Background Preventative strategies for preterm birth are lacking. Recent evidence proposed COVID‐19 lockdowns may have contributed to changes in preterm birth. Aims To determine the prevalence of preterm birth and birth outcomes during and after the COVID‐19 lockdown at the Sunshine Coast University Hospital and the overall state of Queensland, Australia. Methods Retrospective cohort analysis of all births in Queensland including the Sunshine Coast University Hospital, during two epochs, April 1–May 31, 2020 (lockdown) and June 1–July 31, 2020 (post‐lockdown), compared to antecedent calendar‐matched periods in 2018–2019. Prevalence of preterm birth, stillbirth, and late terminations were examined. Results There were 64 989 births in Queensland from April to July 2018–2020. At the Sunshine Coast University Hospital, there was a significantly higher chance of birth at term during both lockdown (odds ratio (OR) 1.81, 95% CI 1.17, 2.79; P = 0.007) and post‐lockdown (OR 2.01, 95% CI 1.27, 3.18; P = 0.003). At the same centre, prevalence of preterm birth was 5.5% (30/547) during lockdown, compared to 9.1% (100/1095) in previous years, a 40.0% relative reduction ( P = 0.016). At this centre during lockdown, emergency caesareans concurrently decreased ( P < 0.01) and instrumental vaginal births increased ( P < 0.01). In Queensland overall, there was a nonsignificant decrease in the prevalence of preterm birth during lockdown. Conclusions There is a link between lockdown and a reduction in the prevalence of preterm birth on the Sunshine Coast. The cause is speculative at present, although increased influenza vaccination rates, decreased transmission of infections, and improved air quality may have been favourable in reducing preterm birth. Further research is needed to determine a causal link.

Aim: To determine the incidence of cervical cancer in women referred through the 2-week-wait pathway for postcoital bleeding and abnormal appearance of the cervix. Methods: A retrospective cohort study was conducted of women with postcoital bleeding, or abnormal appearance of the cervix referred to colposcopy clinics through the 2-week-wait pathway for suspected cervical cancer at Cambridge University Hospitals in the United Kingdom over 5 years. Women were identified from a departmental database. Clinical and demographic data were collected. Categorical data was analyzed with chi-squared or Fisher's exact tests and predictive values were calculated. Results: Of the 604 women referred, 1.16% were diagnosed with cervical cancer. None of the women who were up-to-date with cervical screening were diagnosed with cervical cancer, while 6.25% of women out-ofdate with cervical screening or outside the screening age group were diagnosed with cervical cancer (p < 0.001). The positive predictive value for diagnosing cervical cancer was 1.70% for postcoital bleeding (95% confidence interval [CI] 0.64-3.7) and 0.31% for abnormal appearance of the cervix (95% CI 0.0008-1.7). Conclusions: The incidence of cervical cancer in women referred through the 2-week-wait pathway for postcoital bleeding and abnormal appearance of the cervix is low. These referrals have considerable implications for both patients and clinicians, and have a low predictive value for diagnosing cervical cancer. In light of emerging evidence and changing practices, referral guidelines should be reviewed based on up-to-date data and current practices.

Objectives: To explore the performance of endotheliopathy biomarkers and angiogenic factors in distinguishing pre-eclampsia (PE) from COVID-19 in pregnancy. Methods: Plasma and sera samples were obtained from pregnant women with COVID-19 infection (n= 18) and patients with PE (n = 13). Biomarker assessment included circulating VCAM-1, TNF-receptor I (TNFRI), angiotensin II (ANGII), heparan sulfate (HS), thrombomodulin (TM), C5b9, PAI-1, ADAMTS-13 activity, fms-like tyrosine kinase-1 (sFlt1) and placental growth factor (PlGF). The area under the ROC curve was calculated for each of the biomarkers and for the sFlt1/PlGF ratio. Results: VCAM-1, TNFRI, ANGII, C5b9, sFlt1 and sFlt1/PlGF ratio were significantly higher (p < 0.05) in PE whereas HS and PlGF were significantly lower (p < 0.05) compared to patients with COVID-19. No differences were observed in TM, PAI-1, ADAMTS-13 activity between the study groups. sFlt1/PlGF ratio showed the highest area under the curve (0.96) with a detection rate of 90% for 10% false positive rate (figure 1). PlGF has the lowest area under the curve (0.70) among the studied biomarkers with a detection rate of 0% for 10% false positive rate. Conclusions: PE could be distinguished from COVID-19 by sFlt1/PlGF ratio and other endotheliopathy biomarkers. PlGF should not be used alone in in this context. Instead, the use of sFlt1/PlGF ratio is the best candidate to detect PE and rule out COVID-19.