Social distancing and extremely preterm births in the initial COVID-19 pandemic period
Authors: Shukla Vivek V. , Carper Benjamin A. , Ambalavanan Namasivayam , Rysavy Matthew A. , Bell Edward F. , Das Abhik , Patel Ravi M. , D’Angio Carl T. , Watterberg Kristi L. , Cotten C. Michael , Merhar Stephanie L. , Wyckoff Myra H. , Sánchez Pablo J. , Kumbhat Neha , Carlo Waldemar A. ,   the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, Polin Richard A. , Laptook Abbot R. , Keszler Martin , Hensman Angelita M. , Vieira Elisa , Pierre Lucille St. , Hibbs Anna Maria , Walsh Michele C. , Newman Nancy S. , Smucney Sarah , Zadell Arlene , Poindexter Brenda B. , Schibler Kurt , Grisby Cathy , Kirker Kristin , Wuertz Sandra , Dudley Juanita , Beiersdorfer Traci , Thompson Julia , Goldberg Ronald N. , Finkle Joanne , Fisher Kimberley A. , Laughon Matthew M. , Bose Gennie , Clark Cindy , Kicklighter Stephen D. , White Donna , Carlton David P. , Loggins Yvonne , Laursen Judith , Mackie Colleen , Bottcher Diane I. , Bremer Andrew A. , Higgins Rosemary D. , Archer Stephanie Wilson , Tyson Jon E. , Khan Amir M. , Stoll Barbara J. , Dominguez Gabriela , Eason Elizabeth , Hall Donna J. , Mahatme Apoorva , Martin Karen , Reyna Ilse , Stephens Emily K. , Wade Jaleesa , White Michelle , Nelin Leif D. , Jadcherla Sudarshan R. , Slaughter Jonathan L. , Luzader Patricia , McCool Jacqueline , Warnimont Kyrstin , Purnell Jessica , Small Kristi , Stein Melanie , Sullivan Rox Ann , Marzac Laura , Baugher Hallie , Zettler Eli , Miller Bethany , Beckford Demi R. , DeSantis Brittany , Reedy Rachel , Gantz Marie G. , Bann Carla M. , Zaterka-Baxter Kristin M. , Gabrio Jenna , Leblond David , O’Donnell Auman Jeanette , Van Meurs Krisa P. , Stevenson David K. , Chock Valerie Y. , Ball M. Bethany , Recine Barbara P. , Reichert Elizabeth N. , Collins Monica V. , Cosby Shirley S. , Colaizy Tarah T. , Harmon Heidi M. , Baack Michelle L. , Hogden Laurie A. , Johnson Karen J. , Schmelzel Mendi L. , Walker Jacky R. , Goeke Claire A. , Faruqui Sarah E. , Coulter Brenda J. , Schrimper Bailey M. , Jellison Syndney S. , Elenkiwich Chelsey , Henning Megan M. , Broadbent Megan , Van Muyden Sarah , Fuller Janell , Ohls Robin K. , Beauman Sandra Sundquist , Lacy Conra Backstrom , Hanson Mary , Kuan Elizabeth , DeMauro Sara B. , Eichenwald Eric C. , Abbasi Soraya , Catts Christine , Chaudhary Aasma S. , Dhawan Megan A. , Ghavam Sarvin , Mancini Toni , Puopolo Karen M. , Snyder Jonathan , Guillet Ronnie , Reynolds Anne Marie , Lakshminrusimha Satyan , Sacilowski Michael G. , Rowan Mary , Jensen Rosemary , Jones Rachel , Kent Alison , Prinzing Diane , Scorsone Ann Marie , Binion Kyle , Guilford Stephanie , Orme Constance , Sabaratnam Premini , Rochez Daisy , Li Emily , Donato Jennifer , Brion Luc P. , Duran Joanne , Eubanks Frances , Harrod Michelle , Sepulvida Pollieanna , Vasil Diana M. , Yoder Bradley A. , Baserga Mariana , Minton Stephen D. , Sheffield Mark J. , Rau Carrie A. , Christensen Susan , Coleman Kathleen , Elmont Jennifer O. , Francom Barbara L. , Jordan Jamie , Loertscher Manndi C. , Marchant Trisha , Maxson Earl , McGrath Kandace , Mickelsen Hena G. , Parry D. Melody , Tice Katherine , Weaver-Lewis Kimberlee , Woodbury Kathryn D. 
Published: February 2024

Abstract
Hypothesis
Increased social distancing was associated with a lower incidence of extremely preterm live births (EPLB) during the initial COVID-19 pandemic period.

Study design
Prospective study at the NICHD Neonatal Research Network sites comparing EPLB (220/7–286/7 weeks) and extremely preterm intrapartum stillbirths (EPIS) rates during the pandemic period (March-July, weeks 9–30 of 2020) with the reference period (same weeks in 2018 and 2019), correlating with state-specific social distancing index (SDI).

Results
EPLB and EPIS percentages did not significantly decrease (1.58–1.45%, p = 0.07, and 0.08–0.06%, p = 0.14, respectively). SDI was not significantly correlated with percent change of EPLB (CC = 0.29, 95% CI = −0.12, 0.71) or EPIS (CC = −0.23, 95% CI = −0.65, 0.18). Percent change in mean gestational age was positively correlated with SDI (CC = 0.49, 95% CI = 0.07, 0.91).

Conclusions
Increased social distancing was not associated with change in incidence of EPLB but was associated with a higher gestational age of extremely preterm births.

ClinicalTrials.gov ID
Generic Database: NCT00063063.