The COVID-19 pandemic and birth outcomes in 2020: The role of prenatal care and other channels

We use national birth data to assess the associations between the COVID-19 pandemic during 2020 and birth outcomes in Uruguay. Employing interrupted time series difference-in-differences techniques, we find mixed results, with some pregnancies showing increases in the likelihood of very preterm or very-low-weight births, and some others showing decreases in the incidence of moderate prematurity and moderate low birth weight. Adverse outcomes are more likely among women with low education, women with previous children, and with risk factors, such as smoking or being older than 34. We observe improvements in health at birth for children of non-smokers, women younger than 35, and women with no other children. We underscore the role of health care by showing that women in the private sector, who suffered the strongest contraction in face-to-face prenatal care use, experienced more adverse birth outcomes. Our results also suggest that the economic recession and an increased burden of childcare were behind the increases in preterm and very-low-weight births. Because pollution is an unlikely channel for the positive results, we hypothesize that for some pregnancies, the pandemic improved the intrauterine habitat by leading to a quieter and healthier lifestyle.