Reports from multiple countries revealed a striking decline in premature births during the pandemic. Was this mere coincidence, or linked to COVID-19 restrictions?
It began when an Irish doctor observed a sharp drop in orders for breast milk for preterm infants. Similar trends emerged in Australia, Canada, the United States—where some weeks saw up to 80% fewer newborns under 1.5 kg—and Belgium. A study by Belgium's intermutualist agency found premature births decreased by 30% to 80% from mid-March to late August 2020.
"It's not quite exciting, but close—first, because it's positive news, but mainly as a major trend: prematurity fell during lockdown," says Julie Belhomme, head of obstetrics at CHU Saint-Pierre in Brussels, in the Corona Baby podcast exploring COVID-19's impact on pregnancy, birth, and early parenthood.
Intrigued, Olivier Danhaive, head of neonatology at Cliniques Universitaires Saint-Luc, consulted colleagues in Belgium and Italy. Analyzing data from 45 neonatology units, they confirmed the decline primarily affected moderate preterm infants.
Severe and extreme preterm births, often due to maternal or fetal pathology, remained stable. Less influenced by rest or care variations, these cases suggest the drop in moderate preterms was directly tied to pandemic conditions.
"The obvious explanation is reduced activity among pregnant women," notes Belhomme, though surprised. "Science hasn't proven work during pregnancy is risky. We advise normal activity and exercise. Yet total rest seems effective."
Does inactivity explain it? Possibly, but Belhomme points to "stress over physical activity." Research links high cortisol (stress hormone) to prematurity.
Lockdowns also cut urban air pollution, known to harm pregnant women and fetuses.
