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While pregnancy rates fell at the beginning of the pandemic, researchers expect a birth volume increase based on prospective modeling.
The COVID-19 pandemic may have initially slowed fertility and birth rates, but a study published in JAMA Network Open has data that shows a baby surge may be coming. Molly Stout, MD, MSci, maternal fetal medicine director at Michigan Medicine Von Voigtlander Women's Hospital, served as lead author, conducting the research with colleagues.
They used electronic health records from Michigan Medicine, which is an academic health care system, to examine a cohort of pregnancies between 2017 and 2021. The retrospective data was used to prospectively model pregnancy trends, and project changes in pregnancy volume during the pandemic.
Researchers said this modeling is important because it helps government agencies and health care systems model aging and working populations, as well as estimate the economy’s size accurately. “Often, changes in birth rates are recorded as birth rates change, not modeled prospectively to anticipate these changes and plan accordingly,” researchers said.
Stout and colleagues reported that between 2017-2020, pregnancies increased from 4,100 to 4,620. During this period, there was a total of 28,284 pregnancies, with a median maternal age of 30 years. White women accounted for 18,728 (66.2%) of pregnancies, while Black women accounted for 3,794 (13.4%), and Asian women accounted for 2,177 (7.7%).
Following the 2017-2020 time period, researchers reported a 14% decrease in pregnancies between November 2020 and spring 2021. Researchers associated the decline with a conception window that correlates to the US COVID shutdown, which began in March 2020 with state-ordered restrictions.
Study authors attributed this decrease to women postponing sexual and reproductive health care, the impact of women in the workplace, a shortage of childcare, interruptions in support systems, and economic uncertainty. In addition, researchers said that there were notable racial and ethnic disparities, with Black and Hispanic women significantly more likely than White women to state that they were delaying childbearing or that they wanted fewer children during the pandemic.
Following this decline, the prospective modeling system researchers used predicts a births surge: Michigan Medicine is preparing for a 10-15% increase in births over the usual birthrate that would be expected for the summer of 2021 and the fall. There had been much speculation in mainstream media of a baby boom as a result of the pandemic; however, this is the first study to offer data and evidence on the topic, according to researchers.
"Major societal changes certainly seem to influence reproductive choices, population growth and fertility rates. Usually, we see the effects by modeling birth and death rates, only as the changes are occurring. With this methodology we can accurately project anticipated birth rates ahead of the actual changes," Stout said in a press release.
Stout and colleagues said the study’s limitations include data based on only one academic health facility, which may not be applicable to other regions in the country, or other academic health centers. Authors also reported that no significant differences in maternal demographics were noted pre- and post- COVID-19 pandemic. “This may be because it is too early to detect those nuanced changes or because of the specific demographic composition of our obstetric population,” researchers noted. Another limitation reported by authors was that modeling projections need pregnancies to be known to the health care system. Finally, ongoing pregnancies that do not seek out prenatal care or were subject to early losses or terminations were not captured in the data, researchers said.