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A Meta-Analysis of the Global Stillbirth Rates during the COVID-19 Pandemic
Manoj Mohan1, Kwabena Appiah-Sakyi2, Ashok Oliparambil3
1Department Obstetrics and Gynecology, AsterDM Healthcare, Doha P.O. Box 8703, Qatar.
Journal of Clinical Medicine
|December 9, 2023
Summary
The COVID-19 pandemic increased stillbirth rates, particularly in low- and middle-income countries. Improved access to quality antenatal care is crucial for pregnant women during pandemics.
Area of Science:
- Maternal-fetal medicine
- Infectious disease epidemiology
- Public health
Background:
- COVID-19 has demonstrated varied adverse effects on pregnancy outcomes.
- Existing data on stillbirth rates during the pandemic are inconsistent, necessitating further investigation.
- Understanding the precise impact of COVID-19 on stillbirths is vital for optimizing antenatal care strategies.
Purpose of the Study:
- To conduct a meta-analysis to determine the impact of COVID-19 infection on the stillbirth rate among pregnant women.
- To compare stillbirth rates between pregnant women with and without COVID-19 during the same period.
- To analyze population stillbirth rates before and during the COVID-19 pandemic.
Main Methods:
- A comprehensive meta-analysis was performed, searching multiple databases including PubMed, Embase, Cochrane Library, ClinicalTrials.gov, and Web of Science.
- Included studies provided stillbirth data for women with COVID-19, comparing rates between COVID-19 positive and negative pregnant individuals, and pre-pandemic versus pandemic periods.
- Data extraction was conducted independently by two reviewers, with efforts to obtain missing information directly from study authors.
Main Results:
- The overall stillbirth rate among pregnant women with COVID-19 was 7 per 1000 births.
- This rate was significantly higher in low- and middle-income countries (34 per 1000 births).
- The odds ratio for stillbirth in COVID-19 positive versus negative pregnant women was 1.89; however, no significant difference in population stillbirth rates was observed between pre-pandemic and pandemic periods.
Conclusions:
- While population-level stillbirth rates did not significantly change, evidence suggests an increase during the COVID-19 pandemic, predominantly in low- and middle-income countries.
- Limited access to healthcare during the pandemic is a potential contributing factor to the increased stillbirth rates in these regions.
- Enhanced focus on health education and high-quality maternity care, including in-person and remote consultations, is recommended for pregnant women, especially during health crises.
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