12 Observations from an inner city hospital during COVID-19: preterm birth rate and mode of delivery

COVID-19 is causing an evolving global pandemic and to date the effects on both maternal and fetal outcomes as well as obstetric practice are unclear. Recently, hospitals worldwide have reported a higher rate of cesarean delivery among infected individuals, and a trend in the reduction of preterm births prior to 28 weeks. We aim to investigate the effects of COVID-19 on the rate of preterm birth and the mode of delivery at our institution in the height of the pandemic and unknown risks of this virus. Retrospective review of all pregnant women who delivered live singleton pregnancies at Mount Sinai West between March through May 2020 (pandemic period) compared with March through May 2019 (prepandemic period). Demographic data and outcomes were collected. Student t-test, Chi-square or Fisher exact tests, logistic and linear regression were used as appropriate. A total of 2,436 women were included: 1,306 patients in 2019, 1,135 patients in 2020. There was a 14% decline in overall births at Mount Sinai West during the pandemic period compared with the prepandemic period. There was a statistically significant decline in the rate of operative vaginal delivery during the pandemic period (5% vs 7%, p=0.03), but cesarean delivery rates remained unchanged. There was no difference in PTB <28 weeks gestation in 2019 compared with 2020 (0.6% vs 0.3%, p=0.21). There was a trend showing lower rates of very low birth weight babies in 2020 compared to 2019, however this was not statistically significant (0.6% vs 1.2%, p=0.06). Our study shows no difference in preterm birth during the height of the pandemic, however there was a trend in lower rates of very low birth weight babies. Interestingly, not addressed in the literature before, at our institution there was a 38% decline in operative vaginal delivery rate without a change in cesarean section rate during the pandemic. Perhaps this is suggestive of a more hands off approach by physicians during the height of the unknown risk. Larger numbers will be needed for further evaluation of these trends.View Large Image Figure ViewerDownload Hi-res image Download (PPT)