it would be very impressive if they'd halved theirs. Source, the UK's national perinatal death surveillance report (pdf, page 88): https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/MBRRACE-UK%20Perinatal%20Mortality%20Surveillance%20Report%20for%20Births%20in%202017%20-%20FINAL%20Revised.pdf https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/report... Would 4.21 -> 9.32 still have been significant on that small a sample size?

barbegal 6y ago

This is the most reasonable explanation I have heard and I'm surprised it was not discussed in https://www.medrxiv.org/content/10.1101/2020.06.03.20121442v1 https://www.medrxiv.org/content/10.1101/2020.06.03.20121442v... The increase in stillbirths roughly matches the reduction in pre-term births but the proof would be in the reduction in medically induced births during lockdown for which we don't seem to have the data.

irjustin 6y ago

Interesting, is the data there to show COVID infections of stillbirth? Can that account for at least some of them to offset?

dahfizz 6y ago
Considering only 0.4% of the UK population has gotten covid ( 300,000 cases / 68,000,000 population) I would say it's incredibly tenuous to blame the 400% stillbirths increase on covid infections.

throw57382 6y ago

Take that paper with a grain of salt. If you look at their stillbirth rate in the whole of 2017 (rather than an arbitrarily short period immediately before covid), you find their stillbirth rate was 4.21 per 1,000. They went from 4.21 in 2017, to 2.38 in a few months in 2019, then 9.31 in 2020? The UK hasn't really been improving in stillbirth rates, so it would be very impressive if they'd halved theirs. Source, the UK's national perinatal death surveillance report (pdf, page 88): https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/MBRRACE-UK%20Perinatal%20Mortality%20Surveillance%20Report%20for%20Births%20in%202017%20-%20FINAL%20Revised.pdf https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/report... Would 4.21 -> 9.32 still have been significant on that small a sample size?