Lockdowns offer solution in the fight against premature births

A premature baby lies in a cot with their hands up, wearing a blue pacifier and a cream beanie.

New research shows preterm birth rates dropped significantly during Melbourne’s lockdown periods, which may provide a new treatment option for at-risk pregnancies. 

The joint Monash Health and Monash University study, which included 38,000 births between January 2018 and October 2021, uncovered that both live birth rates and preterm birth rates dropped while COVID-19 ‘lockdown’ restrictions were in place, decreasing at times by more than 15 births per week. 

Lead researcher Associate Professor Atul Malhotra said they weren’t sure exactly what the correlation was yet. 

“We saw consistently during the pandemic and lockdowns that people were changing their behaviours because they were forced to, couldn’t go out and interact with others,” he said. 

“This might have possibly reduced stress levels and infections in the community, which could lead to less premature births spontaneously occurring.” 

For the reduction in live birth rates, people being stuck in certain jurisdictions where movement was limited, pandemic anxiety and a loss of migration are thought to have contributed. 

“Interestingly it is possible, when people realised that COVID-19 isn’t going away, we started to see a post pandemic boom in birth rates too,” A/Prof Malhotra said. 

Associate Professor Malhotra is a consultant neonatologist at Monash Health Newborn, where he helps to care for premature babies at Monash Children’s Hospital and understands the health risks presented to newborns when they are born before reaching full gestation. That’s why he’s working with Professor Ben Mol, Associate Professor Ryan Hodges, Dr Daniel Rolnik, Dr Kirsten Palmer and Dr Peter Neil at Monash Health to commence a trial of at-risk mothers going into a self-imposed lockdown to see if it reduces the chances of a premature birth. First, they will assess the feasibility and acceptability of such an intervention in participants.  

“The mothers that we’re asking to participate in the study are already high risk and have given birth to a premature baby in the past, so they’ve seen the effects of preterm birth and most would do anything to give their babies a better chance,” Associate Professor Malhotra said. 

“It could absolutely be a game changer as we don’t have many strategies that work for preterm births currently.” 

The cause of premature births is still largely unknown, but a few indicators can put women at a higher risk. 

“There are multiple factors including factors such as the woman’s cervical length, infections, stress, exposure to various drugs, alcohol and smoking in pregnancy,” A/Prof Malhotra said. 

“Sometimes we see none of these and preterm births still happen.” 

The study looking into the impacts of self-imposed lockdowns will commence at Monash Health very shortly. 

Changes to birth rates during Melbourne’s lockdowns 

The research, which studied birth rates across all six major lockdowns in Melbourne over the study period, revealed that birth rates: 

  • dropped by 15.7 a week during the first four weeks after lockdown one (late April-to-May, 2020), 
  • dropped by 9.3 a week in the first four weeks after lockdown two (mid-August to mid-September, 2020), and, 
  • increased by 8.1 a week between 1 January and 20 May 2021 (between lockdown 3 and 4). 

Preterm birth rates less than 37 weeks: 

  • decreased by 3.8 a week after lockdown 2, and, 
  • increased by 1.8 a week between lockdown 3 and 4. 

Preterm births less than 34 weeks: 

  • were lower in lockdown 2 and after lockdown 4 but were not statistically significant, and, 
  • were lower by 1.8 births a week after four weeks of lockdown five and into six (August to October 2021). 

Read the full paper, ‘Impact of the COVID-19 pandemic and multiple community lockdowns on total live birth rates and preterm births in Melbourne, Australia’, in the Australian and New Zealand Journal of Obstetrics and Gynaecology (DOI: https://doi.org/10.1111/ajo.13527).