Excess Mortality Caused by the COVID-19 Pandemic Negatively Impacts Birth Numbers in European Countries

Christian De Geyter; Maddalena Masciocchi; Ursula Gobrecht-Keller

Disclosures

Hum Reprod. 2022;37(4):822-827. 

In This Article

Abstract and Introduction

Abstract

Study Question: How did the coronavirus disease 2019 (COVID-19) pandemic affect live birth numbers in Europe?

Summary Answer: In 14 European countries with validated datasets on live birth numbers during the ongoing COVID-19 pandemic, excess mortality was inversely correlated with live birth numbers.

What is Known Already: Since March 2020, in order to minimize spread of severe acute respiratory syndrome coronavirus 2 and reducing strain on the health care systems, many national authorities have imposed containments and restricted both indoor and outdoor recreational activities. Historical events, such as electricity blackouts, have repeatedly been shown to exert incremental effects on birth numbers.

Study Design, Size, Duration: We evaluated the effect of the COVID-19 pandemic and the containments on reproduction and birth numbers in 14 European countries with complete and validated datasets, until March 2021.

Participants/Materials, Setting, Methods: The national demographic offices of 20 European countries were requested to provide the monthly birth numbers from 2015 to March 2021. Among them, 14 countries provided those data. Taking into account seasonal variations, the live birth numbers were compared with excess mortality at two different time intervals during the pandemic.

Main Results and the Role of Chance: At 9 months after the initiation of containments in many European countries, 11 of 14 European countries (78.5%) experienced a decline in live birth numbers, ranging between −0.5% and −11.4%. The decline in live birth numbers was most pronounced in eight European countries with the highest degree of excess mortality. From January to March 2021, live birth numbers continued to decline in 5 of 8 European countries with high excess mortality, whereas live births started to recover in 8 of 14 countries (57.1%).

Limitations, Reasons for Caution: The live birth numbers of some key European countries were not available.

Wider Implications of the Findings: The demographic changes linked to the COVID-19 pandemic may add to the overall socio-economic consequences, most particularly in those countries with pre-existing reduced reproduction rates.

Study Funding/Competing Interest(S): This study did not receive specific funding. The authors have no conflicts of interest to declare.

Trial Registration Number: N/A.

Introduction

The World Health Organization declared coronavirus disease 2019 (COVID-19) a pandemic on 11 March 2020. Confronted with the outbreak of the pandemic, initially in China in late 2019 and in Italy from January 2020 onward, and then rapidly spreading, the authorities of most European countries reacted by imposing travel restrictions, by closing public spaces including schools, and by reducing social contacts through both regional and national lockdowns. The COVID-19 caseload in each European country followed different waves at different time points, as did the degree and duration of containments, which were imposed in most European countries in March 2020. All these measures had a profound global disruptive effect on socio-economic activities, which, together with the costs of increased public expenditure, are likely to have a long-lasting impact on society. In some countries, including England and Wales, the excess mortality owing to the COVID-19 pandemic has been demonstrated to exert a shortening of overall life expectancy (Aburto et al., 2021; Spiers et al., 2021). The effect of the COVID-19 pandemic on live birth numbers has remained unexplored so far. Uncertainty about the economic prospects and concerns about the impact of a COVID-19 infection during pregnancy on the health status of both mother and offspring may have resulted in fewer pregnancies, but containment at home may also have provided the opportunity for more intimacy among couples, resulting in pregnancies. Historical events, such as power outages/electricity blackouts, reducing both indoor and outdoor recreational activities, have repeatedly been shown to exert incremental effects on birth numbers (Udry, 1970; Burlando, 2014). COVID-19 may also directly interfere with male and female fertility (Jing et al., 2020; Wang et al., 2020; Aitken, 2021; Gacci et al., 2021). Here, we quantify the live birth numbers in several European countries before and during the COVID-19 pandemic and correlate these with excess mortality during the pandemic.

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