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Calgary doctor says ‘dramatic’ 40% drop in premature births during lockdown could be global trend

Fewer premature babies born since COVID-19 lockdown has doctors baffled

Pamela Fieber · CBC News · Posted: Jul 27, 2020

Dr. Belal Alshaikh says COVID-19 has brought a curious development to some maternity wards, and he is trying to help researchers from around the world find out why. 4:35

Count this one as a positive side-effect of the COVID-19 pandemic.

Doctors in countries including Denmark, Ireland, Australia, the U.S. and Canada have been reporting that fewer preterm babies are being born.

While peer-reviewed studies investigating the drop are pending, and the downward trend across countries is currently anecdotal, Neonatologist Dr. Belal Alshaikh has been studying the possible phenomenon in Calgary.

“It’s actually not that common to see this drop down in the numbers in many countries,” said Alshaikh, who is also the medical director of the neonatal intensive care unit at the South Health Campus, and has seen the trend right here in Calgary.

Alshaikh told The Homestretch there are two ways to measure preterm birth — gestational age and actual birth weight. And by both measures, the numbers are dramatically lower.

Births considered very premature — born at fewer than 29 to 32 weeks — have dropped by 34 to 40 per cent, he said.

“If we use their gestational age and if we are talking about the very earliest preemies,” Alshaikh said.

“That’s kind of dramatic, actually, and surprising for us.”

The numbers are even more dramatic for babies under one kilogram.

“If we used birth weight, those babies born less than one kilo, the number was actually very low and half of what we used to see in the last few years, during the same period of time of the year.”

Alshaikh said the trend is very unusual.

“Soon after the lockdown in mid-March, we started to see fewer babies coming to our unit and to intensive care units, and these numbers of preemies were also low in April and mid-May,” Alshaikh said. 

“So by that time, by late May, we felt like we needed to look at the numbers, and see where we are. And also at that time we started hearing that other hospitals, in Ireland and Denmark, have also noticed the drop down in the number of preemies.”

When Calgary doctors took a good look at the numbers and compared them to the same time last year, it was an eyeopener.

“We were surprised,” Alshaikh said. “We saw that our number is way lower than what we used to see during this period of time.”

There are three main causes that doctors are looking at.

One is social distancing, which may have cut down on the amount of general infection from contact with others.

Another is less air pollution, from fewer cars being on the roads.

“This might actually help because studies in the past showed that air pollution actually increases the risk for preterm birth,” Alshaikh said.

And simply not going out to work — resting — may be a final key.

“By staying home, a pregnant woman may have less stress from commuting and from work,  and that might have helped them,” Alshaikh said, adding it’s too soon to know for sure which of these lockdown-related factors have contributed the most.

Calgary doctors who noticed a reduced number of premature births during the pandemic lockdown, are seeing those numbers rise again as restrictions have eased. (Jim Lynch, Flickr cc)

 “We see sometimes variation during the year, but it’s not to the degree that we see fewer babies,” Alshaikh said. “And the fact that we see the same trend in Ireland, in Denmark in Australia, it’s kind of surprising for everyone working in this field.”

Preterm birth comes with a host of challenges for the babies and their parents.

“The risk is high on children and their families, and also medical care resources,” Alshaikh said. “For children, the risk increases for vision and hearing problems, and also for learning disability. It’s higher even as the gestational age goes down. For example,  24 weeks is at very high risk compared to babies born at 28 weeks gestation or at 32 weeks gestation.”

Doctors teaming up to study

The Calgary doctors will continue to study the phenomenon, which could hold clues to reducing preterm births in general.

For now, Alshaikh said it’s too early to provide any specific advice to pregnant woman — other than to avoid stress, try to rest at home, get a lot of sleep and focus on good nutrition. 

“We’ve teamed up, actually, with the teams across the world, in Ireland and also in Denmark, and there is also a group in Manitoba working on this project, and we are hoping to understand more the ways to prevent the preterm birth, and also like to see if we can understand more on risk factors that are affecting preterm birth,” Alshaikh said. 

But the Calgary doctor said there is one alarming development already — as the lockdown restriction ease, those preterm birth numbers are already on the rise again.

“We are actually noticing, even in Calgary, that when the restrictions started to be eased, the number of preterm babies coming to our unit and intensive care is going up again, which is quite actually interesting for us,” Alshaikh said. “And we are trying to tease out what factors are affecting this trend.”

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