Photo: Luis Robayo Agence France-Presse
Two recently published studies by researchers from denmark and ireland show a decline for the moment unexplained premature births since the beginning of the confinement.
The pandemic of sars coronavirus and containment that results represent an unprecedented opportunity to study preterm birth and stillbirth, in the hope of a better understanding of the factors that are responsible for it, say two experts who spoke with The Canadian Press.
“This containment and public health measures are a kind of natural experiment to put to rest a very large part of the population, said the head of the service of neonatology CHU Sainte-Justine, dr. Anne Monique Nuyt.
“In the sense of less travel, less stress at work, less exposure to infections seasonal like the flu and other viruses, less pollution and/or less exposure to the pollution, it is also a possibility. So, is it that this has had an impact interesting about the pregnancies ? “
Two recently published studies by researchers from denmark and ireland show a decline for the moment unexplained premature births since the beginning of the confinement.
The Danish researchers have reported a dramatic fall in 90% of births of very preterm infants, i.e. infants born before 28 weeks of gestation.
“It is important what these people are saying, said dr. Marc Beltempo, of the Montreal children’s Hospital. There is a signal and it is necessary that we ask the right questions. But before we come to a conclusion, it is necessary to know, one, is that it is the whole of prematurity (rop), including also a reduction of miscarriages […] and two, what are the causes of prematurity, which decreased with time. “
Seasonal variability
A normal pregnancy lasts between 37 and 40 weeks, but about one baby in ten is born prematurely in North America.
The causes of preterm birth remain poorly understood. Health problems such as diabetes or high blood pressure, infections such as the flu, or even factors such as pollution, stress, socioeconomic status, and fatigue have all been implicated.
Moreover, adds dr. Beltempo, ” you know that there is a seasonal variation in the incidence of preterm birth “.
“In proportion to the number of births, in general it is known that in the summer months in Quebec, it was a little less […] premature babies, so I’m not surprised to see that in the last few weeks it is a little less busy in the units “, he stated.
The containment provides a unique opportunity to study the phenomenon of prematurity and stillbirth to try to discern what has changed and how we can combat them in the future.
Several hypotheses may readily be envisaged, according to the doctor Beltempo.
“There are fewer infections circulating, the mothers are less exposed to environmental factors because they are less the home […] there may be [jobs], or positions that are more at risk, and the fact that the home decreases it too, he said.
“All of these factors may be contributing to a decrease, but before arriving at this conclusion, it is necessary to be certain that it is true and what the causes of prematurity have declined over time. “
Responsibility
Dr. Nuyt believes that the doctors and researchers in quebec have the “responsibility” to take advantage of the terms which are offered to seek to produce knowledge that will benefit to all.
“It’s going to be really important as a society that we seize this occasion to analyze our data to gain information that is relevant to the population, she said. In Quebec, we have a health system that is still quite accessible to all, unlike other countries, we think very especially to our neighbours to the south, so we have a sort of responsibility to get the best information and disseminate it outside of our borders. “
The pandemic has also served to highlight dramatically the inequality in our societies, ” she continues.
Thus, a study conducted in one London hospital found that 5 admissions per 1000 were women who had caught the COVID, said dr. Nuyt.
“[The researchers] have noted that among those pregnant women who had caught the COVID and had to be hospitalized for it, there was an overrepresentation of black women, close to ten times, ethnic minority groups, an overrepresentation of women with overweight, an over-representation of pregnant women older “, she said.
We also know that these are women who have continued to work, notably in the health-care system, ” continues dr. Nuyt. So we can’t assume that the pandemic has had a very positive impact on their pregnancies, whether or not they have been infected by the virus.
“In Quebec we have beautiful data, which are collected, we’ll have to make good use of it, that the ministry of Health and researchers work together to be able to quickly bringing answers to the population questions “, she said in conclusion.
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