Theses Master's

Exploring the Impact of the COVID-19 Pandemic on Preterm Births in New York City: A Prospective Cohort Study

Ravi, Rupa

Pregnant people with coronavirus disease 2019 (COVID-19) may be at risk for severe illness, possibly including preterm birth. However, the full impact of the pandemic on pregnancies remains unknown. This study was conducted with the aim of understanding the impact of COVID-19 on preterm births in a large, racially diverse population, during the first year of the pandemic in New York City.

This retrospective analysis of a prospective cohort study analyzed the medical records for maternal and newborn data for 6294 patients at two affiliate hospitals at a large academic medical center in Upper Manhattan, New York City. Demographic data, clinical findings, and birth outcomes were reviewed, including race/ethnicity. Pearson’s Chi-Square test was used to evaluate categorical variables, and a two-tailed T-test was conducted on continuous variables. Confounders were adjusted for in accordance with prior studies.

A total of 905 pregnant patients were diagnosed with COVID-19 in our cohort based on PCR and serology testing results. The overall prevalence of preterm births was 14.6%, stable from prior to the pandemic. However, further stratification of preterm births revealed an increase in “very preterm” (31 vs 86, 3.3% vs 1.8%, p = 0.007) and “moderate preterm” births (156 vs 513, 16.5% vs 10.3%, p<0.001) comparing those with and without infection, as well as those that delivered pre-pandemic. A majority of the delivering mothers self-identified as Hispanic or Latinx, most significantly among the infected pregnant people (539/905, 59.6%).

This study demonstrates no overall increase in preterm births, but an increase among specific populations and specific gestational periods during the COVID-19 pandemic. This is especially true amongst people of color. These findings must inform public health action moving forward including improved counseling and healthcare services provided to our especially vulnerable populations.

Geographic Areas


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More About This Work

Academic Units
Population and Family Health
Thesis Advisors
De Pinho, Helen
B.A., Mailman School of Public Health, Columbia University
Published Here
August 17, 2022


Masters Thesis

Keywords: preterm birth, COVID-19, mothers, pregnant people, birth outcomes, racial disparities, pandemic, New York City