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.
Journal
European journal of public health
ISSN: 1464-360X
Titre abrégé: Eur J Public Health
Pays: England
ID NLM: 9204966
Informations de publication
Date de publication:
01 Jul 2024
01 Jul 2024
Historique:
medline:
1
7
2024
pubmed:
1
7
2024
entrez:
1
7
2024
Statut:
ppublish
Résumé
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. 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. 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. PTB decreases were similar regardless of SES group, while stillbirth rates rose without marked differences between groups.
Sections du résumé
BACKGROUND
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
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
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
UNASSIGNED
PTB decreases were similar regardless of SES group, while stillbirth rates rose without marked differences between groups.
Identifiants
pubmed: 38946450
pii: 7701776
doi: 10.1093/eurpub/ckad186
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
i58-i66Subventions
Organisme : European Union's Horizon 2020 research and innovation programme
ID : 101018317
Investigateurs
Jeannette Klimont
(J)
Alex Farr
(A)
Sophie Alexander
(S)
Marie Delnord
(M)
Judith Racapé
(J)
Gisèle Vandervelpen
(G)
Wei-Hong Zhang
(WH)
Rumyana Kolarova
(R)
Evelin Jordanova
(E)
Jelena Dimnjakovic
(J)
Željka Draušnik
(Ž)
Urelija Rodin
(U)
Theopisti Kyprianou
(T)
Vasos Scoutellas
(V)
Jitka Jirova
(J)
Petr Velebil
(P)
Anne Vinkel Hansen
(AV)
Laust Hvas Mortensen
(LH)
Liili Abuladze
(L)
Luule Sakkeus
(L)
Mika Gissler
(M)
Anna Heino
(A)
Melissa Amyx
(M)
Béatrice Blondel
(B)
Anne Chantry
(A)
Catherine Deneux Tharaux
(CD)
Mélanie Durox
(M)
Jeanne Fresson
(J)
Alice Hocquette
(A)
Marianne Philibert
(M)
Annick Vilain
(A)
Jennifer Zeitlin
(J)
Dimitra Bon
(D)
Günther Heller
(G)
Björn Misselwitz
(B)
Aris Antsaklis
(A)
István Sziller
(I)
Védís Helga Eiríksdóttir
(VH)
Jóhanna Gunnarsdóttir
(J)
Helga Sól Ólafsdóttir
(HS)
Karen Kearns
(K)
Izabela Sikora
(I)
Rosaria Boldrini
(R)
Marina Cuttini
(M)
Serena Donati
(S)
Marzia Loghi
(M)
Marilena Pappagallo
(M)
Janis Misins
(J)
Irisa Zile-Velika
(I)
Rita Gaidelyte
(R)
Jelena Isakova
(J)
Audrey Billy
(A)
Aline Lecomte
(A)
Jessica Pastore
(J)
Guy Weber
(G)
Miriam Gatt
(M)
Peter Achterberg
(P)
Lisa Broeders
(L)
Ashna Hindori-Mohangoo
(A)
Jan Nijhuis
(J)
Rupali Akerkar
(R)
Hilde Engjom
(H)
Kari Klungsøyr
(K)
Ewa Mierzejewska
(E)
Katarzyna Szamotulska
(K)
Henrique Barros
(H)
Carina Rodrigues
(C)
Mihaela-Alexandra Budianu
(MA)
Alexandra Cucu
(A)
Mihai Horga
(M)
Lucian Puscasiu
(L)
Petru Sandu
(P)
Vlad Tica
(V)
Ján Cáp
(J)
Miha Lucovnik
(M)
Ivan Verdenik
(I)
Adela Recio Alcaide
(AR)
María Fernández-Elorriaga
(M)
Mireia Jané
(M)
Maria José Vidal
(MJ)
Óscar Zurriaga
(Ó)
Karin Källén
(K)
Anastasia Nyman
(A)
Tonia Rihs
(T)
Diane Anderson
(D)
Samantha Clarke
(S)
Hannah McConnell
(H)
Alison Macfarlane
(A)
Sinead Magill
(S)
Kirsten Monteath
(K)
Siobhán Morgan
(S)
Joanne Murphy
(J)
Mark Piper
(M)
Sonya Scott
(S)
Lucy Smith
(L)
Craig Thomas
(C)
Martin Williams
(M)
Claudia Habl
(C)
Cara Pries
(C)
Richard Pentz
(R)
Stefan Mathis-Edenhofer
(S)
Andrea Schmidt
(A)
Alexander Grabenhofer-Eggerth
(A)
Johannes Weiss
(J)
Sophie Sagerschnig
(S)
Anita Gottlob
(A)
Lorenz Dolanski
(L)
Alexander Degelsegger-Marquez
(A)
Beate Gruber
(B)
Katharana Habimana
(K)
Petronille Bogaert
(P)
Marie Delnord
(M)
Nienke Schutte
(N)
Kim Vyncke
(K)
Tadek Krzywania
(T)
Linda Abboud
(L)
Miriam Saso
(M)
Brecht Devleesschauwer
(B)
Barthélémy Moreau de Lizoreux
(BM)
Pascal Derycke
(P)
Pierre Daubresse
(P)
Sasha Milbeck
(S)
Karin De Ridder
(K)
Charles-Andrew Van de Catsyne
(CA)
Sejla Cilovic Lagarija
(SC)
Anina Chileva
(A)
Jelena Dimnjakovic
(J)
Jakov Vukovic
(J)
Sarka Dankova
(S)
Ondrej Májek
(O)
Sigrid Vorobjov
(S)
Jane Idavain
(J)
Merika Rätsep
(M)
Hanna Tolonen
(H)
Mari Mäkinen
(M)
Mika Gissler
(M)
Jennifer Zeitlin
(J)
Marianne Philibert
(M)
Laure Carcaillon-Bentata
(L)
Romana Haneef
(R)
Tatjana Makovski
(T)
Martin Thißen
(M)
Stefanie Seeling
(S)
Angela Fehr
(A)
Thomas Ziese
(T)
Christina Georgakopoulou
(C)
Elena Petelos
(E)
Christog Lionis
(C)
Dimitra Lingri
(D)
Tóth Kornél
(T)
Ágnes Töll
(Á)
Peter Bezzegh
(P)
István Csizmadia
(I)
Róbert Láng
(R)
Kiss Csaba
(K)
Alan Cahill
(A)
Michael Courtney
(M)
Pauline White
(P)
Kelly Ailish
(K)
Patricia Clarke
(P)
Sharon Kappala
(S)
Breda Smyth
(B)
Luigi Palmieri
(L)
Brigid Unim
(B)
Andrea Faragalli
(A)
Janis Misins
(J)
Irisa Zile
(I)
Ausra Zelviene
(A)
Audronè Astrauskiené
(A)
Guy Weber
(G)
Dorita Buttigieg
(D)
Neville Calleja
(N)
Oleg Lozan
(O)
Rodica Gramme
(R)
Mariken Tijhuis
(M)
Daniela Moye Holz
(DM)
Henk Hilderink
(H)
Linda Berger-Symons
(L)
Marit de Vries
(M)
Håkon Haaheim
(H)
Frode Forland
(F)
Zuzana Nordeng
(Z)
Tricia Larose
(T)
Malgorzata Strozyk
(M)
Pawel Maryniak
(P)
Krystyna Drogon
(K)
Karolina Węgrzyn
(K)
Tomasz Wisniewski
(T)
Kinga Paciorek
(K)
Paulo Nogueira
(P)
Leonor Bacelar-Nicolau
(L)
Rodrigo Feteira Santos
(RF)
Luís Lapão
(L)
Mariana Peyroteo
(M)
Marília Silva Paulo
(MS)
Teresa Montez
(T)
Carlos Dias
(C)
Veronica Gomez
(V)
Lucinda Oliveira das Neves
(LOD)
Andre Peralta-Santos
(A)
Petru Sandu
(P)
Elena Gabriela Gaftonie
(EG)
Edit Fekete
(E)
Lacramioara Brinduse
(L)
Silviu Radulescu
(S)
Maja Krstic
(M)
Aleksandar Medaveric
(A)
Jan Cap
(J)
Metka Zaletel
(M)
Matej Vinko
(M)
Tatjana Kofol Bric
(TK)
Inmaculada León Gómez
(IL)
Carmen Rodriguez-Blazquez
(C)
M João Forjaz
(MJ)
Marta Marin
(M)
Amparo Larrauri
(A)
Rebeca Ramis
(R)
Asuncion Diaz
(A)
Ester Angulo-Pueyo
(E)
Cesar Garriga
(C)
Teresa Valero
(T)
Francisco Estupiñán
(F)
Sandra Garcia-Armesto
(S)
Enrique Bernal-Delgado
(E)
Juan González García
(JG)
Javier Gómez-Arrue Azpiazu
(JG)
Ramon Launa Garces
(RL)
Teresa López-Cuadrado
(T)
Ramón Launag
(R)
Carlos Telleria
(C)
Meriam Seral
(M)
Ester Angulo-Pueyo
(E)
Lovisa Syden
(L)
Ashley Akbari
(A)
Ronan Lyons
(R)
Sarag Aldridge
(S)
Informations de copyright
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Public Health Association.