Trends in perinatal health during the COVID-19 pandemic:

On this page

• Hospital births
• Hospital stays and admissions
• C-sections and inductions
• Hypertensive disorders and diabetes
• Infant health outcomes
• More information
• Methodology
• References

Some studies suggest that pregnant people are at increased risk of adverse outcomes from COVID-19 infection, such as preterm (premature) birth ^{Footnote 1Footnote 2}. To reduce this risk, the COVID-19 vaccine is recommended for all pregnant people ^{Footnote 3}.

Perinatal health is the wellbeing of the pregnant person and newborn during pregnancy, childbirth, and postpartum. We use Perinatal Health Indicators to measure and monitor perinatal health in Canada.

This dashboard presents trends over time for key perinatal health indicators during the COVID-19 pandemic. We compared March 2020 to February 2023 with the previous 5 years (March 2015 to February 2020).

We analyzed data from the Canadian Institute for Health Information's Discharge Abstract Database (CIHI-DAD). The data cover people who gave birth (including live births and stillbirths) in hospitals and the infants born during this time. The information presented excludes Quebec, as Quebec hospital records are not available in the CIHI-DAD.

Hospital births

The number of hospital births continued to decrease during the pandemic.

Before the pandemic, the number of hospital live births was decreasing. This continued in the pandemic years, though the numbers fluctuated during this time. This trend was similar to all live births reported by Statistics Canada ^{Footnote 4}.

Figure 1. Number of hospital live births in Canada (excluding Quebec), ≥20 weeks gestational age

Notes

• * The dotted line separates the pre-pandemic and pandemic periods.

Hospital stays and admissions

The rates of postpartum hospital admissions did not change during the pandemic while rates of antenatal (before birth) hospital admissions continued to decrease. The average length of hospital stay for a delivery slightly decreased over the pandemic period.

Figure 2. Hospital admission rates and length of stay (days) in Canada (excluding Quebec)

Notes

• * The dotted line separates the pre-pandemic and pandemic periods.
• Antenatal period is the time during the entire pregnancy from conception to giving birth.
• Postpartum period is the time after giving birth.

C-sections and inductions

C-section (Caesarean) rates continued to increase during the pandemic. Induction rates were stable.

The rate of C-sections increased steadily during the 5 years before the pandemic and during the 3 years of the pandemic. The number of C-sections changed proportionally with the number of hospital births, keeping a steady increase in the rate (Figure 3).

Figure 3. C-section rates and counts among hospital births in Canada (excluding Quebec), ≥ 20 weeks gestational age

Notes

• * The dotted line separates the pre-pandemic and pandemic periods.

The number of inductions in the first year of the pandemic was similar to the year before. However, the induction rate increased somewhat due to the lower number of hospital births that year. During the 3 pandemic years, induction rates were relatively stable (Figure 4).

Figure 4. Induction rates and counts among hospital births in Canada (excluding Quebec), ≥20 weeks gestational age

Notes

• * The dotted line separates the pre-pandemic and pandemic periods.

Hypertensive disorders and diabetes

During the pandemic, rates of hypertensive (high blood pressure) disorders of pregnancy and diabetes in pregnancy continued to increase.

Diabetes in pregnancy includes type 1, type 2, and gestational diabetes. During the first year of the pandemic, the rate of diabetes in pregnancy was lower than the previous year, but this difference was not statistically significant ^{Footnote 5}. The diabetes rate continued to increase thereafter, following the pre-pandemic trend (Figure 5).

Hypertensive disorders of pregnancy include:

• pre-existing hypertension
• gestational hypertension
• pre-eclampsia
• eclampsia

Rates of hypertensive disorders of pregnancy increased prior to the pandemic. Rates continued to increase during the pandemic years (Figure 5).

Figure 5. Hypertension and diabetes rates among persons delivering in hospital in Canada (excluding Quebec), ≥20 weeks gestational age

Notes

• * The dotted line separates the pre-pandemic and pandemic periods.

Infant health outcomes

Trends in infant health outcomes remained similar to those before the pandemic.

During the pandemic, the rates of infants admitted to the neonatal intensive care unit (NICU) were similar to before the pandemic. Rates of infants who were small or large for their gestational age were relatively stable before and during the pandemic. Stillbirth rates and preterm birth rates also showed no significant change (Figure 6).

Figure 6. Infant outcomes in Canada (excluding Quebec)

Notes

• * The dotted line separates the pre-pandemic and pandemic periods.

More information

• Government of Canada:
  • Perinatal Health Indicators
  • Substance-related poisoning hospitalizations among people who are pregnant in Canada
  • Congenital Anomalies in Canada Data Tool
  • COVID-19: Pregnancy, childbirth and caring for a newborn
• The Society of Obstetricians and Gynecologists of Canada:
  • COVID-19 and Pregnancy (PDF, 879 KB)
  • Statement on COVID-19 Vaccination in Pregnancy (PDF, 398 KB)
• Canadian Surveillance of COVID-19 in Pregnancy: Epidemiology, Maternal and Infant Outcomes

Methodology

• Deliveries include live births and stillbirths.
• Infant birth records and maternal delivery records (livebirth and stillbirth) were restricted to a gestational age of at least 20 weeks.
• Antenatal and postpartum admissions were identified using the sixth digit of ICD-10-CA codes. Antenatal conditions were identified with a 3 as the sixth digit and postpartum admissions were identified with a 4 as the sixth digit.
• Preterm birth is defined as babies who were born under 37 weeks gestation including both singleton and multiple live births.
• Small-for-gestational-age and large-for-gestational-age calculations were restricted to singleton infants with a gestational age of 22 to 43 weeks ^{Footnote 6}.

References