Lack of changes in preterm delivery and stillbirths during COVID-19 lockdown in a European region

Arnáez, Juan; Ochoa-Sangrador, Carlos; Caserío, Sonia; Gutiérrez, Elena; Jiménez, María del Pilar Márquez; Castañón, Leticia; Benito, Marta; Peña, Ana María Matilla; Hernández, N.; Hortelano, Miryam; Schuffelmann, Susana; Prada, María Teresa Pérez; Diego, P.; Villagómez, Francisco Joaquín; García‐Alix, Alfredo

doi:10.1007/s00431-021-03984-6

Cited by 65 publications

(67 citation statements)

References 9 publications

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“…In contrast, Wood et al observed no reduction in preterm birth rates [ 19 ]. Other studies reported no changes during the lockdown period [ 20 , 15 , 21 , 22 ]. Different approaches to birth outcomes research might explain the differences between studies.…”

Section: Discussionmentioning

confidence: 99%

“…Similar to studies that reported a lower rate of adverse pregnancy outcomes, our findings in regard of reduced preterm births and low birth weight during the lockdown may be explained by a variety of factors. The latter include greater focus on hygiene and home confinement, less work-related strain, more opportunities for rest and nutritional support, the support systems provided during the lockdown, reduced exposure to infection [ 18 , 21 ] as well as the postponement or suspension of medical interventions leading to iatrogenic preterm delivery. According to Phillip et al the Covid-19 lockdown was likely to cause socio-environmental changes and behavioral modifications, and thus exert a beneficial impact on pregnancies during this period [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Our data showed no change in stillbirths during the lockdown. A nationwide cohort study in Sweden [ 20 ] and a retrospective study in Spain [ 21 ] also reported no change in stillbirth rates among the different study periods. In contrast, Ashish et al in Nepal [ 8 ] and Khalil et al in the UK [ 10 ] reported a significantly higher rate of stillbirth during the pandemic compared to the pre-pandemic period.…”

Section: Discussionmentioning

confidence: 99%

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Changes in pregnancy outcomes during the COVID-19 lockdown in Iran

Ranjbar

Allahqoli

Ahmadi

et al. 2021

BMC Pregnancy Childbirth

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Background The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran. Methods We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women’s hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period. Results We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods. Conclusions In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Changes in pregnancy outcomes during the COVID-19 lockdown in Iran

Ranjbar

Allahqoli

Ahmadi

et al. 2021

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

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“…3 Following this finding, similar reductions in PTBs were reported from the Netherlands, 1 Japan, 4 Italy, 5 Tennessee, 6 New York, 7 Israel, 8 and the USA 9 and a report from Ireland described a reduced proportion of very low birth weight babies. 10 However, smaller studies from California, 11 Philadelphia, 12 Israel, 13 Spain, 14 and London, 15 as well as a recent nationwide Swedish study 16 could not confirm these findings.…”

Section: Introductionmentioning

confidence: 93%

Preterm birth, stillbirth, and early neonatal mortality during the Danish COVID-19 lockdown

Hedley

Hedermann

Hagen

et al. 2021

Preprint

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Importance: Using provisional or opportunistic data, three nationwide studies (The Netherlands, USA, and Denmark) have identified a reduction in preterm or extremely preterm births during periods of COVID-19 restrictions. However, these findings have been challenged as none of the studies accounted for perinatal deaths. Objective: To determine whether the reduction in extremely preterm births, observed in Denmark during the COVID-19 lockdown, could be a result of an increase in number of perinatal deaths; and to assess the impact of extended COVID-19 restrictions on the prevalence of preterm birth and perinatal death. Design: The study is a nationwide Danish register-based prevalence proportion study using detailed data to capture all births (induced abortions were excluded) throughout Denmark. We assessed the prevalence of stillbirth, preterm birth, and early neonatal death. Setting: Population-based study Participants: All singleton pregnancies delivered in Denmark, between February 27, and September 30, 2015-2020. COVID-19 lockdown was studied in 31,164 births and the extended period of COVID-19 restrictions in 214,862 births. Exposure: COVID-19 restrictions broadly (February 27, to September 30, 2020) or COVID-19 lockdown specifically (March 12, to April 14, 2020). Main Outcome: Prevalence of preterm births, stillbirths and early neonatal deaths across the periods under study. Results: The extremely preterm birth rate was reduced (OR 0.27, 95% CI 0.07 to 0.86) during the strict lockdown period, while perinatal mortality was not significantly different. During the extended period of restrictions, the extremely preterm birth rate was marginally reduced, and a significant reduction in the stillbirth rate (OR 0.69, 0.50 to 0.95) was observed. No changes in early neonatal mortality rates were found. Conclusion and Relevance: Stillbirth and extremely preterm birth rates were reduced in Denmark during the period of COVID-19 restrictions and lockdown, respectively, suggesting that aspects of these containment and control measures confer an element of protection. The present observational study does not allow for causal inference; however, the results support design of studies to ascertain whether behavioural or social changes for pregnant women may improve pregnancy outcomes.

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“…What has been clear so far is that hospital admissions have decreased; for example, a study taking place during an interval of 10 weeks found that there was a 43.2 percent decrease in hospital admissions and a 66.4 percent decrease in reported obstetric emergencies compared to the previous year’s similar calendar months [ 12 ]. However, researchers found that either the proportions of preterm live births decreased during the pandemic [ 13 ] or that they did not differ during the lockdown [ 14 ], or the opposite, with higher preterm birth rates happening during the COVID-19 pandemic, compared with a period before the pandemic [ 15 ]. Thus, what they all have in common is analyzing a short period of two or three months during the full lockdown in the Spring of 2020 and a possible explanation that maternal activity might be related to a decreased risk of preterm delivery, as the study suggests.…”

Section: Introductionmentioning

confidence: 99%

Exploring Pregnancy Outcomes Associated with SARS-CoV-2 Infection

et al. 2021

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Background and Objectives: The ongoing pandemic proved to be a tremendous challenge to all economic layers, healthcare, and people safety. As more than one year elapsed since the beginning of the COVID-19 pandemic, a multitude of medical studies involving the SARS-CoV-2 virus helped researchers and medical practitioners in understanding the effects it has on all sorts of patients until effective vaccines were finally developed and distributed for mass vaccination. Still, the SARS-CoV-2 and its new variants remain a potential threat towards all categories of patients, including a more delicate group represented by pregnant women. Thus, the current study aims to investigate the potential effects on obstetrical outcomes after a positive SARS-CoV-2 infection. Materials and Methods: This single-center prospective cohort study investigated the pregnancy outcomes in a total of 1039 eligible pregnant women between 30 August 2020 and 30 January 2021. Multiple patient characteristics and obstetrical outcomes were tested and analyzed in a multivariate regression model to establish potential risks determined by a COVID-19-positive pregnancy towards the mother and the newborn. Results: In the study sample, there were 938 pregnancies included without COVID-19 and 101 pregnant women identified with a positive COVID-19 infection. COVID-19 was significantly associated with a 2-fold increase in the risk of premature rupture of membranes and 1.5 times higher risk of preterm birth with emergency c-sections and lower APGAR scores. Also, significantly more newborns were given birth prematurely, with lower APGAR scores after the mothers were infected with SARS-CoV-2. Conclusions: A third-trimester infection with SARS-CoV-2 is a significant risk factor for preterm birth via an emergency cesarean section, a premature rupture of membranes, and a lower APGAR score in newborns, as compared with pregnancies where COVID-19 was not identified.

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Lack of changes in preterm delivery and stillbirths during COVID-19 lockdown in a European region

Cited by 65 publications

References 9 publications

Changes in pregnancy outcomes during the COVID-19 lockdown in Iran

Changes in pregnancy outcomes during the COVID-19 lockdown in Iran

Preterm birth, stillbirth, and early neonatal mortality during the Danish COVID-19 lockdown

Exploring Pregnancy Outcomes Associated with SARS-CoV-2 Infection

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