Increasing Preterm Delivery and Small for Gestational Age Trends in South Carolina during the COVID-19 Pandemic

Kalyan J. Chundru (), Jeffrey E. Korte, Chun-Che Wen, Brian Neelon, Dulaney A. Wilson, Julio Mateus, John L. Pearce, Mallory Alkis, Matthew Finneran, Sarah Simpson, Hermes Florez, Kelly J. Hunt and Angela M. Malek
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Kalyan J. Chundru: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Jeffrey E. Korte: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Chun-Che Wen: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Brian Neelon: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Dulaney A. Wilson: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Julio Mateus: Department of Obstetrics & Gynecology, Maternal-Fetal Medicine Division, Atrium Health, Charlotte, NC 28204, USA
John L. Pearce: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Mallory Alkis: Department of Obstetrics & Gynecology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
Matthew Finneran: Department of Obstetrics & Gynecology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
Sarah Simpson: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Hermes Florez: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Kelly J. Hunt: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Angela M. Malek: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA

IJERPH, 2024, vol. 21, issue 4, 1-16

Abstract: Preterm delivery (PTD) complications are a major cause of childhood morbidity and mortality. We aimed to assess trends in PTD and small for gestational age (SGA) and whether trends varied between race–ethnic groups in South Carolina (SC). We utilized 2015–2021 SC vital records linked to hospitalization and emergency department records. PTD was defined as clinically estimated gestation less than (<) 37 weeks (wks.) with subgroup analyses of PTD < 34 wks. and < 28 wks. SGA was defined as infants weighing below the 10th percentile for gestational age. This retrospective study included 338,532 (243,010 before the COVID-19 pandemic and 95,522 during the pandemic) live singleton births of gestational age ≥ 20 wks. born to 260,276 mothers in SC. Generalized estimating equations and a change-point during the first quarter of 2020 helped to assess trends. In unadjusted analyses, pre-pandemic PTD showed an increasing trend that continued during the pandemic (relative risk (RR) = 1.04, 95% CI: 1.02–1.06). PTD < 34 wks. rose during the pandemic (RR = 1.07, 95% CI: 1.02–1.12) with a significant change in the slope. Trends in SGA varied by race and ethnicity, increasing only in Hispanics (RR = 1.02, 95% CI: 1.00–1.04) before the pandemic. Our study reveals an increasing prevalence of PTD and a rise in PTD < 34 wks. during the pandemic, as well as an increasing prevalence of SGA in Hispanics during the study period.

Keywords: preterm; small for gestational age; COVID-19 pandemic; racial disparities; trends; maternal health; infant outcomes; South Carolina; USA (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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