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Simon I, König-Bachmann M, Wimmer-Puchinger B, Zenzmaier C. [Peripartal COVID-19-Related Restrictions and Psychological Burden - A Quantitative Survey in Austria]. Z Geburtshilfe Neonatol 2024. [PMID: 38631376 DOI: 10.1055/a-2293-2203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
INTRODUCTION The period from pregnancy to postpartum is a vulnerable time with an increased risk of mental illness. The COVID-19 pandemic led to restrictions in peripartum care, such as infection control measures, or restrictions regarding accompanying persons. MATERIAL AND METHODS Effects of COVID-19-related restrictions on the psyche and well-being during the peripartum period in Austria were retrospectively assessed using a partially standardized online questionnaire. In addition to closed questions on restrictions and psychological stress, this also contained the Edinburgh Postnatal Depression Scale (EPDS). RESULTS Data from 850 women who had given birth during the pandemic were included in the analysis. In 8.5% of cases, appointments were canceled during prenatal care, 10.7% had to wear a face mask during the birth. One in 10 women had to cope with the birth and one in 5 with the puerperium without a companion. Unaccompanied women were significantly less likely to feel well cared for during the birth, more likely to feel alone in the puerperium and, according to the EPDS score, were more likely (39% vs. 20%; p<0.001) to have a high probability of postpartum depression. CONCLUSIONS The pandemic-related restrictions led to anxiety, worry, loneliness and an increased risk of depression during the peripartum period. The balance of mental health was negatively affected by measures and restrictions. Even in times of pandemic, more attention needs to be paid to the vulnerable peripartum period.
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Affiliation(s)
- Imola Simon
- Department Gesundheit, Fachhochschule Burgenland, Campus Pinkafeld, Pinkafeld, Austria
| | - Martina König-Bachmann
- FH-Bachelor Studiengang Hebamme, fhg - Zentrum für Gesundheitsberufe Tirol GmbH/fh gesundheit, Innsbruck, Austria
| | | | - Christoph Zenzmaier
- FH-Bachelor Studiengang Hebamme, fhg - Zentrum für Gesundheitsberufe Tirol GmbH/fh gesundheit, Innsbruck, Austria
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Charles CM, Souza Neto LA, Soares CF, Souza Araújo T, Torezzan C, Lima EEC, Munezero A, Bahamondes L, Souza RT, Costa ML, Cecatti JG, Pacagnella RC. Preterm births prevalence during the COVID-19 pandemic in Brazil: results from the national database. Sci Rep 2023; 13:14580. [PMID: 37666901 PMCID: PMC10477268 DOI: 10.1038/s41598-023-37871-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/28/2023] [Indexed: 09/06/2023] Open
Abstract
The SARS-CoV-2 (COVID-19) pandemic impacted the health systems between and within countries, and in the course of the pandemic sexual and reproductive health services were the most disrupted. Findings from high-income settings have reported significant changes in preterm birth prevalence during the pandemic period. To understand the possible effects of the COVID-19 pandemic on preterm birth numbers at the Brazilian national level. We compare the number of preterm deliveries during the COVID-19 pandemic period (2020 and 2021) with previous years. We conducted a population-based cross-sectional study taking the period from January 2017 to December 2021 to account. We use individual-level live births data from the Brazilian Live Birth Information System (SINASC), and we estimate the odds ratio (OR) of preterm deliveries using propensity score weighting analysis in Brazil and its regions. During the study period (from 2017 to 2021), about 2.7 million live births were recorded per year, and the missing value for gestational age at delivery was less than 1.5%. The preterm birth prevalence slightly increased during the COVID-19 pandemic compared to the pre-pandemic period (11.32% in 2021 vs 11.09% in 2019, p-value < 0.0001). After adjusting for sociodemographic variables, the OR of preterm births in Brazil has significantly increased, 4% in 2020 (OR: 1.04 [1.03-1.05] 95% CI, p-value < 0.001), and 2% in 2021(OR: 1.02 [1.01-1.03] 95% CI, p-value < 0.001), compared to 2019. At the regional level, the preterm birth pattern in the South, Southeast and Northeast regions show a similar pattern. The highest odds ratio was observed in the South region (2020 vs 2019, OR: 1.07 [1.05-1.10] 95% CI; 2021 vs 2019, OR: 1.03 [1.01-1.06] 95% CI). However, we also observed a significant reduction in the ORs of preterm births in the northern region during the COVID-19 pandemic (2020 vs 2019, OR: 0.96 [0.94-0.98] 95% CI) and (2021 vs 2019, OR: 0.97 [0.95-0.99] 95% CI). Our analysis shows that the pandemic has increased regional variation in the number of preterm births in Brazil in 2020 and 2021 compared to the pre-pandemic years.
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Affiliation(s)
- Charles M'poca Charles
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
- Provincial Health Administration, DPS Manica, Chimoio, Mozambique
| | - Luiz Alves Souza Neto
- Institute of Mathematics, Statistics and Scientific Computing (IMEEC), University of Campinas, Campinas, SP, Brazil
- School of Applied Sciences (FCA), University of Campinas, Campinas, SP, Brazil
| | - Camila Ferreira Soares
- College of Philosophy and Human Sciences (IFCH), University of Campinas, Campinas, SP, Brazil
| | - Tacildo Souza Araújo
- Institute of Mathematics, Statistics and Scientific Computing (IMEEC), University of Campinas, Campinas, SP, Brazil
| | - Cristiano Torezzan
- Center for Population Studies (NEPO), University of Campinas, Campinas, SP, Brazil
| | - Everton Emanuel Campos Lima
- College of Philosophy and Human Sciences (IFCH), University of Campinas, Campinas, SP, Brazil
- Center for Population Studies (NEPO), University of Campinas, Campinas, SP, Brazil
| | - Aline Munezero
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | - Luis Bahamondes
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
- Campinas Reproductive Health Research Center (CEMICAMP), Campinas, Brasil
| | - Renato Teixeira Souza
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | - Maria Laura Costa
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
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Giordano V, Fuiko R, Witting A, Unterasinger L, Steinbauer P, Bajer J, Farr A, Hoehl S, Deindl P, Olischar M, Berger A, Klebermass-Schrehof K. The impact of pandemic restrictive visiting policies on infant wellbeing in a NICU. Pediatr Res 2023; 94:1098-1103. [PMID: 36959317 PMCID: PMC10034238 DOI: 10.1038/s41390-023-02562-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Given the countrywide lockdown in the first pandemic period and the respective Hospital restrictive policies, we aimed to investigate if the SARS-COV-2 pandemic was associated to a reduced parental presence in the NICU and in which form this had an impact on infant wellbeing. METHODS Retrospective cohort study about altered NICUs parental presence (measured by number of visits and kangaroo care time) due to pandemic restrictive policies and its impact on infant wellbeing (measured through The Neonatal Pain Agitation and Sedation scale and nurses' descriptive documentation). RESULTS Presence of both parents at the same time was significantly lower during pandemic. Contrary, maternal presence only and total kangaroo-care time were higher within the pandemic (163.36 ± 94.07 vs 122.71 ± 64.03; p = 0.000). Lower NPASS values were documented during the lookdown (1.28 ± 1.7 vs 1.78 ± 2.2; p = 0.000). CONCLUSION Data collected through the pandemic confirm the importance of parental presence for infants' wellbeing in a NICU setting. IMPACT Parental support is an extremely important aspect for infants hospitalized in an intensive care unit. Their presence was limited in many NICUs worldwide during the SARS-COV-2 pandemic. This study confirm the importance of parental presence for infants' wellbeing also in a pandemic situation. Our results support a family-centered newborn individualized developmental care approach in the NICU.
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Affiliation(s)
- Vito Giordano
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Paediatrics (CCP), Medical University of Vienna, Vienna, Austria.
| | - Renate Fuiko
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Paediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Andrea Witting
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Paediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Lukas Unterasinger
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Comprehensive Center for Paediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Philipp Steinbauer
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Paediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Johanna Bajer
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Paediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Alex Farr
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Comprehensive Center for Paediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Stefanie Hoehl
- Department of Developmental and Educational Psychology, University of Vienna, Vienna, Austria
| | - Philipp Deindl
- Department of Neonatology and Pediatric Intensive Care Medicine, University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Monika Olischar
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Paediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Angelika Berger
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Paediatrics (CCP), Medical University of Vienna, Vienna, Austria
| | - Katrin Klebermass-Schrehof
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Paediatrics (CCP), Medical University of Vienna, Vienna, Austria
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Lyu T, Liang C, Liu J, Hung P, Zhang J, Campbell B, Ghumman N, Olatosi B, Hikmet N, Zhang M, Yi H, Li X. Risk for stillbirth among pregnant individuals with SARS-CoV-2 infection varied by gestational age. Am J Obstet Gynecol 2023; 229:288.e1-288.e13. [PMID: 36858096 PMCID: PMC9970919 DOI: 10.1016/j.ajog.2023.02.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Despite previous research findings on higher risks of stillbirth among pregnant individuals with SARS-CoV-2 infection, it is unclear whether the gestational timing of viral infection modulates this risk. OBJECTIVE This study aimed to examine the association between timing of SARS-CoV-2 infection during pregnancy and risk of stillbirth. STUDY DESIGN This retrospective cohort study used multilevel logistic regression analyses of nationwide electronic health records in the United States. Data were from 75 healthcare systems and institutes across 50 states. A total of 191,403 pregnancies of 190,738 individuals of reproductive age (15-49 years) who had childbirth between March 1, 2020 and May 31, 2021 were identified and included. The main outcome was stillbirth at ≥20 weeks of gestation. Exposures were the timing of SARS-CoV-2 infection: early pregnancy (<20 weeks), midpregnancy (21-27 weeks), the third trimester (28-43 weeks), any time before delivery, and never infected (reference). RESULTS We identified 2342 (1.3%) pregnancies with COVID-19 in early pregnancy, 2075 (1.2%) in midpregnancy, and 12,697 (6.9%) in the third trimester. After adjusting for maternal and clinical characteristics, increased odds of stillbirth were observed among pregnant individuals with SARS-CoV-2 infection only in early pregnancy (odds ratio, 1.75, 95% confidence interval, 1.25-2.46) and midpregnancy (odds ratio, 2.09; 95% confidence interval, 1.49-2.93), as opposed to pregnant individuals who were never infected. Older age, Black race, hypertension, acute respiratory distress syndrome or acute respiratory failure, and placental abruption were found to be consistently associated with stillbirth across different trimesters. CONCLUSION Increased risk of stillbirth was associated with COVID-19 only when pregnant individuals were infected during early and midpregnancy, and not at any time before the delivery or during the third trimester, suggesting the potential vulnerability of the fetus to SARS-CoV-2 infection in early pregnancy. Our findings underscore the importance of proactive COVID-19 prevention and timely medical intervention for individuals infected with SARS-CoV-2 during early and midpregnancy.
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Affiliation(s)
- Tianchu Lyu
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Chen Liang
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC.
| | - Jihong Liu
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Peiyin Hung
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Jiajia Zhang
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Berry Campbell
- Department of Obstetrics and Gynecology, School of Medicine Columbia, University of South Carolina, Columbia, SC
| | - Nadia Ghumman
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Bankole Olatosi
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Neset Hikmet
- Department of Integrated Information Technology, College of Engineering and Computing, University of South Carolina, Columbia, SC
| | - Manting Zhang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Honggang Yi
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
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5
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Lau M, Kraus V, Schulze AF, Rausch TK, Krüger M, Göpel W. Observational study on the neonatal outcome during the COVID-19 pandemic in Germany. Acta Paediatr 2023; 112:1892-1897. [PMID: 37306278 DOI: 10.1111/apa.16873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/24/2023] [Accepted: 06/09/2023] [Indexed: 06/13/2023]
Abstract
AIM We aimed to determine stillbirth, preterm birth, perinatal complications, and the developmental outcome of children born preterm during the COVID-19 pandemic in Germany. METHODS National data from the perinatal survey of preterm and term infants born in 2017-2020 between 22 March and 31 December were evaluated. Neurodevelopment of preterm infants at 2 years corrected age was tested with the Parent Report of Children's Abilities-Revised questionnaire and by clinical testing with Bayley scales, either before or during the COVID-19 pandemic. Statistical significance was calculated using a Pearson's chi-square-independence test and a linear regression model. RESULTS In 2020, there was an increase of stillbirths of 0.02% (p = 0.01) and a decrease in preterm births by 0.38% (p < 0.001). No changes were found in a representative subgroup of infants with regard to neurodevelopmental scores (mental developmental index and psychomotor developmental index) or in parent survey data (non-verbal cognition scale and language development scale). CONCLUSION Increasing rates of stillbirths and decreasing preterm births in Germany were observed. Existing networks might stabilise neurodevelopment of preterm infants during the COVID-19 pandemic.
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Affiliation(s)
- M Lau
- Department of Paediatrics, University Hospital of Schleswig-Holstein, University of Lübeck, Lübeck, Germany
| | - V Kraus
- Chair of Social Paediatrics, School of Medicine of the Technical University of Munich, Munich, Germany
- Pediatric Neurology, School of Medicine and Munich Municipal Hospital Group, Technical University of Munich, Munich, Germany
| | | | - T K Rausch
- Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany
| | - M Krüger
- Neonatology, Munich Municipal Hospital Group, Munich, Germany
| | - W Göpel
- Department of Paediatrics, University Hospital of Schleswig-Holstein, University of Lübeck, Lübeck, Germany
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6
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Mihajlovic S, Nikolic D, Milicic B, Santric-Milicevic M, Glushkova N, Nurgalieva Z, Lackovic M. Association of Pre-Pregnancy Obesity and COVID-19 with Poor Pregnancy Outcome. J Clin Med 2023; 12:jcm12082936. [PMID: 37109271 PMCID: PMC10144693 DOI: 10.3390/jcm12082936] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND AND OBJECTIVES During the COVID-19 pandemic, a possible overlap of obesity and COVID-19 infection has raised concerns among patients and healthcare professionals about protecting pregnant women from developing a severe infection and unwanted pregnancy outcomes. The aim of this study was to evaluate the associations of body mass index with clinical, laboratory, and radiology diagnostic parameters as well as pregnancy complications and maternal outcomes in pregnant patients with COVID-19. MATERIALS AND METHODS Clinical status, laboratory, and radiology diagnostic parameters and pregnancy outcomes were analyzed for pregnant women hospitalized between March 2020 and November 2021 in one tertiary-level university clinic in Belgrade, Serbia, due to infection with SARS-CoV-2. Pregnant women were divided into the three sub-groups according to their pre-pregnancy body mass index. For testing the differences between groups, a two-sided p-value <0.05 (the Kruskal-Wallis and ANOVA tests) was considered statistically significant. RESULTS Out of 192 hospitalized pregnant women, obese pregnant women had extended hospitalizations, including ICU duration, and they were more likely to develop multi-organ failure, pulmonary embolism, and drug-resistant nosocomial infection. Higher maternal mortality rates, as well as poor pregnancy outcomes, were also more likely to occur in the obese group of pregnant women. Overweight and obese pregnant women were more likely to develop gestational hypertension, and they had a higher grade of placental maturity. CONCLUSIONS Obese pregnant women hospitalized due to COVID-19 infection were more likely to develop severe complications.
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Affiliation(s)
- Sladjana Mihajlovic
- University Hospital "Dragisa Misovic", Heroja Milana Tepica 1, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Dejan Nikolic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Department of Physical Medicine and Rehabilitation, University Children's Hospital, 11000 Belgrade, Serbia
| | - Biljana Milicic
- Department of Medical Statistics and Informatics, School of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milena Santric-Milicevic
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center-School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Natalya Glushkova
- Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty 050044, Kazakhstan
| | - Zhansaya Nurgalieva
- Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty 050044, Kazakhstan
| | - Milan Lackovic
- University Hospital "Dragisa Misovic", Heroja Milana Tepica 1, 11000 Belgrade, Serbia
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Yao X, Zhu L, Yin J, Wen J. Impacts of COVID-19 pandemic on preterm birth: a systematic review and meta-analysis. Public Health 2022; 213:127-134. [PMID: 36410118 PMCID: PMC9579188 DOI: 10.1016/j.puhe.2022.10.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The COVID-19 pandemic has significantly affected healthcare systems and daily well-being. However, the reports of the indirect impacts of the pandemic on preterm birth remain conflicting. We performed a meta-analysis to examine whether the pandemic altered the risk of preterm birth. STUDY DESIGN This was a systematic review and meta-analysis of the previous literature. METHODS We searched MEDLINE and Embase databases until March 2022 using appropriate keywords and extracted 63 eligible studies that compared preterm between the COVID-19 pandemic period and the prepandemic period. A random effects model was used to obtain the pooled odds of each outcome. The study protocol was registered with PROSPERO (No. CRD42022326717). RESULTS The search identified 3827 studies, of which 63 reports were included. A total of 3,220,370 pregnancies during the COVID-19 pandemic period and 6,122,615 pregnancies during the prepandemic period were studied. Compared with the prepandemic period, we identified a significant decreased odds of preterm birth (PTB; <37 weeks' gestation; pooled odds ratio [OR; 95% confidence interval (CI)] = 0.96 [0.94, 0.98]; I2 = 78.7%; 62 studies) and extremely PTB (<28 weeks' gestation; pooled OR [95% CI] = 0.92 [0.87, 0.97]; I2 = 26.4%; 25 studies) during the pandemic, whereas there was only a borderline significant reduction in the odds of very PTB (<32 weeks' gestation; pooled OR [95% CI] = 0.93 [0.86, 1.01]; I2 = 90.1%; 33 studies) between the two periods. There was significant publication bias for PTB. CONCLUSION Pooled results suggested the COVID-19 pandemic was associated with preterm birth, although there was only a borderline significant reduction for very PTB during the pandemic compared with the prepandemic period. Large studies showed conflicting results, and further research on whether the change is related to pandemic mitigation measures was warranted.
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Affiliation(s)
- X.D. Yao
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - L.J. Zhu
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - J. Yin
- Department of Neonatology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China,Corresponding author
| | - J. Wen
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China,Corresponding author
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8
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Magnus MC, Oakley LL, Hansen AV, Örtqvist AK, Petersen TG, Mortensen LH, Bliddal M, Andersen AMN, Stephansson O, Håberg SE. Fetal death after the introduction of COVID-19 mitigation measures in Sweden, Denmark and Norway: a registry-based study. Sci Rep 2022; 12:20625. [PMID: 36450919 PMCID: PMC9709372 DOI: 10.1038/s41598-022-25036-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
It remains unclear whether the rate of fetal death has changed during the COVID-19 pandemic. We assessed the impact of COVID-19 mitigation measures on fetal death in Sweden (449,347 births), Denmark (290,857 pregnancies) and Norway (261,057 pregnancies) using robust population-based registry data. We used Cox regression to assess the impact of the implementation of pandemic mitigation measures on March 12th, 2020, on miscarriage (fetal loss before gestational week 22) and stillbirth (fetal loss after gestational week 22). A total of 11% of 551,914 pregnancies in Denmark and Norway ended in miscarriage, while the proportion of stillbirths among 937,174 births across the three countries was 0.3%. There was no difference in the risk of fetal death during the year following pandemic mitigation measures. For miscarriage, the combined hazard ratio (HR) for Norway and Denmark was 1.01 (95% CI 0.98, 1.03), and for stillbirth, the combined HR for all three countries was 0.99 (95% CI 0.89, 1.09). We observed a slightly decreased risk of miscarriage during the first 4 months, with an HR of 0.94 (95% CI 0.90, 0.99) after lockdown. In conclusion, the risk of fetal death did not change after the implementation of COVID-19 pandemic mitigation measures in the three Scandinavian countries.
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Affiliation(s)
- Maria C. Magnus
- grid.418193.60000 0001 1541 4204Centre for Fertility and Health, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway
| | - Laura L. Oakley
- grid.418193.60000 0001 1541 4204Centre for Fertility and Health, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway ,grid.8991.90000 0004 0425 469XDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Anne V. Hansen
- grid.5254.60000 0001 0674 042XDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark ,grid.437930.a0000 0001 2248 6353Statistics Denmark, Copenhagen, Denmark
| | - Anne K. Örtqvist
- grid.4714.60000 0004 1937 0626Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden ,Department of Obstetrics and Gynaecology, Visby County Hospital, Visby, Sweden
| | - Tanja G. Petersen
- grid.7143.10000 0004 0512 5013Open, Odense University Hospital, Odense, Denmark
| | - Laust H. Mortensen
- grid.5254.60000 0001 0674 042XDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark ,grid.437930.a0000 0001 2248 6353Statistics Denmark, Copenhagen, Denmark
| | - Mette Bliddal
- grid.10825.3e0000 0001 0728 0170OPEN, University of Southern Denmark, Odense, Denmark ,grid.10825.3e0000 0001 0728 0170Clinical Pharmacology, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Anne-Marie Nybo Andersen
- grid.5254.60000 0001 0674 042XDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Olof Stephansson
- grid.4714.60000 0004 1937 0626Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Department of Women’s Health, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Siri E. Håberg
- grid.418193.60000 0001 1541 4204Centre for Fertility and Health, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway
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9
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Vivanti AJ, Fesquet S, Gabriel D, Letourneau A, Crenn-Hebert C, De Luca D, Bouyer J, Novelli S, Benachi A, Veil R. Impact of the 1st Wave of the COVID-19 Pandemic and Lockdown on In Utero Transfer Activity in the Paris Area, France. J Clin Med 2022; 11:jcm11164850. [PMID: 36013088 PMCID: PMC9410163 DOI: 10.3390/jcm11164850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background: To assess changes in the number and profile of in utero transfer requests during the first lockdown. Methods: An observational, retrospective, cohort study. All pregnant women, from the Paris area (France), for whom a request for in utero transfer to the transfer unit was made during the first lockdown in France (from 17 March to 10 May 2020) or during a mirror period (years 2016 to 2019) were included. We compared the numbers and proportions of various indications for in utero transfer, the rates of in utero transfer acceptance and the proportion of outborn deliveries. Results: 206 transfer requests were made during the lockdown versus 227, 236, 204 and 228 in 2016, 2017, 2018 and 2019, respectively. The relative proportion of requests for threatened preterm births and for fetal growth restriction decreased from 45% in the mirror period to 37% and from 8 to 3%, respectively. The transfer acceptance rates and outborn deliveries did not differ between time periods. Conclusions: Although a reduction in in utero transfer requests was observed for certain indications, the first lockdown was not associated with a decrease in acceptance rates nor in an increase in outborn births of pregnancies with a high risk of prematurity in the Paris area.
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Affiliation(s)
- Alexandre J. Vivanti
- Division of Obstetrics and Gynecology, DMU Santé des Femmes et des Nouveau-Nés, Antoine Béclère Hospital, Paris Saclay University, AP-HP, 92140 Clamart, France
- Groupe de Recherche sur les Infections pendant la Grossesse (GRIG), 75000 Paris, France
- Correspondence: ; Tel.: +33-145-374-441
| | - Stanislas Fesquet
- Division of Obstetrics and Gynecology, DMU Santé des Femmes et des Nouveau-Nés, Antoine Béclère Hospital, Paris Saclay University, AP-HP, 92140 Clamart, France
| | - Diane Gabriel
- Epidemiology and Public Health Department, Bicêtre Hospital, Paris Saclay University, AP-HP, 94270 Le Kremlin Bicêtre, France
| | - Alexandra Letourneau
- Division of Obstetrics and Gynecology, DMU Santé des Femmes et des Nouveau-Nés, Antoine Béclère Hospital, Paris Saclay University, AP-HP, 92140 Clamart, France
| | - Catherine Crenn-Hebert
- Perinat-ARS-IDF, Regional Health Agency of Ile-de-France (ARS-IDF), 93200 Saint-Denis, France
- Division of Obstetrics and Gynecology, Louis Mourier Hospital, AP-HP, 92025 Colombes, France
| | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, DMU Santé des Femmes et des Nouveau-Nés, Antoine Béclère Hospital, Paris Saclay University, AP-HP, 92140 Clamart, France
| | - Jean Bouyer
- CESP, Inserm, UVSQ, Université Paris-Saclay, 94807 Villejuif, France
| | - Sophie Novelli
- CESP, Inserm, UVSQ, Université Paris-Saclay, 94807 Villejuif, France
| | - Alexandra Benachi
- Division of Obstetrics and Gynecology, DMU Santé des Femmes et des Nouveau-Nés, Antoine Béclère Hospital, Paris Saclay University, AP-HP, 92140 Clamart, France
| | - Raphaël Veil
- Epidemiology and Public Health Department, Bicêtre Hospital, Paris Saclay University, AP-HP, 94270 Le Kremlin Bicêtre, France
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10
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Salerno C, Donno V, Melis B, Perrone E, Menichini D, Facchinetti F, Monari F. Stillbirth occurrence during COVID-19 pandemic: a population-based prospective study. J Perinat Med 2022; 50:653-659. [PMID: 35671748 DOI: 10.1515/jpm-2022-0129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/23/2022] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Data collected worldwide on stillbirth (SB) rates during the Covid-19 pandemic are contradictory. Variations may be due to methodological differences or population characteristics. The aim of the study is to assess the changes in SB rate, risk factors, causes of death and quality of antenatal care during the pandemic compared to the control periods. METHODS This prospective study is based on the information collected by the Emilia-Romagna Surveillance system database. We conducted a descriptive analysis of SB rate, risk factors, causes of death and quality of cares, comparing data of the pandemic (March 2020-June 2021) with the 16 months before. RESULTS During the pandemic, the SB rate was 3.45/1,000 births, a value in line with the rates of previous control periods. Neonatal weight >90th centile was the only risk factor for SB that significantly changed during the pandemic (2.2% vs. 8.0%; p-value: 0.024). No significant differences were found in the distribution of the causes of death groups. Concerning quality of antenatal cares, cases evaluated with suboptimal care (5.2%) did not change significantly compared to the control period (12.0%), as well as the cases with less than recommended obstetric (12.6% vs. 14%) and ultrasound evaluations (0% vs. 2.7%). CONCLUSIONS During the COVID-19 pandemic, no significant differences in SB rates were found in an area that maintained an adequate level of antenatal care. Thus, eventual associations between SB rate and the COVID-19 infection are explained by an indirect impact of the virus, rather than its direct effect.
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Affiliation(s)
- Cristina Salerno
- Obstetrics and Gynecology Unit, Mother-Infant and Adult Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Valeria Donno
- Obstetrics and Gynecology Unit, Mother-Infant and Adult Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Beatrice Melis
- Obstetrics and Gynecology Unit, Mother-Infant and Adult Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Enrica Perrone
- International Doctorate School in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniela Menichini
- Primary Care Service, Regional Health Authority of Emilia-Romagna, Bologna, Italy
| | - Fabio Facchinetti
- Obstetrics and Gynecology Unit, Mother-Infant and Adult Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesca Monari
- Obstetrics and Gynecology Unit, Mother-Infant and Adult Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
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11
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Epidemiology of Antepartum Stillbirths in Austria-A Population-Based Study between 2008 and 2020. J Clin Med 2021; 10:jcm10245828. [PMID: 34945123 PMCID: PMC8709287 DOI: 10.3390/jcm10245828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Across Europe, the incidence of antepartum stillbirth varies greatly, partly because of heterogeneous definitions regarding gestational weeks and differences in legislation. With this study, we sought to provide a comprehensive overview on the demographics of antepartum stillbirth in Austria, defined as non-iatrogenic fetal demise ≥22+0 gestational weeks (/40). (2) Methods: We conducted a population-based study on epidemiological characteristics of singleton antepartum stillbirth in Austria between January 2008 and December 2020. Data were derived from the validated Austrian Birth Registry. (3) Results: From January 2008 through December 2020, the antepartum stillbirth rate ≥20+0/40 was 3.10, ≥22+0/40 3.14, and ≥24+0/40 2.83 per 1000 births in Austria. The highest incidence was recorded in the federal states of Vienna, Styria, and Lower and Upper Austria, contributing to 71.9% of all stillbirths in the country. In the last decade, significant fluctuations in incidence were noted: from 2011 to 2012, the rate significantly declined from 3.40 to 3.07‰, whilst it significantly increased from 2.76 to 3.49‰ between 2019 and 2020. The median gestational age of antepartum stillbirth in Austria was 33+0 (27+2–37+4) weeks. Stillbirth rates ≤26/40 ranged from 164.98 to 334.18‰, whilst the lowest rates of 0.58–8.4‰ were observed ≥36/40. The main demographic risk factors were maternal obesity and low parity. (4) Conclusions: In Austria, the antepartum stillbirth rate has remained relatively stable at 2.83–3.10 per 1000 births for the last decade, despite a significant decline in 2012 and an increase in 2020.
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