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Am J Perinatol 2024; 41(S 01): e236-e248
DOI: 10.1055/a-1878-0503
Original Article

Population-Level Study on Fetal Deaths and Preterm Births during SARS-CoV-2 Pandemic in the State of Michigan

Monika Bajaj
1   Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Central Michigan University, Children's Hospital of Michigan and Hutzel Women's Hospital, Detroit, Michigan
,
Roberto Romero
2   Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland
3   Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
4   Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan
5   Center for Molecular Medicine and Genetics, Wayne State University, Detroit, Michigan
8   Detroit Medical Center, Detroit, Michigan
,
Lindsey Myers
6   Division for Vital Records and Health Statistics, Department of Health and Human Services, Lansing, Michigan
,
Jeffrey Duncan
6   Division for Vital Records and Health Statistics, Department of Health and Human Services, Lansing, Michigan
,
Lami Yeo
2   Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland
7   Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan
,
Sanket Jani 
1   Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Central Michigan University, Children's Hospital of Michigan and Hutzel Women's Hospital, Detroit, Michigan
,
Girija Natarajan
1   Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Central Michigan University, Children's Hospital of Michigan and Hutzel Women's Hospital, Detroit, Michigan
› Author Affiliations
Funding This research was supported, in part, by the Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS); and, in part, with Federal funds from NICHD/NIH/DHHS under Contract No. HHSN275201300006C. Dr. Romero has contributed to this work as part of his official duties as an employee of the United States Federal Government.
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Abstract

Objective The aim of the study is to explore the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on preterm birth at different gestational ages and fetal death in the state of Michigan.

Study Design Data on live births and fetal deaths in the state of Michigan from March to November in the years 2017 through 2020 were obtained from Michigan Department of Health and Human Services (MDHHS). Preterm birth rate, fetal death rate (per 1,000 live births) overall and stratified by race and maternal comorbidities during the period of pandemic (March–November 2020) were compared with the same period (March–November) in the prepandemic years (2017–2019).

Results Of 328,879 live births and 1,470 fetal deaths during the study period, 77,983 live births and 242 fetal deaths were reported in 2020. Compared with prepandemic years, fetal death rate per 1,000 live births was significantly lower in 2020 (3.1 vs. 4.7 [2017], 5.2 [2018], 4.4 [2019], p-value <0.001). The adjusted risk for fetal death in 2020 was decreased (odds ratio [OR] = 0.64 [95% confidence interval (CI): 0.56–0.74], p <0.0001), compared with prepandemic years. Fetal death was significantly associated with African-American race, pregnancy hypertension and prepregnancy diabetes. No significant difference in the proportion of preterm births (<37 weeks' gestation) was noted between pandemic and prepandemic years (9.9 vs. 10.0%, p = 0.50). There was no significant difference in the risk of preterm birth across gestational age strata (<28, 28–316/7, 32–366/7, 37–416/7, and >42 weeks) between pandemic and prepandemic years on multinomial analysis. Significant associations with preterm birth across all years included African American race, lower level of maternal education, pregnancy-induced hypertension, chronic hypertension, prepregnancy diabetes, congenital anomalies, previous preterm birth, and prolonged rupture of membranes >12 hours.

Conclusion Fetal death rate was significantly lower whereas preterm births remained unchanged during pandemic in comparison with prepandemic years in the state of Michigan.

Key Points

  • A decrease in fetal death rate was noted during SARS CoV-2 pandemic in the State of Michigan.

  • Overall state-wide rates of preterm birth did not change in 2020, compared to previous years.

  • Significant risk factors associated with preterm birth and fetal deaths did not differ between prepandemic and pandemic years.

Keywords

SARS CoV-2 - COVID-19 - fetal deaths - preterm birth - pandemic


Publication History

Received: 06 July 2021

Accepted: 26 May 2022

Accepted Manuscript online:
16 June 2022

Article published online:
01 October 2022

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