Live births in Europe down 14% nine months after the start of the COVID-19 pandemic and the first lockdowns

In Europe, in January 2021, just nine to ten months after the first peak of the COVID-19 epidemic and the first lockdowns, the number of live births fell by 14% compared to the average number of live births in January 2018 and 2019.

Researchers of a study published in Human reproduction, say the decline may be due to lockdowns imposed in many European countries, rather than people contracting COVID-19 and experiencing complications from the infection, such as death, miscarriage or stillbirth. For that to be the case, there would be a fall live births just weeks or months after contracting COVID-19, which they didn’t observe

The study’s first author, Dr. Léa Pomar, an obstetrician-sonographer at the University Hospital of Lausanne and an associate professor at the School of Medical Sciences in Lausanne, Switzerland, said: “The decline in fertility nine months after the start pandemic is more common in countries where health care systems there were difficulties, and the number of hospitals was exceeded. This led to lockdowns and social distancing measures to try to contain the pandemic.

“The longer the lockdowns were in place, the fewer pregnancies there were during that period, even in countries that were not severely affected by the pandemic. We believe that couples’ fears of a health and social crisis during the first wave of COVID-19 contributed to the decline in live births at nine months.”

Previous pandemics in the 20th and 21st centuries, such as the 1918 Spanish flu pandemic and the 2013 Ebola and 2016 Zika outbreaks, have also been linked to declining birth rates nine months after their peaks. The reasons were high parental mortality during the first two pandemics and high fetal mortality as a result of direct exposure to the Zika virus. The desire of couples to postpone pregnancy during the crisis also played a role. The researchers of the current study wondered if a similar trend would be observed after the COVID-19 pandemic.

They looked at data from 24 European countries for the period immediately before and after the first wave of the COVID-19 pandemic. They adjusted the live birth rate for seasonal fluctuations and found that January 2021 was the only month in which there was a significant decline in live births.

At the national level, a decrease in the birth rate in January 2021 was observed in Belgium (decrease by 12%), Estonia (13%), France (14%), Italy (17%), Latvia (15.5%), Lithuania (28%) . , Portugal (18%), Romania (23%), Russia (19%), Spain (23.5%), Ukraine (24%), England and Wales (13%) and Scotland (14%). Seven countries had intensive care units overcrowded (by more than 100%), and six of them (Belgium, France, Italy, Spain, England and Scotland) experienced a significant fall in birth rates. A seventh country, Denmark, did not. Only two of the nine countries that had a small or moderate impact on intensive care units had a decline in births after nine months.

March 2021 was the only month with a live birth rate similar to the monthly rate before the pandemic, which corresponds to a rebound nine to 10 months after the end of the lockdown. However, researchers say this rebound does not appear to offset the decline in births in January 2021.

Further analysis showed that the duration of the lockdown was the only factor associated with a decrease in live births in January 2021 compared to January 2018 and January 2019. In addition, countries with lower income per capita in January 2021, the number of live births decreased by more than 10%. Sweden, which did not quarantine but there was a great number of deaths, there was no fall in live births.

“The correlation we found with lockdown duration may reflect a much more complex phenomenon, in which lockdowns are government decisions used as a last resort measure to contain a pandemic. Lockdown duration directly affects couples,” Dr Pomar said.

He said the information from this study is important for health services and policy makers. “This is of particular importance for health services, which could adapt staffing levels to post-pandemic birth patterns: fewer pregnancies are expected during a pandemic, but there may be a rebound in pregnancies after the pandemic is over. The fact that the fertility recovery does not seem to offset the decline in January 2021 could have long-term implications for demographics, especially in Western Europe, where the population is aging.”

Dr. Pomar and his colleagues plan to test whether there are similar trends after subsequent waves of pandemics and lockdowns. “Over time, the pandemic becomes endemic, its effects during pregnancy become better known, vaccination is available, and it is possible that this decline in fertility was mitigated in subsequent waves,” he said.

Limitations of the study are that it was based on national data, which may limit the ability to identify other potential factors contributing to the decline or increase in live births, and the researchers only collected data up to April 2021, making it impossible to identify seasonal differences in births for 2021 .

Professor Christian De Gaiter of the University of Basel, Switzerland, was not involved in the study and is associate editor of the journal. Human reproduction. In a commentary accompanying the article, he writes: “These observations are important because they show that human reproductive behavior, as evidenced by live births, changes during dramatic events, epidemics, and global crises… Fewer live births lead to greater growth . rapid population aging and lower economic growth.

“Some rebound in live births after each of these crises may alleviate these constraints, but successive multiple crises can also cause live births not to recover… People now know that profound stressors during pregnancy can affect placental function, health newborns. and even future fertility… The undulating fertility aspirations brought on by crises will invariably affect fertility treatment; in addition, temporary fluctuations in the living birth the numbers will affect the workload on maternity wards, school facilities and, ultimately, national socio-economic stability.’