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Socioeconomic disparities in changes to preterm birth and stillbirth rates during the first year of the COVID-19 pandemic: a study of 21 European countries

2024; Oxford University Press; Volume: 34; Issue: Supplement_1 Linguagem: Inglês

10.1093/eurpub/ckad186

1464-360X

Jennifer Zeitlin, Marianne Philibert, Henrique Barros, Lisa Broeders, Ján Cáp, Željka Draušnik, Hilde Engjom, Alex Farr, J. Fresson, Miriam Gatt, Mika Gissler, Günther Heller, Jelena Isakova, Karin Källén, Theopisti Kyprianou, Marzia Loghi, Kirsten Monteath, Laust Hvas Mortensen, Tonia Rihs, Luule Sakkeus, Izabela Sikora, Katarzyna Szamotulska, P Velebil, Ivan Verdenik, Guy Weber, Irisa Zīle, Óscar Zurriaga, Lucy Smith, Jeannette Klimont, Alex Farr, Sophie Alexander, Marie Delnord, Judith Racapé, Gisèle Vandervelpen, Wei Hong Zhang, Rumyana Kolarova, Evelin Jordanova, Jelena Dimnjaković, Željka Draušnik, Urelija Rodin, Theopisti Kyprianou, Vasos Scoutellas, Jitka Jírová, P Velebil, Anne Vinkel Hansen, Laust Hvas Mortensen, Liili Abuladze, Luule Sakkeus, Mika Gissler, Anna Heino, Melissa Amyx, Béatrice Blondel, Anne Alice Chantry, Catherine Deneux‐Tharaux, Mélanie Durox, J. Fresson, Alice Hocquette, Marianne Philibert, Annick Vilain, Jennifer Zeitlin, Dimitra Bon, Günther Heller, Björn Misselwitz, Aris Antsaklis, István Sziller, Védís Helga Eiríksdóttir, Jóhanna Gunnarsdóttir, Helga Sól Ólafsdóttir, Karen Kearns, Izabela Sikora, Rosaria Boldrini, Marina Cuttini, Serena Donati, Marzia Loghi, Marilena Pappagallo, Jānis Misiņš, Irisa Zīle, Rita Gaidelyte, Jelena Isakova, Audrey Billy, Aline Lecomte, Jessica Pastore, Guy Weber, Miriam Gatt, Peter Achterberg, Lisa Broeders, Ashna D. Hindori‐Mohangoo, Jan G. Nijhuis, Rupali Akerkar, Hilde Engjom, Kari Klungsøyr, Ewa Mierzejewska, Katarzyna Szamotulska, Henrique Barros, Carina Rodrigues, Mihaela-Alexandra Budianu, Alexandra Cucu, Mihai Horga, Lucian Puşcaşiu, Petru Sandu, Vlad Tica, Ján Cáp, Miha Lučovnik, Ivan Verdenik, Adela Recio Alcaide, María Fernández Elorriaga, Mireia Jané, M.J. Méndez Vidal, Óscar Zurriaga, Karin Källén, Anastasia Nyman, Tonia Rihs, Diane Anderson, Samantha Clarke, H. McConnell, Alison Macfarlane, Sinead Magill, Kirsten Monteath, Siobhán Morgan, Joanne Murphy, Mark Piper, Sonya M. Scott, Lucy Smith, Craig J. Thomas, Bryan Williams, Claudia Habl, Cara Pries, Richard Pentz, Stefan Mathis-Edenhofer, Andrea Schmidt, Alexander Grabenhofer-Eggerth, Johannes Weiss, Sophie Sagerschnig, Anita Gottlob, Lorenz Dolanski, Alexander Degelsegger-Márquez, Beate Gruber, Katharana Habimana, Petronille Bogaert, Marie Delnord, Nienke Schutte, Kim Vyncke, Tadek Krzywania, L A Abboud, Miriam Saso, Brecht Devleesschauwer, Barthélémy Moreau de Lizoreux, Pascal Derycke, Pierre Daubresse, Sasha Milbeck, Karin De Ridder, Charles-Andrew Van de Catsyne, Šejla Cilović Lagarija, Anina Chileva, Jelena Dimnjaković, Jakov Vuković, Šárka Daňková, Ondřej Májek, Sigrid Vorobjov, Jane Idavain, Merika Rätsep, Hanna Tolonen, Mari Mäkinen, Mika Gissler, Jennifer Zeitlin, Marianne Philibert, Laure Carcaillon‐Bentata, Romana Haneef, Tatjana T. Makovski, Martin Thißen, Stefanie Seeling, Angela Fehr, Thomas Ziese, Christina Georgakopoulou, Elena Petelos, Christog Lionis, Dimitra Lingri, Tóth Kornél, Ágnes Töll, Péter Bezzegh, István Csizmadia, Róbert Láng, Kiss Csaba, Alan Cahill, Michael Courtney, Pauline White, Kelly Ailish, P.D. Clarke, Sharon Kappala, Breda Smyth, Luigi Palmieri, Brigid Unim, Andrea Faragalli, Jānis Misiņš, Irisa Zīle, Ausra Zelviene, Audronè Astrauskiené, Guy Weber, Dorita Buttigieg, Neville Calleja, Oleg Lozan, Rodica Gramme, Mariken Tijhuis, Daniela Moye Holz, Henk Hilderink, Linda Berger-Symons, Marit de Vries, Håkon Haaheim, Frode Forland, Zuzana Nordeng, Tricia L. Larose, Malgorzata Strozyk, Pawel Maryniak, Krystyna Drogon, Karolina Węgrzyn, Tomasz Wisniewski, Kinga Paciorek, Paulo Nogueira, Leonor Bacelar–Nicolau, Rodrigo Feteira Santos, Luís Velez Lapão, Mariana Peyroteo, Marília Silva Paulo, Teresa Montez, Carlos Tadeu dos Santos Dias, Verónica Gómez, Lucinda Oliveira das Neves, André Peralta‐Santos, Petru Sandu, Elena Gabriela Gaftonie, Edit Fekete, Lăcrămioara Aurelia Brîndușe, Silviu Radulescu, Maja Krstić, Aleksandar Medaveric, Ján Cáp, Metka Zaletel, Matej Vinko, Tatjana Kofol Bric, Inmaculada León Gómez, Carmen Rodríguez–Blázquez, Maria João Forjaz, Marta Marin, Amparo Larrauri, Rebeca Ramis, Asunción Díaz, Ester Angulo-Pueyo, César Garriga, Teresa Valero, Francisco Estupiñán‐Romero, Sandra García-Armesto, Enrique Bernal-Delgado, Juan González García, Javier Gómez-Arrue Azpiazu, Ramon Launa Garces, Teresa López‐Cuadrado, Ramón Launag, Carlos Telleria, Meriam Seral, Ester Angulo-Pueyo, Lovisa Sydén, Ashley Akbari, Ronan A Lyons, S Aldridge,

Global Maternal and Child Health

Abstract Background Despite concerns about worsening pregnancy outcomes resulting from healthcare restrictions, economic difficulties and increased stress during the COVID-19 pandemic, preterm birth (PTB) rates declined in some countries in 2020, while stillbirth rates appeared stable. Like other shocks, the pandemic may have exacerbated existing socioeconomic disparities in pregnancy, but this remains to be established. Our objective was to investigate changes in PTB and stillbirth by socioeconomic status (SES) in European countries. Methods The Euro-Peristat network implemented this study within the Population Health Information Research Infrastructure (PHIRI) project. A common data model was developed to collect aggregated tables from routine birth data for 2015–2020. SES was based on mother’s educational level or area-level deprivation/maternal occupation if education was unavailable and harmonized into low, medium and high SES. Country-specific relative risks (RRs) of PTB and stillbirth for March to December 2020, adjusted for linear trends from 2015 to 2019, by SES group were pooled using random effects meta-analysis. Results Twenty-one countries provided data on perinatal outcomes by SES. PTB declined by an average 4% in 2020 {pooled RR: 0.96 [95% confidence intervals (CIs): 0.94–0.97]} with similar estimates across all SES groups. Stillbirths rose by 5% [RR: 1.05 (95% CI: 0.99–1.10)], with increases of between 3 and 6% across the three SES groups, with overlapping confidence limits. Conclusions PTB decreases were similar regardless of SES group, while stillbirth rates rose without marked differences between groups.