LAUSR

Objective To assess the impact of public health measures taken during the COVID-19 pandemic on perinatal health indicators. Design Interrupted time series analysis comparing periods of the pandemic with the previous 5 years. Setting Yorkshire and the Humber region, England (2015–2020). Main outcome measures Relative risk (RR) of stillbirth, extreme preterm (EPT, <27 weeks’ gestational age) delivery, hypoxic ischaemic encephalopathy (HIE) and meconium aspiration syndrome (MAS), antenatal transfer for threatened EPT delivery and postnatal transfer for EPT birth, HIE or MAS. Results Stillbirths fell from 3.7/1000 deliveries prepandemic to 2.9/1000 afterwards; EPT births decreased from 2.5/1000 to 1.8/1000 live births. Following adjustment, during the first lockdown there were decreased antenatal transfers (RR 0.74, 95% CI 0.57 to 0.94) with non-statistically significant increased stillbirth (RR 1.08, 95% CI 0.78 to 1.51) and decreased EPT admissions (RR 0.88, 95% CI 0.60 to 1.29). Over the entire pandemic period, antenatal transfer (RR 0.64, 95% CI 0.55 to 0.76) and EPT birth (RR 0.73, 95% CI 0.56 to 0.94) decreased; stillbirths showed non-statistically significant increases overall (RR 1.21, 95% CI 0.98 to 1.49) but with increasing trend through the pandemic (RR 1.11, 95% CI 1.00 to 1.22). No changes were seen for HIE, MAS, postnatal transfers or in subgroup analyses by ethnicity. Conclusions Lower rates of antenatal transfer and extreme preterm birth were identified, alongside an apparent increase in stillbirth over time. The findings provide evidence that effects on perinatal activity related to the pandemic changed over time. This interrupted time series analyses identified decreased rates of antenatal transfers for threatened extreme preterm delivery decreased rates of admission to neonatal intensive care for babies born extremely preterm and increased stillbirth rates during the 2020 SARS-CoV-2 pandemic in the Yorkshire and Humber region.