Decline in births among disadvantaged areas during the COVID-19 pandemic

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 (Image: Pixabay CC0)
(Image: Pixabay CC0)

In the wake of the pandemic, there have been fewer births in poorer, more disadvantaged areas, while there has hardly been any change in births in affluent and more advantaged areas. This was shown by an analysis of administrative data from Scotland. The initial results were published in the European Journal of Public Health by a study team from MedUni Vienna’s Center for Public Health together with colleagues from the University of Glasgow.

The disruptions to healthcare, the economy and social life during the COVID-19 pandemic may have created barriers to starting or expanding families. Because of inequalities in family circumstances that existed before the pandemic, these new barriers may have been greater among disadvantaged groups than advantaged groups. This could be due to, for example, changes in access to relevant services or increased uncertainty about income and employment.

The so-called lockdown cohort (LoCo) describes babies born about 9 months after the first stringent lockdown measures imposed in response to the COVID-19 pandemic. In most European countries, this means that the lockdown cohort will begin around November 2020. The most important difference between the LoCo and all other birth cohorts is that the LoCo was conceived during the COVID-19 pandemic.

Disadvantaged groups more adversely affected by COVID-19 pandemic Within the first months of the COVID-19 pandemic, it became clear that, as in previous pandemics, disadvantaged groups bore a disproportionate share of the economic and health-related burden. The pandemic may have made it more difficult for disadvantaged families to realise their plans for having a baby than for advantaged families, compared with before the pandemic. Therefore, the LoCo may include fewer babies born to disadvantaged families, and/or more babies born to advantaged families. Put differently, the lockdown cohort may start life, on average, more socially advantaged than babies conceived before and after the COVID-19 pandemic. This leads to the statistical effect that babies conceived during the COVID-19 pandemic, and their mothers, are likely to be healthier on average than babies conceived before and after the pandemic. The researchers describe this as the LoCo (Lockdown Cohort)-effect.

Significant decline in number of births in disadvantaged areas Leveraging Scotland’s leading data infrastructure, the research team analysed the number of monthly births in Scotland up until November 2021 - including about 12 months of the lockdown cohort. Starting with November 2020, the number of babies born in the most deprived 20% of Scottish areas was well below the number expected based on the number of births outside the LoCo. This discrepancy peaked in February 2021, when 727 babies were born in the most deprived 20% of Scottish areas instead of the expected 942. That equates to 20% fewer babies than are normally born in these areas in a February. Between November 2020 and November 2021, there were about 10% fewer births overall in the most deprived areas than would have been expected during this period. In contrast, there was little change in the number of births in the 40% least deprived areas of Scotland.

Fewer children, but healthier across their life course Thus, the LoCo effect does not mean that the COVID-19 pandemic has actively improved the health of pregnant women or infants. "From what we’ve seen so far, however, the pandemic has significantly changed who was able to have a baby and who wasn-t" explains Moritz Oberndorfer from MedUni Vienna’s Center for Public Health. "These changes are related to factors that are known to affect children’s health, not just in infancy but throughout their lives. This combination of sudden changes in average parental characteristics and their known influence on the health of their offspring can result in a birth cohort that is unexpectedly healthy, despite being born during a global crisis."

Publication: European Journal of Public Health
The LoCo (Lockdown Cohort) effect: why the LoCo may have better life prospects than previous and subsequent birth cohorts
Moritz Oberndorfer, Ruth Dundas, Alastair H Leyland, Anna Pearce