An obstetrician at Emory University School of Medicine in Atlanta, Dr. “Despite considerable effort, the causes of preterm birth have been so elusive,” said Dennis Jamieson, who was not involved in the new study. Even though the global study only found a 4 percent decline, “I think any reduction in prematurity is remarkable and important,” she said.
“The next step is really to look at the why,” Dr. Jamieson said.
Dr Azad and Dr Roy Philip, co-authors of the new paper and also Irish neonatologists at the University Maternity Hospital Limerick, who found a surprising drop in very early births at their hospital in 2020, both said it was possible the lockdown Cause quite different effects on different groups of people. A pregnant woman like Ms Baker, who was able to stay at home in a less stressful environment with good support, would probably have benefited. A frontline worker without health insurance can have a different experience.
As such, the findings highlight how much is still unknown about what causes preterm birth. “Even if there are 52 million births in the study, it’s not going to answer all the questions immediately,” Dr. Philip said. “But at the very least it should prompt people to look more closely at what is the norm during pregnancy.”
The study also highlighted the unequal preterm birth rates in different countries. Over five years of data, the United States had the highest preterm birth rate of any high-income nation – just shy of 10 percent. Finland’s rate, by contrast, was less than 6 percent.
The disparity isn’t surprising, Dr. Jamieson said. “Unfortunately, the United States is an outlier for a lot of important maternal and child health outcomes when you compare it to other high-income countries.”
Future research could use this global data set to investigate such variations in maternal health. Dr Azad said they originally hoped to dig into the drivers of prematurity during the lockdown, not just its frequency: were changes in air pollution related to changes in preterm births? What about sanitation, or income, or access to health care? But they lacked funds for further investigation, Dr. Azad said, and now other projects that were shelved at the start of the pandemic have caught up with him and his colleagues.
Dr. Azad suspects that his one tweet today could launch a massive international research effort. In spring 2020 people had “this burning desire to do something, either to help with the pandemic or to build something,” she said. Some researchers even worked on the project without pay. “I am a scientist; I don’t like to use the word ‘magical,'” she said. “But it was magical.”
Now that the mysteries of premature birth will have to wait for other investigators, Dr Azad said, “we don’t all have that much extra time now.”