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.

Rights

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite as

Zeitlin, J., Philibert, M., Barros, H., Broeders, L., Cap, J., Draušnik, Ž., Engjom, H., Farr, A., Fresson, J., Gatt, M., Gissler, M., Heller, G., Isakova, J., Källén, K., Kyprianou, T., Loghi, M., Monteath, K., Mortensen, L., Rihs, T., Sakkeus, L., Sikora, I., Szamotulska, K., Velebil, P., Verdenik, I., Weber, G., Zile, I., Zurriaga, O. & Smith, L. 2024, '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', European Journal of Public Health, 34(S1), pp. i58-i66. https://doi.org/10.1093/eurpub/ckad186

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Last updated: 05 August 2024
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