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Effects of the SARS-CoV-2 pandemic on perinatal activity in Yorkshire and the Humber region during 2020: an interrupted time series analysis
  1. Andrei Scott Morgan1,2,3,
  2. Charlotte Bradford4,
  3. Hilary Farrow5,
  4. Elizabeth S Draper6,
  5. Cath Harrison7,8
  1. 1 Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre of Research in Epidemiology and StatisticS (CRESS), Université Paris Cité, INSERM, INRAE, Paris, F-75006, France
  2. 2 Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
  3. 3 Department of Neonatalogy, Port-Royal Maternity, Paris, France
  4. 4 Yorkshire & Humber Neonatal Operational Delivery Network, Sheffield, UK
  5. 5 Yorkshire & Humber Maternity Clinical Network, NHS England and NHS Improvement - North East and Yorkshire, York, UK
  6. 6 Department of Health Sciences, University of Leicester, Leicester, UK
  7. 7 Embrace Transport Service, Sheffield Childrens’ Hospital NHS Foundation Trust, Barnsley, UK
  8. 8 Department of Neonatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  1. Correspondence to Dr Andrei Scott Morgan, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre of Research in Epidemiology and StatisticS (CRESS), Université Paris Cité, INSERM, INRAE, Paris, F-75006, France; andrei.morgan{at}


Objective To assess the impact of public health measures taken during the COVID-19 pandemic on perinatal health indicators.

Design Interrupted time series analysis comparing periods of the pandemic with the previous 5 years.

Setting Yorkshire and the Humber region, England (2015–2020).

Main outcome measures Relative risk (RR) of stillbirth, extreme preterm (EPT, <27 weeks’ gestational age) delivery, hypoxic ischaemic encephalopathy (HIE) and meconium aspiration syndrome (MAS), antenatal transfer for threatened EPT delivery and postnatal transfer for EPT birth, HIE or MAS.

Results Stillbirths fell from 3.7/1000 deliveries prepandemic to 2.9/1000 afterwards; EPT births decreased from 2.5/1000 to 1.8/1000 live births. Following adjustment, during the first lockdown there were decreased antenatal transfers (RR 0.74, 95% CI 0.57 to 0.94) with non-statistically significant increased stillbirth (RR 1.08, 95% CI 0.78 to 1.51) and decreased EPT admissions (RR 0.88, 95% CI 0.60 to 1.29). Over the entire pandemic period, antenatal transfer (RR 0.64, 95% CI 0.55 to 0.76) and EPT birth (RR 0.73, 95% CI 0.56 to 0.94) decreased; stillbirths showed non-statistically significant increases overall (RR 1.21, 95% CI 0.98 to 1.49) but with increasing trend through the pandemic (RR 1.11, 95% CI 1.00 to 1.22). No changes were seen for HIE, MAS, postnatal transfers or in subgroup analyses by ethnicity.

Conclusions Lower rates of antenatal transfer and extreme preterm birth were identified, alongside an apparent increase in stillbirth over time. The findings provide evidence that effects on perinatal activity related to the pandemic changed over time.

  • epidemiology
  • neonatology
  • Covid-19

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Data availability statement

Data are available on reasonable request.

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  • Presented at REaSoN Meeting 2021; 4th Congress of Joint European Neonatal Societies 2021.

  • Contributors ASM and CH conceived the study. ASM and ESD were involved in developing the methodology. ASM, CH, CB and HF were involved in data collection; ASM and CB were responsible for data curation, and ASM conducted the data analysis, drafted the initial manuscript and coordinated revisions. All authors were involved in reviewing and approving the final manuscript. ASM is the guarantor for the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.