Hospitals see significant drop in premature births during lockdown | Hacker News Reader

Hospitals see significant drop in premature births during lockdown

nytimes.com

66 pointsSpoppys29 comments

Adding my uneducated guess:

- there's some evidence that healthcare in general can benefit from deliberate less intervention by patients and medical staff [0]

- maternity intervention is notorious for intervention (historically for good reasons) yet, today, so much extra can be profited by just pre-planning interventions that are distorting incentives [1]

- pandemic has raised the stakes of leaving home, particularly visiting hospitals so people think twice before deciding to go for intervention - patients preserveer more. That includes expecting mothers.

[0] this an opinion https://www.theguardian.com/commentisfree/2014/jul/19/patien...

[1] https://www.wilsoncenter.org/event/too-much-too-soon-address...

In Switzerland we had a massive spike in untreated heart attacks precisely because your third point. It's good that people don't go to the ER for minor things but people should know that symptoms of a heart attack are not to be taken lightly.

This seems plausible if induced labours were not excluded from the data sets.

this question will sound as uneducated as the speculation above: aren't induced labours only 1 scenario of (possibly) superfluous intervention?

Also, I couldn't find reference in the article where they describe that data as being excluded..

I was thinking in terms of less travel induced stress, both physical and mental.

I was on pre term labour watch last year and spent 12 weeks on bed rest in hospital. While the drs never knew the reason for why I was at risk (body showed early labour signs) I felt it was likely stress related. Spending 3 months in bed with all my meals provided and my basic needs met enabled me to relax and get to term. Old school treatment but it proved to work. I'd say stress correlates directly to pre term births.

Uneducated guess: I've read a few studies linking air pollution to pregnancy disorders. Maybe the effects are even stronger than previously thought.

I think the article already provides a more likely educated guess:

"By staying home, some pregnant women may have experienced less stress from work and commuting, gotten more sleep and received more support from their families, the researchers said."

I am not saying air pollution should be dismissed as a factor, but the elephant in the room is that the stress levels experienced in a _lot_ of workplaces are not compatible with pregnancy.

It is also unfair to expect someone to just be 'equally performing' in the workplace during pregnancy.

From an evolutionary standpoint high stress levels are created by threats, if there are threats you are better off (from an evolutionary standpoint) suffering a miscarriage or early pregnancy since you would more likely be alive to try another pregnancy later when the external conditions present no threats.

Being in a global pandemic is arguably much more stressful than work. I'm much more stressed than I would be in an office. Could be the particular variety of stress, but that's post-hoc rationalisation.

A good piece of general evidence I once heard against this is: premature births & miscarriages did not increase in London during The Blitz (I think they may have even reduced). There's a big narrative around stress and all of its wild short-term health implications, but I'm not convinced it translates into reality. It's not easy to measure.

> Being in a global pandemic is arguably much more stressful than work.

Depends where you live and on your lifestyle. I know that for me and close friends it actually has the opposite effect, I'm much more chill than before covid and I doubt we're the only ones.

Most likely, pregnant women who aren’t working can rest more. They can sit when the want, go to the restroom when the want, etc. These are things that take a cumulative toll when working / add a cumulative benefit when not.

It sounds appealing as an explanation, but so does the general stress argument. I'm skeptical of concrete explanations in general.

The stress of fearing a pandemic is perhaps quite different from the everyday stresses of work. We may find them both severe - even the fear much worse; but it's still conceivable the everyday stresses are worse specifically to the extent they influence birth weight. Perhaps everyday stress is more immediate; perhaps it's more physical; or perhaps it's more social - or perhaps we're grasping at straws and it's something else entirely.

In any case; just because a pandemic is stressful doesn't necessarily mean that stress that matters here isn't lower. All those various strains don't affect us in the same way.

It could also be that they are sleeping more, which people will try and shoehorn into: "that's a form of stress!" Stress is a buzzword, I'm wary of manhandling the theory too much as counterpoints come up, especially if it involves playing with semantics.

Exactly; stress isn't one clearly defined thing, and the forms do matter: therefore the focus on overall stress isn't that useful.

It's worse than that: "it's stress" is a lexical tautology. By definition anything that causes a miscarriage was a stressor.

My experience has been that people have a net greater degree of stress right now vs. pre-pandemic.

People are changing interpersonal work stress for interpersonal family stress which is itself magnified by the circumstances, plus the stress of a pandemic.

I have no idea what the cause could be, but to argue that "premie births are down because stress is down" can't possibly by tested right now, when stress is at an all-time high.

> Can't possibly by tested right now, when stress is at an all-time high.

I am not sure how to word this but I think there is a distinction between the anxiety experienced during the current pandemic and a more extreme 'high cortisol' 'high adrenaline' stress.

This would be the type of stress you would experience if someone threathened you with a knife or a gun on the street. The problem is that a lot of people experience a very similar hormonal response but induced by for example being berated face-to-face by an abusive employer or getting into a near confrontation with someone in traffic or public transport.

The anxiety you describe is indeed 'stressful' and arguably we all have different experiences but I would speculate that if you experience anxiety about the current situation but in the confort of your home and with all your basic needs met, than perhaps that will still generate less 'hormonal' stress levels than the face-to-face interactions associated with some workplaces, commutes, etc.

Pandemic just made my lifestyle the default option most people are living now. Lots of time outdoors. Home cooked meals. Avoid most other humans not in my immediate family (wife, kids). My stress levels aren’t any higher. My one casualty is my preferred sport/hobby (Brazilian Jiu Jitsu) is not feasible. It’s extremely high contact.

I would love to see a proper experiment testing that.

From anegdotal evidence it seems to me interpersonal relations in families got better because of lockdowns and working remotely.

Working exclusively from home since mid-March has certainly made some aspects of pregnancy easier - if I was tired, I could cross the hall and take a short nap in a proper bed, and had my whole house of food to choose from at any time, the quality of which is more under my control than what happens to be in the company canteen or vending machines that day, and wasn’t killing 1.5-2 hours a day getting to and from the office.

Also, I wasn’t exposed to all the other random illnesses besides Covid-19.

If this wasn’t our first kid, I probably would have been more stressed due to childcare problems, though.

This being Germany, I’ve been off work since I hit week 34, pandemic or no pandemic.

> It is also unfair to expect someone to just be 'equally performing' in the workplace during pregnancy.

I was equally performing during pregnancy. The thing about pregnancy is that it varies a lot.

Which is why it’s fair to expect variance, which is what the op was suggesting.

Less drinking/clubs

I guess it is to early for that since most women only accidentally drink during the first two months of pregnancy?

Well, that would depend on self-discipline, which of course is completely absent in the US today.

My labor and delivery nurse MIL speculates it is because of the increase in fevers associated with Covid. More young moms coming in with fevers and testing positive with Covid.

Fevers cause fewer preterm births? Can you explain how that works?

Parents are losing their babies sooner due to fevers.

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