Impact of Wuhan lockdown on the indications of cesarean delivery and newborn weights during the epidemic period of COVID-19

Abstract

Objective To prevent the rapid spread of COVID-19, the Chinese government implemented a strict lockdown in Wuhan starting on 23 January, 2020, which inevitably led to the changes in indications for the mode of delivery. In this retrospective study, we present the changes in the indications for cesarean delivery (CD) and the birth weights of newborns after the lockdown in Wuhan. Methods A total of 3,432 pregnant women in the third trimester of their pregnancies who gave birth in our hospital from 23 January 2019 to 24 March 2020 were selected as the observation group, while 7,159 pregnant women who gave birth from 1 January 2019 to 22 January 2020 were selected as the control group; control group was matched using propensity score matching (PSM). A comparative analysis of the two groups was performed with the chisquare test, t test and rank sum test. Results The difference in the overall rate of CD between the two groups was not statistically significant (p<0.05). Among the indications for CD, CD on maternal request (CDMR) and fetal distress were also significantly more common in the observation group (p<0.05) than the control group. Furthermore, we found that the weight of newborns was significantly heavier in the observation group than in the control group when considering full-term or close-to-fullterm births (p<0.05). Conclusions The results may provide useful information to management practices regarding pregnancy and childbirth after lockdown in other cities or countries, enabling better control of the rate of

Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis

“…Of 3592 abstracts screened, 192 were relevant for full-text review and 40 met the inclusion criteria for systematic review ( figure 1 ). 4 , 5 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 A list of excluded studies with reasons for exclusion is provided in the appendix (p 6) . Reporting on resource use or service reconfiguration outcomes is summarised in the appendix (p 27) .…”

“…Of the 40 included studies, 31 for which comparable outcomes were also reported in at least one other study were included in the meta-analysis. 4 , 12 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 24 , 25 , 26 , 27 , 28 , 30 , 31 , 32 , 33 , 34 , 37 , 38 , 40 , 42 , 45 , 46 , 47 , 48 , 49 Table 1 shows the characteristics of the 40 included studies, all of which used a historical cohort design. 17 countries were represented, with substantial variation in pandemic mitigation measures among countries.…”

“…The main weaknesses were inconsistent definition and reporting of outcomes, inconsistency in selection of control groups, and retrospective study design. For example, although 18 papers 4 , 5 , 14 , 15 , 16 , 17 , 19 , 20 , 21 , 26 , 28 , 30 , 31 , 32 , 33 , 38 , 47 , 49 reported on preterm birth, variation in the gestational age cutoffs and use of ranges limited their comparability.…”

“…Nine studies 16 , 17 , 20 , 28 , 30 , 31 , 32 , 35 , 47 had a comparison group of annually matched periods from several preceding years ( table 1 ). 18 studies 4 , 5 , 13 , 14 , 18 , 21 , 22 , 25 , 26 , 27 , 29 , 36 , 37 , 41 , 43 , 44 , 46 , 48 had a comparison group from immediately before the lockdown period in the respective country. Exposed sample sizes varied from nine to 56 720 pregnancies ( table 2 ).…”

“…Exposed sample sizes varied from nine to 56 720 pregnancies ( table 2 ). Only 19 studies 5 , 14 , 15 , 16 , 19 , 21 , 22 , 24 , 26 , 28 , 30 , 33 , 34 , 39 , 41 , 42 , 47 adjusted for socioeconomic status, ethnic background, comorbidities, or other confounding factors.…”