Impact of COVID-19 mitigation measures on perinatal outcomes in the Netherlands

Objective

Investigate the acute impact of COVID-19 mitigation measures implemented in March 2020 on a comprehensive range of perinatal outcomes.

Study design

National registry-based quasi-experimental study.

Methods

We obtained data from the Dutch Perinatal Registry (2010–2020) which was linked to multiple population registries containing sociodemographic variables. A difference-in-discontinuity approach was used to examine the impact of COVID-19 mitigation measures on various perinatal outcomes. We investigated preterm birth incidence across onset types, alongside other perinatal outcomes including low birth weight, small-for-gestational-age, NICU admission, low-APGAR-score, perinatal mortality, neonatal death, and stillbirths.

Results

The analysis of the national-level dataset revealed a consistent pattern of reduced preterm births after the enactment of COVID-19 mitigation measures on March 9, 2020 (OR = 0.80, 95% CI 0.68–0.96). A drop in spontaneous preterm births post-implementation was observed (OR = 0.80, 95% CI 0.62–0.98), whereas no change was observed for iatrogenic births. Regarding stillbirths (OR = 0.95, 95% CI 0.46–1.95) our analysis did not find compelling evidence of substantial changes. For the remaining outcomes, no discernible shifts were observed.

Conclusions

Our findings confirm the reduction in preterm births following COVID-19 mitigation measures in the Netherlands. No discernible changes were observed for other outcomes, including stillbirths. Our results challenge previous concerns of a potential increase in stillbirths contributing to the drop in preterm births, suggesting alternative mechanisms.