Impact of COVID-19 on Perinatal Outcomes and Birth Locations in a Large US Metropolitan Area

• Published in: Healthcare (Basel) Vol. 12; no. 3; p. 340
• Main Authors: Lee, Esther G, Perez, Alejandra, Patel, Arth, Patel, Aloka L, Waters, Thaddeus, Fricchione, Marielle, Johnson, Tricia J
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.01.2024
• Subjects: academic medical centers; Babies; Binomial distribution; birth hospital designation; Births; Childbirth; Clinical outcomes; COVID-19; Ethnicity; Health aspects; Health care delivery; Health care policy; Infants (Premature); Labor force; length of stay; Medical colleges; Metropolitan areas; Neighborhoods; Neonatal care; Pandemics; Patient outcomes; Population-based studies; Postal codes; Premature birth; preterm birth; Shelter in place; Socioeconomic factors; Socioeconomic status; Stillbirth; United States; Illinois; United States > US; Chicago Illinois; COVID-19; preterm birth; length of stay; birth hospital designation; academic medical centers
• ISSN: 2227-9032; 2227-9032
• DOI: 10.3390/healthcare12030340

This was a population-based study to determine the impact of COVID-19 on birth outcomes in the Chicago metropolitan area, comparing pre-pandemic (April-September 2019) versus pandemic (April-September 2020) births. Multivariable regression models that adjusted for demographic and neighborhood characteristics were used to estimate the marginal effects of COVID-19 on intrauterine fetal demise (IUFD)/stillbirth, preterm birth, birth hospital designation, and maternal and infant hospital length of stay (LOS). There were no differences in IUFD/stillbirths or preterm births between eras. Commercially insured preterm and term infants were 4.8 percentage points (2.3, 7.4) and 3.4 percentage points (2.5, 4.2) more likely to be born in an academic medical center during the pandemic, while Medicaid-insured preterm and term infants were 3.6 percentage points less likely (-6.5, -0.7) and 1.8 percentage points less likely (-2.8, -0.9) to be born in an academic medical center compared to the pre-pandemic era. Infant LOS decreased from 2.4 to 2.2 days (-0.35, -0.20), maternal LOS for indicated PTBs decreased from 5.6 to 5.0 days (-0.94, -0.19), and term births decreased from 2.5 to 2.3 days (-0.21, -0.17). The pandemic had a significant effect on the location of births that may have exacerbated health inequities that continue into childhood.