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(Reuters Health) – Fewer women in Tennessee delivered preterm babies while stay-at-home orders were in effect due to the COVID-19 pandemic than was typical for the same period in previous years, a new study finds.

Researchers examined Tennessee birth records for March 22 to April 30, elavil medication 2020, while statewide stay-at-home orders were in effect, and compared preterm births during this period to the same date range in the five previous years. Overall, the preterm birth rate was 10.2% during the stay-at-home order period of 2020, compared with 11.3% in the previous years.

Late preterm births at 35 to 36 weeks’ gestation were also less common during the pandemic year, at a rate of 5.8% vs. 6.5% in previous years.

In adjusted analysis, the odds of preterm births during the 2020 stay-at-home order were significantly lower than in previous years (aOR 0.86), after accounting for maternal age, education, race and ethnicity, diabetes, and hypertension.

The study wasn’t designed to determine whether or how the pandemic itself or stay-at-home orders might directly impact preterm births. Researchers also lacked data on adverse events such as stillbirths, and it’s possible that results from Tennessee might not reflect what happened elsewhere.

“Preterm birth affects 1 in 10 births each year and it is a complex, multi-factorial problem, so it is important not to jump to conclusions about the findings,” said senior study author Dr. Stephen Patrick, director of the Vanderbilt Center for Child Health Policy and a neonatologist at Vanderbilt University Medical Center in Nashville, Tennessee.

“Still, this study provides some hope that there may be something we can learn to make a difference for this substantial public health problem,” Dr. Patrick said by email.

Even though it’s not certain why preterm births declined during the lockdown, similar trends have been seen in some other studies, particularly in home income countries, said Dr. Asma Khalil, a professor of maternal fetal medicine at St. George’s Hospital and the University of London, in the UK. The topic remains controversial, however, because other studies have found no significant change in preterm births during the pandemic, Dr. Khalil, who wasn’t involved in the study, said by email.

However, several mechanisms might explain the decline in preterm births seen in the study, Dr. Khalil said. This includes environmental and behavioral factors influencing maternal wellbeing such as reductions in stress, physical work, exposure to pollution, exposure to infections. In addition, women who smoke or use drugs might have less opportunities to do these things during stay-at-home orders, both of which can make preterm births more likely, Dr. Khalil said.

“There are potentially lessons – good things – to learn from the COVID-19 pandemic,” Dr. Khalil said. “Researchers are currently studying the possible mechanisms of the observed reduction in preterm birth, so that we can develop or discover means of preventing it in the future.”

SOURCE: JAMA Pediatrics, online March 15, 2021.

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