CHOP Researchers Receive Funding to Study Effects of COVID-19 on Preterm Birth

Researchers at Children's Hospital of Philadelphia (CHOP) have formed a new consortium that will study the effects of the COVID-19 pandemic  on preterm birth and prenatal care, funded by $300,000 in grants from the Independence Blue Cross Foundation, Highmark Blue Cross Blue Shield Delaware's donor-advised fund, and BluePrints for the Community. The consortium, known as the AQUEDUCT Perinatal Research Collaborative, will also include researchers from Yale University, Nemours Children's Health System, and Northwestern University.

"The COVID-19 pandemic has led to profound changes in the way prenatal care is being delivered and utilized, on top of changes to the way pregnant women lead their everyday lives," said Heather H. Burris, MD, an attending neonatologist at CHOP and co-lead investigator of the research. "This funding will allow us to explore the effect these shifts are having on preterm birth and perinatal care and whether those effects vary by socioeconomic or demographic groups."

The research builds on earlier analyses that Dr. Burris and colleagues have performed using local data on the impact of COVID-19 on preterm births and stillbirths in Philadelphia. In this new collaborative, the members of AQUEDUCT (Advancing Quality, Utilization, and Equity for the Dyad: Understanding Care Together) will analyze a national cohort of patients insured by Highmark-BCBS who are pregnant and/or delivering between 2018 and 2020, with the COVID-19 era defined as beginning in March 2020.

The researchers will look at both spontaneous and medically-indicated preterm births as well as stillbirth rates, using data from the large and diverse AQUEDUCT cohort to assess the impact of the pandemic on these outcomes, which could provide important information about the drivers of preterm birth. The research team will also examine how often patients attended prenatal visits and what tests they underwent at each appointment.

In analyzing the data, the researchers intend to assess the demographics of the mother, as well as infant health metrics and hospital characteristics, including whether it is an urban or rural hospital and has a neonatal intensive care unit (NICU).

In an effort to better understand the factors leading to preterm birth, the rates of which have not substantially changed in three decades, the research team will analyze both spontaneous preterm birth (spontaneous onset of labor or water breaking) and medically-indicated preterm birth (preterm delivery via labor induction or cesarean section that is required for the health of the mother or infant). The researchers will also examine the number of prenatal care visits, along with use of ultrasounds, telehealth visits, glucose tolerance tests, and other tests typically performed at prenatal visits.

"With this collaboration among neonatal researchers, the Independence Blue Cross Foundation, and Highmark Blue Cross Blue Shield Delaware, we will determine not only the effects of the COVID-19 pandemic on birth outcomes and prenatal care, but we may also learn important lessons about prenatal best practices that could improve prenatal care and birth outcomes outside of a pandemic scenario," Dr. Burris said. "By bringing together national leaders in neonatology and perinatal epidemiology from esteemed institutions, this consortium will work together to answer critical questions about the pandemic and its impact on the way families seek and receive medical care, which will improve our understanding of preterm birth and how to reduce its frequency."

About Children's Hospital of Philadelphia

Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals, and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country. In addition, its unique family-centered care and public service programs have brought the 595-bed hospital recognition as a leading advocate for children and adolescents.