Author: Anna Wald, MD, MPH reviewing
NEJM Journal Watch
An increase in stillbirths during the pandemic was noted in a large London hospital, but none occurred among women with documented COVID-19; indirect explanations are also possible.
The effects of the COVID-19 pandemic on pregnancy outcomes continue to be examined. Investigators at a large British hospital assessed rates of stillbirth and preterm delivery among 1681 births during the 4 months immediately before February 1, 2020, (prepandemic) compared with 1718 births from February 1 to June 14, 2020, (pandemic). Demographic characteristics of the women in both groups were similar.
Rates of preterm birth did not differ between groups. However, stillbirth rates were 1.2% (prepandemic) versus 7% (pandemic; P=0.01). Routine testing for COVID-19 was not conducted during the pandemic period, and all women with stillbirths were asymptomatic. Postmortem and placental pathology were not consistent with viral infection, indicating that none of the stillbirths occurred in women with COVID-19.
As the authors point out, the reasons for the large difference in stillbirth incidence after the pandemic’s onset remain unclear but may include fewer prenatal visits because of hesitance to visit health care facilities. More data from diverse geographic areas will be useful for confirming this observation.