Since the Covid-19 pandemic took hold, doctors in many parts of the world have noticed a dramatic reduction in the number of premature babies being born during the lockdown. The question is: what could explain this trend? Although much more research needs to be done before conclusions are reached, scientists are pondering over a few intriguing possibilities.
In the largest study of its kind to date, a study in the Netherlands concluded that the number of premature births was “greatly reduced” following the introduction of Covid-19 lockdown measures in the country.
As reported in the journal The Lancet Public Health this week, researchers from the Erasmus Medical Centre in Rotterdam studied the births of 1.5 million infants born in the Netherlands between 2010 and 2020, around 56,000 of whom were born after the country "locked down" in early March. They discovered a significant drop in the number of premature babies born after March 9, 2020 – the official date lockdown came into swing – compared to similar periods in all of the previous years. The drop in pre-term births was most clearly seen in people living in wealthier neighborhoods, but there was evidence it also occurred across the board.
It's not the first study to make this observation; there have been similar preliminary accounts from both Denmark and Ireland. The researchers of the new study didn’t specifically look to understand why this trend is occurring. However, drawing on other research, they speculated on a few ideas.
Firstly, they noted that the lockdown period may have seen a significant decrease in the number of lurgies and bugs knocking around the population. Physical distancing, self-isolation, lack of commuting, closing of schools, and increased awareness of hygiene may have contributed to a reduction in contact with pathogens, meaning people were less likely to be infected. Considering general infections are a risk factor for preterm births, this could be an important factor.
The study also notes that soon-to-be mothers may have benefited from less work-related stress by avoiding the “rat race” during their later months of pregnancy. On the other hand, lockdown is known to have had a deeply negative effect on the mental health of many people. Further to that point, researchers have highlighted that prospective parent's mental health had also suffered during the initial lockdown.
Lastly, and perhaps most interestingly, the researchers point to the significant decrease in air pollution as a likely suspect. A number of studies highlighted that air quality improved in many parts of the world during the Covid-19 lockdown as a result of the reduction in fossil fuel use from the slowdown of industrial activity and the sharp decline in travel. This is especially noteworthy considering exposure to air pollution in pregnancy has been associated with the risk of premature birth through increasing levels of toxic chemicals in the blood, which causes stress to the immune system. In fact, up to 18 percent of preterm births have been associated with air pollution.
These factors remain speculative for now, but researchers are keen to get to the bottom of this question as it could help increase our understanding of the factors that influence premature births, the primary contributor to death in early childhood. Perhaps if scientists can identify why the initial Covid-19 lockdown of early 2020 saw a decline in premature birth, then they can pinpoint some ways to reduce the risk of preterm birth and, in doing so, save lives.