Thacher Jesse D, Vilhelmsson Andreas, Blomberg Annelise J, Rylander Lars, Jöud Anna, Schmidt Lone, Hougaard Charlotte Ørsted, Elmerstig Eva, Vassard Ditte, Mattsson Kristina
Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
BMJ Sex Reprod Health. 2025 Jan 6;51(1):9-17. doi: 10.1136/bmjsrh-2023-202162.
Pandemics are linked with declining birth rates, but little is known about how the COVID-19 pandemic has influenced childbearing decisions. We aimed to investigate the associations between the COVID-19 pandemic and reproductive decisions, specifically to identify potential changes in the frequency of deliveries and induced abortions in Skåne, Sweden.
Using the Skåne Healthcare Register, we identified women aged 15-45 years who had at least one pregnancy-related care visit registered between 1 January 2013 and 11 November 11 2021. Deliveries and induced abortions were identified, and changes in weekly delivery and abortion counts were assessed using an interrupted time series design. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated from a Poisson regression model.
During the study period we identified 129 131 deliveries and 38 591 abortions. Compared with the counterfactual (exposed interval assuming COVID-19 had not occurred), pandemic exposure was associated with fewer deliveries (RR 0.93; 95% CI 0.89 to 0.98). For abortions, pandemic exposure appeared to be associated with fewer abortions (RR 0.95; 95% CI 0.90 to 1.00); however, age-related differences were found. Among women aged 25 years and over, pandemic exposure was more strongly associated with fewer abortions. Contrastingly, among women aged under 25 years, abortions appeared to increase.
The COVID-19 pandemic seemed to have contributed to a decline in births in Southern Sweden. During the same period, abortions declined in women in the older age range, but contrastingly increased among younger women.
大流行与出生率下降有关，但对于新冠疫情如何影响生育决策却知之甚少。我们旨在调查新冠疫情与生殖决策之间的关联，特别是确定瑞典斯科讷地区分娩和人工流产频率的潜在变化。
利用斯科讷医疗保健登记册，我们确定了在2013年1月1日至2021年11月11日期间至少有一次与妊娠相关护理就诊记录的15至45岁女性。确定分娩和人工流产情况，并采用中断时间序列设计评估每周分娩和流产数量的变化。通过泊松回归模型估计相对风险（RRs）和95%置信区间（CIs）。
在研究期间，我们确定了129131例分娩和38591例人工流产。与反事实情况（假设未发生新冠疫情的暴露区间）相比，疫情暴露与分娩数量减少有关（RR 0.93；95%CI 0.89至0.98）。对于人工流产，疫情暴露似乎与人工流产数量减少有关（RR 0.95；95%CI 0.90至1.00）；然而，发现了年龄相关差异。在25岁及以上的女性中，疫情暴露与人工流产减少的关联更强。相反，在25岁以下的女性中，人工流产数量似乎增加了。
新冠疫情似乎导致了瑞典南部出生人数的下降。在同一时期，年龄较大的女性人工流产数量下降，但年轻女性的人工流产数量却相反地增加了。
