Collateral damage of the pandemic: Spiked stillbirth rates

 One of the disturbing trends we are picking up on since the COVID-19 pandemic hit is the exceedingly rising rates of stillbirths - the death of babies in the womb. Due to the lockdown and restrictions amidst the pandemic, pregnancy complications are going undiagnosed resulting in increasing stillbirths around the world. In trying to protect pregnant women from getting COVID-19, doctors are missing other threats to pregnancies and the mother's health. A large study from Nepal published in The Lancet reported that since the lockdown in March, the number of stillbirths increased from 14 per 1,000 to 21 per 1,000 deaths by the end of May. This showed a 50% increase in stillbirths with the largest spike in the first four weeks of the lockdown. Another study from St. George’s of the University of London, reported a fourfold increase of stillbirths from 2.38 per 1,000 births between October 2019 and January 2020, to 9.31 per 1,000 births between February and June 2020. 

In addition to rising stillbirths, the numbers of births taking place in the hospital are decreasing indicating births happening unattended at home or in other facilities. This trend was also shown in Nepal and Scotland. The increased stillbirths are not caused by COVID-19 says K.C., a perinatal epidemiologist at Uppsala University in Sweden, it’s likely a result of altered access to antenatal care. 

WHO recommends at least 8 medical visits during pregnancy, even for low-risk pregnancies. However due to the pandemic, in addition to various barriers to access to antenatal care, fear of getting COVID-19 infection has resulted in cancellations of antenatal care appointments and substitution of in-person visits by remote care. This especially affects first-time pregnant women, who might not know what to expect and look out for during their pregnancies without in-person antenatal care visits. While more studies need to be done to explore the exact effects of the pandemic on pregnancy outcomes, what we know so far calls for better support for maternal and newborn health services especially in low and middle-income countries. 

-Bethel 

Reference 

https://www.nature.com/articles/d41586-020-02618-5