Stillbirth rates rose in Melbourne’s COVID-19 lockdown, despite dropping overall in past three years

When lockdowns began and medical appointments took a shift towards telehealth last year, researchers started watching the numbers very closely.Would telehealth be as good as face-to-face care? How much would a fear of getting infected with COVID-19 deter people from going into clinics and hospitals?Key points:Stillbirth rose from one in 400 to one in 300 during Melbourne’s lockdownsThis equates to 23 more stillbirths in the year studiedThis sits against a backdrop of fewer stillbirths overallOne statistic of particular interest to maternal foetal medicine specialists like Lisa Hui was whether the pandemic would affect the rate of stillbirth.While stillbirth is a shattering event for parents who experience it, it’s relatively rare, meaning subtle shifts in its rate are difficult to measure.So Dr Hui, from the University of Melbourne, the Mercy Hospital for Women and the Northern Hospital, launched a program to pull together data from all the public hospitals where babies are born in metropolitan Melbourne, in the hope the dataset would be large enough to show any trends.Space to play or pause, M to mute, left and right arrows to seek, up and down arrows for volume.ListenDuration: 29 minutes 15 seconds29m Stillbirths increase in Melbourne lockdown. Listen to the full story on the Health Report.Download 26.8 MBAt first, it looked like stillbirth rates were going OK.But it now looks like the numbers increased during the Melbourne lockdown period  — from one in 400 births to one in 300. “If the stillbirth rate had stayed at the pre-pandemic rate, we would have expected 62 stillbirths during that lockdown year, but we observed 85, so 23 more than expected,” Dr Hui said.The study, which is available in preprint form but has not yet been peer reviewed, looks specifically at women who were pregnant with one child that had no signs of congenital abnormalities, and gave birth from 24 weeks of pregnancy onwards in the year between March 2020 and 2021.These births were compared to all pregnancies in the same period over the previous two years. What drove the increase? It’s hard to pinpoint exactly what’s behind the increase, but the study also found there was a drop in the number of premature births.Helplines:Lifeline on 13 11 14MensLine Australia on 1300 789 978BeyondBlue on 1300 22 46 36SANDS (miscarriage, stillbirth and newborn death support) on 1300 072 637Stillbirth Foundation (research and education to prevent stillbirth) on 02 9557 9070Red Nose on 1300 308 307Emergency services on 000 (triple zero) if you are in immediate dangerThis included those that happen for medical reasons, like when a baby isn’t growing on schedule or there’s restricted blood flow through the umbilical cord. These situations, where baby isn’t thriving normally in the womb, are known to significantly increase the risk of stillbirth, Dr Hui said.”What we are having to consider is that perhaps the reduction in face-to-face care and women’s reluctance to come into hospital because they were perceived as hotspots of infection might have reduced our ability to detect these pregnancies at risk of stillbirth,” she said.”So what we’d like to do now is indepth individual case analysis of these losses during lockdown, and see if there was some avoidable factors that we can address.”It’s still early days in trying to unpick what happened, and we certainly don’t want parents to be alarmed or feel guilty.”But stillbirth has dropped overallWhile Dr Hui’s findings are concerning, they sit against a backdrop of fewer stillbirths overall. Just two weeks ago, Safer Care Victoria announced a decline in stillbirths thanks to the Safer Baby Bundle.The initiative focuses on five factors shown to reduce the risk of stillbirth:stopping smokingbetter screening for babies who aren’t growing properlymums paying attention to their baby’s movements in the wombside-sleeping in the third trimestershared decision-making between mothers and caregivers around the timing of birthCoronavirus questions answeredBreaking down the latest news and research to understand how the world is living through an epidemic, this is the ABC’s Coronacast podcast.Read moreSafer Care Victoria said there had been a 21 per cent decline in stillbirth over the past three years — the first real change to the state’s stillbirth rate in almost 20 years. Dr Hui said her study — which she recently presented to the International Stillbirth Alliance — had looked at a smaller, more specific population: just women who were pregnant for a prolonged period during lockdown in metropolitan Melbourne.”So just within the ‘ring of steel’, and it’s only in public hospitals, so it’s about 75 per cent of all births in metropolitan Melbourne,” she said.”It doesn’t reflect the experience for the country as a whole, and I think that’s important to remember.”Health in your inboxGet the latest health news and information from across the ABC.What you need to know about coronavirus:

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