The longitudinal impact of the COVID-19 pandemic on births in a single NYC health-care system

The SARS-CoV-2 (COVID-19) pandemic has led to reductions in pregnancy intention and subsequent births in the United States (US). We sought to describe how fluctuations in COVID-19 case rates impacted numbers of births at NYU Langone Health (NYULH) to better understand the impact of the ongoing pandemic on New York City (NYC) births. Beginning in March 2020, three COVID-19 “waves'' and two “dips'' were identified using the US Centers for Disease Control and Prevention seven-day moving average of cases per 100,000 in NYC. We compared the number of births at two NYULH hospitals (Manhattan and Brooklyn) nine months following a COVID-19 wave or dip with births during the same window (to account for seasonality) two years prior (pre-COVID). We also performed a sensitivity analysis to account for post-COVID population movement using change-of-address request data from the US Postal Service. Table 1 shows numbers of births recorded in the periods of interest. Compared with pre-COVID, the largest reduction in births followed Wave 1 (-29.28%); as the pandemic went on, the difference vs. pre-COVID diminished. By Wave 2, the percent change was -6.38% and by Wave 3, there was a net increase (5.34%). Manhattan had a steeper decrease in live births following Wave 1; births rebounded in Brooklyn after Dip 2; and both sites reported increases following Wave 3, with a greater increase in Brooklyn (Figure 1). These trends were slightly attenuated after accounting for migration. Births initially decreased during the pandemic; however, this decline attenuated as time passed and then reversed by Wave 3, when the number of births surpassed pre-COVID. This reversal may have resulted from delayed pregnancy intention or other factors . Changes in the number of births during the pandemic varied by hospital site, with a greater rebound in Brooklyn. Future studies are warranted that focus on the interplay between secular events, such the COVID-19 pandemic, and individual-level factors, including sociodemographics, in shaping pregnancy intention.View Large Image Figure ViewerDownload Hi-res image Download (PPT)