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

Area of Science:

• Perinatal Epidemiology
• Public Health
• Maternal-Fetal Medicine

Background:

• Preterm delivery (PTD) and small for gestational age (SGA) are significant contributors to infant morbidity and mortality.
• Understanding trends and disparities in PTD and SGA is crucial for targeted public health interventions.

Purpose of the Study:

• To examine trends in PTD and SGA in South Carolina from 2015-2021.
• To assess if these trends differed across racial-ethnic groups.
• To evaluate the impact of the COVID-19 pandemic on PTD and SGA rates.

Main Methods:

• Retrospective analysis of linked vital records, hospitalization, and emergency department data (2015-2021).
• Inclusion of 338,532 singleton live births in South Carolina.
• Utilized generalized estimating equations and change-point analysis to assess trends before and during the pandemic.

Main Results:

• An increasing trend in PTD was observed pre-pandemic, which continued during the pandemic (RR=1.04).
• PTD < 34 weeks significantly increased during the pandemic (RR=1.07).
• SGA trends varied by race-ethnicity, showing an increase only in Hispanic infants pre-pandemic (RR=1.02).

Conclusions:

• The study highlights an increasing prevalence of PTD, with a concerning rise in very preterm births during the COVID-19 pandemic.
• Disparities in SGA prevalence were noted, with a specific increase among Hispanic populations.
• Findings underscore the need for continued monitoring and tailored interventions to address PTD and SGA trends and associated racial-ethnic disparities.