Temporal trends in pregnancy outcomes during a health system shock

TY - JOUR

T1 - Temporal trends in pregnancy outcomes during a health system shock

AU - Tydeman, Florence

AU - Dalrymple, Kathryn V.

AU - McGreevy, Alice

AU - Poston, Lucilla

AU - Dasgupta, Tisha

AU - Easter, Abigail

AU - Khalil, Asma

AU - Long, Lisa

AU - Mistry, Hiten D.

AU - Rajasingam, Daghni

AU - Silverio, Sergio A.

AU - Soley-Bori, Marina

AU - Wang, Yanzhong

AU - White, Sara L.

AU - The RESILIENT Study Group

AU - The Early Life Cross Linkage in Research, Born in South London (eLIXIR-BiSL) Partnership

AU - Wolfe, Ingrid

AU - Van Citters, Aricca D.

AU - Seed, Paul

AU - Nelson, Eugene C.

AU - Fox-Rushby, Julia

AU - Duncan, Emma L.

AU - Boulding, Harriet

AU - Bick, Debra

AU - Gill, Carolyn

AU - de Jongh, Leonardo

AU - Higgins, Finola

AU - Broadbent, Matthew

AU - Jewell, Amelia

AU - Kazeem, Toyin

AU - Spring, Sarah

AU - Grey, Amanda

AU - Pickard, Lucy

AU - Absoud, Michael

AU - Gillett, Cheryl

AU - Sandall, Jane

AU - Ashworth, Mark

AU - Edwards, David

AU - Stewart, Robert

AU - von Dadelszen, Peter

AU - Magee, Laura A.

N1 - Publisher Copyright: © The Author(s) 2026.

PY - 2026/7/14

Y1 - 2026/7/14

N2 - Background: To better understand reported COVID-19 pandemic effects on pregnancy, we examined temporal trends in pregnancy outcomes in a diverse population from South London, United Kingdom. Methods: We included 31,411 singleton pregnancies with complete registration and birth outcomes across pre-pandemic (May 1/2019–March 22/2020, 24.5%), pandemic lockdowns (March 23/2020–July 17/2021, 32.3%), and pandemic without lockdown epochs (July 18/2021–April 22/2023, 43.2%). Multivariable regression was employed to evaluate outcomes by study epoch, adjusting for potential confounders (e.g., ethnicity, deprivation, site), followed by generalized additive modelling to visualise monthly trends. Results: Here we show that of 17 outcomes: six have stable trends (e.g., preterm birth, stillbirth); eight show linear trends, either decreasing (e.g., gestational age at birth, vaginal tears) or increasing (e.g., Caesareans, postpartum haemorrhage); and three show quadratic (complex) trends (e.g., secondary mental health services, labour induction). Conclusions: Overall, most outcomes during the pandemic mirror pre-pandemic trends, with fluctuations observed likely due to site-specific responses. Our findings highlight the need for temporal analysis of pregnancy outcomes.

AB - Background: To better understand reported COVID-19 pandemic effects on pregnancy, we examined temporal trends in pregnancy outcomes in a diverse population from South London, United Kingdom. Methods: We included 31,411 singleton pregnancies with complete registration and birth outcomes across pre-pandemic (May 1/2019–March 22/2020, 24.5%), pandemic lockdowns (March 23/2020–July 17/2021, 32.3%), and pandemic without lockdown epochs (July 18/2021–April 22/2023, 43.2%). Multivariable regression was employed to evaluate outcomes by study epoch, adjusting for potential confounders (e.g., ethnicity, deprivation, site), followed by generalized additive modelling to visualise monthly trends. Results: Here we show that of 17 outcomes: six have stable trends (e.g., preterm birth, stillbirth); eight show linear trends, either decreasing (e.g., gestational age at birth, vaginal tears) or increasing (e.g., Caesareans, postpartum haemorrhage); and three show quadratic (complex) trends (e.g., secondary mental health services, labour induction). Conclusions: Overall, most outcomes during the pandemic mirror pre-pandemic trends, with fluctuations observed likely due to site-specific responses. Our findings highlight the need for temporal analysis of pregnancy outcomes.

UR - https://www.scopus.com/pages/publications/105045021498

U2 - 10.1038/s43856-026-01493-x

DO - 10.1038/s43856-026-01493-x

M3 - Article

C2 - 42098270

VL - 6

SP - 1

EP - 12

JO - Communications Medicine

JF - Communications Medicine

IS - 1

M1 - 391

ER -