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Foster HS, Forkpa M, Van Tienhoven XA, Schwartz N, Srinivas S, Parry S, Mccabe MG. Are Neonatal Birth Weights Reduced in Low-Risk Patients Diagnosed with COVID-19 during Pregnancy? Am J Perinatol 2024. [PMID: 38955216 DOI: 10.1055/a-2358-9710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
OBJECTIVE Studies have shown that the 2019 novel coronavirus disease (COVID-19) may be associated with an increased risk of adverse pregnancy outcomes including preeclampsia, preterm birth, and stillbirth. However, the relationship between COVID-19 and abnormal fetal growth (i.e., low neonatal birth weight) has not been elucidated. Because other viruses affect fetal growth, obstetrical providers began to recommend ultrasound studies during the third trimester to assess fetal growth in patients with COVID-19 during pregnancy. The aim of this study was to determine if neonatal birth weight was different between low-risk patients diagnosed with COVID-19 during pregnancy and low-risk patients without COVID-19 in pregnancy, to ascertain if third trimester growth ultrasound is warranted in this patient population. STUDY DESIGN We performed a retrospective cohort study of low-risk pregnant patients (who had no other indications for sonographic fetal surveillance during the third trimester) with and without COVID-19 during pregnancy. Patient demographics, gestational dating, neonatal birth weights, and corresponding Alexander growth curve birth weight percentiles were collected. The primary outcome was small-for-gestational age (SGA) neonates, defined as birth weight < 10th percentile for gestational age at delivery (SGA10). RESULTS Our cohort (N = 513) included 248 COVID-19-exposed patients and 265 patients who did not have COVID-19 during pregnancy. Gestational age at delivery and average neonatal birth weights were similar in COVID-19-exposed (38 weeks 5 days, 3,266 g) and unexposed patients (38 weeks 4 days, 3,224 g; p = 0.434, 0.358). Rates of SGA10 neonates were similar in the COVID-19-exposed (22/248, 8.9%) and -unexposed (23/265, 8.7%, p = 0.939) groups. Timing and severity of COVID-19 during pregnancy also were not associated with rates of SGA neonates. CONCLUSION In a cohort of low-risk patients, rates of SGA neonates were similar in patients with and without COVID-19 during pregnancy. These findings suggest that ultrasound surveillance to detect fetal growth restriction in low-risk patients with COVID-19 during pregnancy is not warranted. KEY POINTS · COVID-19 may be associated with fetal growth restriction.. · There are normal infant weights in patients with COVID-19 in pregnancy.. · Growth ultrasound is not needed in patients with COVID-19..
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Affiliation(s)
- Hannah S Foster
- Department of Maternal Fetal Medicine, Pregnancy and Perinatal Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Markolline Forkpa
- Department of Maternal Fetal Medicine, Pregnancy and Perinatal Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Nadav Schwartz
- Department of Maternal Fetal Medicine, Pregnancy and Perinatal Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sindhu Srinivas
- Department of Maternal Fetal Medicine, Pregnancy and Perinatal Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Samuel Parry
- Department of Maternal Fetal Medicine, Pregnancy and Perinatal Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Meaghan G Mccabe
- Department of Maternal Fetal Medicine, Pregnancy and Perinatal Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
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Abdelwahab M, Voest JAD, Metz TD, Hughes BL, Grobman WA, Saade GR, Manuck TA, Longo M, Simhan HN, Rouse DJ, Mendez-Figueroa H, Gyamfi-Bannerman C, Bailit JL, Costantine MM, Sehdev HM, Tita ATN. Gestational Weight Gain and Neonatal Biometry during the COVID-19 Pandemic: A Multicenter Observational Cohort. Am J Perinatol 2024. [PMID: 38810962 DOI: 10.1055/a-2335-2480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
OBJECTIVE This study aimed to test the hypothesis that being pregnant and delivering during the coronavirus disease 2019 (COVID-19) pandemic was associated with changes in gestational weight gain (GWG) or frequency of small- (SGA) or large-for-gestational-age (LGA) neonates. STUDY DESIGN Secondary analysis of a multicenter observational cohort comparing pregnant people who delivered during the COVID-19 pandemic (June-December 2020) to people who delivered prior to the pandemic (March-December 2019). Those with multiple gestations, fetuses with major congenital anomalies, implausible GWG values, unavailable body mass index (BMI), or who were severe acute respiratory syndrome coronavirus-2-positive were excluded. The primary outcome was frequency of optimal recommended GWG based on prepregnancy BMI. Neonatal outcomes included birth weight, ponderal index, and frequency of SGA, LGA, and small head circumference for live births. Multivariable regression analysis was used to assess associations between exposure to the pandemic and outcomes. RESULTS A total of 10,717 pregnant people were included in our analysis. A total of 4,225 pregnant people were exposed to the pandemic and 6,492 pregnant people delivered prior to the COVID-19 pandemic. Pregnant people exposed to the pandemic were older and more likely to have gestational diabetes. The frequency of appropriate GWG was 28.0% during the pandemic and 27.6% before the pandemic (adjusted odds ratio [aOR]: 1.02, 95% confidence interval [CI]: 0.93-1.11). Excessive GWG was more likely (54.9 vs. 53.1%; aOR: 1.08, 95% CI: 1.001-1.17), and inadequate GWG was less likely during the pandemic (17.0 vs. 19.3%; aOR: 0.86, 95% CI: 0.77-0.95). The frequency of SGA was 5.4% during the pandemic and 6.1% before the pandemic (aOR: 0.90, 95% CI: 0.76-1.06), and the frequency of LGA was 16.0% during the pandemic versus 15.0% before the pandemic (aOR: 1.06, 95% CI: 0.95-1.18). Other neonatal outcomes including birth weight percentile (62.1 [35.8-83.2] vs. 60.2 [34.4-82.2]; adjusted mean difference (aMD) = 1.50, 95% CI: -0.28 to 3.29), ponderal index (2.6 g/cm3 [2.4-2.8] in both groups; aMD = 0.01, 95% CI: 0.00-0.02), and small head circumference for livebirths (<10th percentile [8.2 vs. 8.1%; aOR: 1.03, 95% CI: 0.89-1.19], <3rd percentile [3.5 vs. 3.1%; aOR: 1.16, 95% CI: 0.93-1.44]) were similar between groups as well. CONCLUSION Being pregnant and delivering during the COVID-19 pandemic was associated with a higher likelihood of excessive GWG and a lower likelihood of inadequate GWG. KEY POINTS · Delivering during the COVID-19 pandemic was associated with higher likelihood of excessive GWG.. · Delivering during the COVID-19 pandemic was associated with lower likelihood of inadequate GWG.. · COVID-19 pandemic was not associated with changes in frequency of SGA or LGA..
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Affiliation(s)
- Mahmoud Abdelwahab
- Departments of Obstetrics and Gynecology of The Ohio State University, Columbus, Ohio
| | - Jessica A de Voest
- The George Washington University Biostatistics Center, Washington, District of Columbia
| | - Torri D Metz
- Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Brenna L Hughes
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - William A Grobman
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois
| | - George R Saade
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Tracy A Manuck
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Monica Longo
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Hyagriv N Simhan
- Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Dwight J Rouse
- Department of Obstetrics and Gynecology, Brown University, Providence, Rhode Island
| | - Hector Mendez-Figueroa
- Department of Obstetrics and Gynecology, University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas
| | | | - Jennifer L Bailit
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Maged M Costantine
- Departments of Obstetrics and Gynecology of The Ohio State University, Columbus, Ohio
| | - Harish M Sehdev
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alan T N Tita
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
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Kumar S, Hill C, Halliday TJ. Effects of COVID-19 pandemic on low birth weight in a nationwide study in India. COMMUNICATIONS MEDICINE 2024; 4:118. [PMID: 38877222 PMCID: PMC11178855 DOI: 10.1038/s43856-024-00545-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/05/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Among newborns, those born in India have the highest prevalence of low birth weight (LBW). The COVID-19 pandemic exacerbated the risk factors for LBW. This study examined whether birth outcomes deteriorated during the pandemic period compared to those during the pre-pandemic period. METHODS This cross-sectional study included nationally representative data on 198,203 infants. Multivariate ordinary least square and logistic regression models with district fixed effects were fitted to compare the birth outcomes in the pandemic period (April 2020-April 2021) and the pre-pandemic period (July 2014-December 2019). Regression models were adjusted for covariates-gender and birth order of the child, mother's age and education, rural residence, religion, caste, and household wealth. RESULTS The pandemic cohort includes 11,851 infants (5.8%), while the pre-pandemic cohort includes 192,764 infants (94.2%). The LBW prevalence rate is 20% in the pandemic cohort and 17% in the pre-pandemic cohort. The covariate-adjusted model shows significant differences in birth weight (11 grams) and LBW (aOR: 1.08; 95% CI: 1.03-1.14) between the pandemic and pre-pandemic cohorts. CONCLUSIONS Our findings show that babies born during the COVID-19 pandemic are more likely to be LBW. The subgroup analyses indicate significant differences by religion but not by maternal education, caste, and wealth group.
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Affiliation(s)
- Santosh Kumar
- Keough School of Global Affairs, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Clare Hill
- Keough School of Global Affairs, University of Notre Dame, Notre Dame, IN, 46556, USA
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Collins-Smith A, Prasannan L, Shan W, Dori E, Katzow M, Blitz MJ. Effect of Lockdown Period of COVID-19 Pandemic on Maternal Weight Gain, Gestational Diabetes, and Newborn Birth Weight. Am J Perinatol 2024; 41:e584-e593. [PMID: 35973792 PMCID: PMC10243366 DOI: 10.1055/a-1925-1347] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE This study aimed to determine whether the lockdown period of the initial novel coronavirus disease 2019 (COVID-19) surge in New York affected gestational weight gain (GWG), newborn birth weight (BW), and the frequency of gestational diabetes mellitus (GDM). Maternal and newborn outcomes during the first wave of the pandemic were compared with those during the same timeframe in the previous 2 years. STUDY DESIGN Retrospective cross-sectional study of all live singleton term deliveries from April 1 to July 31 between 2018 and 2020 at seven hospitals within a large academic health system in New York. Patients were excluded for missing data on: BW, GWG, prepregnancy body mass index, and gestational age at delivery. We compared GWG, GDM, and BW during the pandemic period (April-July 2020) with the same months in 2018 and 2019 (prepandemic) to account for seasonality. Linear regression was used to model the continuous outcomes of GWG and BW. Logistic regression was used to model the binary outcome of GDM. RESULTS A total of 20,548 patients were included in the study: 6,672 delivered during the pandemic period and 13,876 delivered during the prepandemic period. On regression analysis, after adjustment for study epoch and patient characteristics, the pandemic period was associated with lower GWG (β = -0.46, 95% confidence interval [CI]: -0.87 to -0.05), more GDM (adjusted odds ratio [aOR] = 1.24, 95% CI: 1.10-1.39), and no change in newborn BW (β = 0.03, 95% CI: -11.7 to 11.8) compared with the referent period. The largest increases in GDM between the two study epochs were noted in patients who identified as Hispanic (8.6 vs. 6.0%; p < 0.005) and multiracial/other (11.8 vs. 7.0%; p < 0.001). CONCLUSION The lockdown period of the pandemic was associated with a decrease in GWG and increase in GDM. Not all groups were affected equally. Hispanic and multiracial patients experienced a larger percentage change in GDM compared with non-Hispanic white patients. KEY POINTS · The COVID-19 lockdown was associated with decreased GWG and increased GDM.. · No change in newborn BW was seen during the lockdown.. · Overall, the lockdown did not have a large clinical effect on these pregnancy outcomes..
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Affiliation(s)
- Ana Collins-Smith
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Lakha Prasannan
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Weiwei Shan
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Ezra Dori
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Michelle Katzow
- Department of Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
- Department of Research, Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
| | - Matthew J. Blitz
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
- Department of Research, Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
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Bajaj M, Romero R, Myers L, Duncan J, Yeo L, Jani S, Natarajan G. Population-Level Study on Fetal Deaths and Preterm Births during SARS-CoV-2 Pandemic in the State of Michigan. Am J Perinatol 2024; 41:e236-e248. [PMID: 35709722 PMCID: PMC10065952 DOI: 10.1055/a-1878-0503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE The aim of the study is to explore the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on preterm birth at different gestational ages and fetal death in the state of Michigan. STUDY DESIGN Data on live births and fetal deaths in the state of Michigan from March to November in the years 2017 through 2020 were obtained from Michigan Department of Health and Human Services (MDHHS). Preterm birth rate, fetal death rate (per 1,000 live births) overall and stratified by race and maternal comorbidities during the period of pandemic (March-November 2020) were compared with the same period (March-November) in the prepandemic years (2017-2019). RESULTS Of 328,879 live births and 1,470 fetal deaths during the study period, 77,983 live births and 242 fetal deaths were reported in 2020. Compared with prepandemic years, fetal death rate per 1,000 live births was significantly lower in 2020 (3.1 vs. 4.7 [2017], 5.2 [2018], 4.4 [2019], p-value <0.001). The adjusted risk for fetal death in 2020 was decreased (odds ratio [OR] = 0.64 [95% confidence interval (CI): 0.56-0.74], p <0.0001), compared with prepandemic years. Fetal death was significantly associated with African-American race, pregnancy hypertension and prepregnancy diabetes. No significant difference in the proportion of preterm births (<37 weeks' gestation) was noted between pandemic and prepandemic years (9.9 vs. 10.0%, p = 0.50). There was no significant difference in the risk of preterm birth across gestational age strata (<28, 28-316/7, 32-366/7, 37-416/7, and >42 weeks) between pandemic and prepandemic years on multinomial analysis. Significant associations with preterm birth across all years included African American race, lower level of maternal education, pregnancy-induced hypertension, chronic hypertension, prepregnancy diabetes, congenital anomalies, previous preterm birth, and prolonged rupture of membranes >12 hours. CONCLUSION Fetal death rate was significantly lower whereas preterm births remained unchanged during pandemic in comparison with prepandemic years in the state of Michigan. KEY POINTS · A decrease in fetal death rate was noted during SARS CoV-2 pandemic in the State of Michigan.. · Overall state-wide rates of preterm birth did not change in 2020, compared to previous years.. · Significant risk factors associated with preterm birth and fetal deaths did not differ between prepandemic and pandemic years..
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Affiliation(s)
- Monika Bajaj
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Central Michigan University, Children's Hospital of Michigan and Hutzel Women's Hospital, Detroit, Michigan
| | - Roberto Romero
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, Michigan
- Detroit Medical Center, Detroit, Michigan
| | - Lindsey Myers
- Division for Vital Records and Health Statistics, Department of Health and Human Services, Lansing, Michigan
| | - Jeffrey Duncan
- Division for Vital Records and Health Statistics, Department of Health and Human Services, Lansing, Michigan
| | - Lami Yeo
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan
| | - Sanket Jani
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Central Michigan University, Children's Hospital of Michigan and Hutzel Women's Hospital, Detroit, Michigan
| | - Girija Natarajan
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Central Michigan University, Children's Hospital of Michigan and Hutzel Women's Hospital, Detroit, Michigan
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Asumadu ODK, Boah M, Chirawurah D, Ndago JA, Yakong VN, Kanligi DA, Adokiya MN. Pregnancy outcomes before and during COVID-19 pandemic in Tamale Metropolis, Ghana: A retrospective cohort study. PLoS One 2024; 19:e0302589. [PMID: 38687775 PMCID: PMC11060567 DOI: 10.1371/journal.pone.0302589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 04/08/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic affected expectant mothers seeking maternal health services in most developing countries. Access and utilization of maternal health services including antenatal care (ANC) attendance and skilled delivery declined drastically resulting in adverse pregnancy outcomes. This study assessed pregnancy outcomes before and during COVID-19 pandemic in Tamale Metropolis, Ghana. METHODS/DESIGN A retrospective cohort study design was employed. A random sampling technique was used to select 450 women who delivered before or during the COVID-19 pandemic in Tamale Metropolis, Ghana. The respondents were interviewed using structured questionnaire at their homes. In this study, the data collected were socio-demographics characteristics, ANC attendance, before or during pandemic delivery, place of delivery and birth outcomes. Chi-square test and bivariate logistic regression analyses were performed under significant level of 0.05 to determine factors associated with the outcome variables. RESULT Of the 450 respondents, 51.8% were between 26 and 30 years of age. More than half (52.2%) of the respondents had no formal education and 93.3% were married. The majority (60.4%) of the respondents described their residence as urban setting. About 31.6% of the women delivered before the pandemic. The COVID-19 pandemic influenced place of delivery. The proportion of women who attended at least one ANC visit (84.5% before vs 70.5% during), and delivered at a hospital (76.8% before vs 72.4% during) were higher before the pandemic. More women were likely to deliver at home during COVID-19 (OR: 2.38, 95%CI: 1.52-3.74, p<0.001). Similarly, there was statistically significance difference between before and during COVID-19 delivery on at least one ANC attendance (OR: 2.72, 95%CI: 1.58-1.67, p<0.001). Women who delivered during COVID-19 were about twice more likely to develop complications (OR: 1.72, 95%CI: 1.03-2.87, p = 0.04). CONCLUSION ANC attendance and health facility delivery decreased while pregnancy complications increased during COVID-19. During disease outbreaks, outreach engagement strategies should be devised to increase access and utilization of maternal health services for marginalized and underserved populations. The capacity of health workers should be strengthened through skills training to manage adverse birth outcomes.
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Affiliation(s)
- Obed Duah Kwaku Asumadu
- Department of Social and Behavioural Change, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Michael Boah
- Department of Epidemiology, Biostatistics and Disease Control, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Dennis Chirawurah
- Department of Occupational and Environmental Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Joyce Aputere Ndago
- Department of Social and Behavioural Change, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Vida Nyagre Yakong
- Department of Preventive Health Nursing, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - David Abatanie Kanligi
- Pediatric Unit, Savelugu Municipal Hospital, Ghana Health Service, Tamale, Northern Region, Ghana
| | - Martin Nyaaba Adokiya
- Department of Epidemiology, Biostatistics and Disease Control, School of Public Health, University for Development Studies, Tamale, Ghana
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Kirchengast S, Fellner J, Haury J, Kraus M, Stadler A, Schöllauf T, Hartmann B. The Impact of Higher Than Recommended Gestational Weight Gain on Fetal Growth and Perinatal Risk Factors-The IOM Criteria Reconsidered. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:147. [PMID: 38397638 PMCID: PMC10887580 DOI: 10.3390/ijerph21020147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024]
Abstract
A too-high gestational weight gain, in combination with steadily increasing obesity rates among women of reproductive age, represents an enormous obstetrical problem, as obesity and high gestational weight gain are associated with enhanced fetal growth, low vital parameters, and increased cesarean section rates. This medical record-based study investigates the association patterns between too-low as well as too-high gestational weight gain, according to the 2009 Institute of Medicine (IOM) guidelines, and fetal growth, as well as birth mode and pregnancy outcome. The data of 11,755 singleton births that had taken place between 2010 and 2020 at the Public Clinic Donaustadt in Vienna, Austria, were analyzed. Birth weight, birth length, head circumference, APGAR scores, and pH values of the arterial umbilical cord blood described fetal growth as well as the vital parameters after birth. Gestational weight gain was classified as too low, recommended, or too high according to the different weight status categories of the IOM guidelines. Birth weight, birth length, and head circumference of the newborn were significantly increased (p < 0.001) among underweight, normal-weight, and overweight women who gained more weight than recommended. Among obese women, only birthweight was significantly (p < 0.001) higher among women who gained more weight than recommended. Furthermore, a too-high gestational weight gain was significantly associated with an increased risk of macrosomia and emergency cesarean sections among underweight, normal-weight, and overweight women, but not among obese ones. Obese and morbidly obese women experiencing excessive gestational weight gain showed no significantly increased risk of macrosomia or emergency cesarean section. However, among obese mothers, a too-low gestational weight gain reduced the risk of emergency cesarean sections significantly (p = 0.010). Consequently, the IOM recommendations for gestational weight gain fit only partly for pregnant women in Austria. In the case of obese and morbidly obese women, new guidelines for optimal pregnancy weight gain should be considered.
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Affiliation(s)
- Sylvia Kirchengast
- Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria (J.H.); (M.K.)
| | - Josef Fellner
- Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria (J.H.); (M.K.)
| | - Julia Haury
- Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria (J.H.); (M.K.)
| | - Magdalena Kraus
- Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria (J.H.); (M.K.)
| | - Antonia Stadler
- Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria (J.H.); (M.K.)
| | - Teresa Schöllauf
- Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria (J.H.); (M.K.)
| | - Beda Hartmann
- Department of Gynecology and Obstetrics, Clinic Donaustadt, 1030 Vienna, Austria;
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Chen Y, Fan J, Li X, Ye Y, Lv Y, Zheng S, Hu J, Pu Y, Liu T. Associations of COVID-19 lockdown with birth weight in China. Front Pediatr 2024; 12:1336108. [PMID: 38318453 PMCID: PMC10838992 DOI: 10.3389/fped.2024.1336108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/08/2024] [Indexed: 02/07/2024] Open
Abstract
Background During the special period of the global spread of COVID-19, pregnant women are sensitive groups to the impacts of COVID-19 epidemic. However, the effects of lockdown measures implemented in response to the COVID-19 on fetal birthweight remain unclear. Objectives This study investigated the associations of COVID-19 lockdown with birth weight in Chinese population. Methods We collected 730,153 data of participants from hospitals of five cities in the south of China, we defined the time period of level I response (1/23-2/24/2020) as level I lockdown, and women who were pregnant during level I lockdown as the exposure group. Women who were pregnant during the same calendar month from 2015 to 2019 were defined as the unexposed group. We quantitatively estimate the individual cumulative exposure dose by giving different weights to days with different emergency response levels. Generalized linear regression models were used to estimate the association between COVID-19 lockdown exposure with birth weight and risk of low birth weight (<2,500 g) and macrosomia (>4,000 g). Results The birth weight of the exposed group is heavier than the unexposed group (3,238.52 vs. 3,224.11 g: adjusted β = 24.39 g [95% CI: 21.88, 26.91 g]). The exposed group had a higher risk of macrosomia (2.8% vs. 2.6%; adjusted OR = 1.17 [95% CI: 1.12, 1.22]). More obvious associations were found between COVID-19 lockdown and macrosomia in women who experienced the lockdown in their early pregnancy. Women who experienced the lockdown at their 4-7 weeks of pregnancy showed statistically significant heavier birth weight than unexposed group (after adjustment): β = 1.28 (95% CI: 1.11, 1.46) g. We also observed a positive association between cumulative exposure dose of COVID-19 lockdown in all pregnant women and birth weight, after divided into four groups, Q1: β = 32.95 (95% CI: 28.16, 37.75) g; Q2: β = 18.88 (95% CI: 14.12, 23.64) g; Q3: β = 19.50 (95% CI: 14.73, 24.28) g; Q4: β = 21.82 (95% CI: 17.08, 26.56) g. However, there was no statistically significant difference in the risk of low birth weight between exposed and unexposed groups. Conclusions The COVID-19 lockdown measures were associated with a heavier birth weight and a higher risk of macrosomia. Early pregnancy periods may be a more susceptible exposure window for a heavier birth weight and a higher risk of macrosomia. We also observed a positive association between cumulative exposure dose of COVID-19 lockdown and birth weight. The government and health institutions should pay attention to the long-term health of the infants born during the COVID-19 lockdown period, and follow up these mothers and infants is necessary.
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Affiliation(s)
- Yumeng Chen
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jingjie Fan
- The Prevention and Health Care Department, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Xiaowei Li
- Department of Health Management, Dongguan Qingxi Hospital, Qingxi Town, Dongguan, China
| | - Yufeng Ye
- Radiological Department, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Yanyun Lv
- The Health Care Office of the Hospital Infection Department, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, China
| | - Suijin Zheng
- The Affiliated Houjie Hospital, Guangdong Medical University, Dongguan, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yudong Pu
- Precision Medicine Center, Dongguan Songshan Lake Central Hospital, Dongguan, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
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Li X, Yao X, Bai L, Lu R, Geng S, Ling X, Wen J, Hu L. Impacts of the COVID-19 pandemic on early pregnancy outcomes among women undergoing frozen-thawed embryo transfer: a retrospective cohort study. HUM FERTIL 2023; 26:1477-1484. [PMID: 37668066 DOI: 10.1080/14647273.2023.2251680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 06/27/2023] [Indexed: 09/06/2023]
Abstract
The effect of COVID-19 pandemic on early pregnancy outcomes among women undergoing frozen-thawed embryo transfer (FET) remains unclear. We aimed to evaluate whether early pregnancy outcomes were altered in patients undergoing FET during the pandemic. In this retrospective cohort study, women conceived through FET in 2016-2021 from two hospitals in China were included. The early pregnancy outcomes were compared using Logistic regression model, including biochemical pregnancy rate (BPR), clinical pregnancy rate (CPR), and early pregnancy loss rate (EPLR). A total of 16,669 (67.2%) and 6,113 (26.8%) FET cycles enrolled before and during the pandemic, respectively. Univariate analyses showed that women undergoing FET during the pandemic had significantly increased BPR (72.9% vs. 69.7%) and CPR (59.5% vs. 55.0%), and significantly decreased EPLR (13.7% vs. 16.7%) compared to pre-pandemic (all P < 0.001). Moreover, after adjustment, the results were in accordance with univariate analysis for CPR [adjusted OR (95%CI) = 1.08 (1.01-1.14)] and EPLR [adjusted OR (95%CI) = 0.82 (0.73-0.91)], while the statistical significance between BPR and the pandemic disappeared. In summary, women conceived by FET did not have a reduced possibility of clinical pregnancy and a higher risk of early pregnancy loss during the pandemic compared with the pre-pandemic.
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Affiliation(s)
- Xin Li
- Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Xiaodie Yao
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Lijing Bai
- Department of Reproduction, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
| | - Renjie Lu
- Department of Pharmacy, The Third People's Hospital of Changzhou, Changzhou, Jiangsu, China
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Shijie Geng
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Xiufeng Ling
- Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Juan Wen
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Lingmin Hu
- Department of Reproduction, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
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Benyamini Raischer H, Garmi G, Malchi D, Nachshon AA, Inbar S, Romano S, Salim R. Impact of COVID-19 mandatory lockdown on maternal gestational weight gain and neonatal macrosomia rate at an academic medical center in Israel. J Matern Fetal Neonatal Med 2023; 36:2204391. [PMID: 37127549 DOI: 10.1080/14767058.2023.2204391] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND In an effort to prevent the spread of coronavirus disease 2019 (COVID-19), governments restricted outdoor activities and imposed lockdown quarantine. This change in lifestyle probably affected individuals' eating habits and physical activity. OBJECTIVE To examine the effect of lockdown due to the COVID-19 pandemic on maternal antenatal weight gain, neonatal macrosomia, and other maternal and neonatal outcomes of women delivering at an academic medical center in Israel. METHOD A retrospective, two-period cohort study conducted at a university teaching medical center in Afula, Israel. The study period was between April and September 2020. This period signifies worsening in pandemic situations, during which citizens experienced strict prolonged lockdown measures. The parallel unexposed period (control period) was between April and September 2019. Singleton pregnancies delivered at >24 weeks were eligible. Primary outcome was incidence of macrosomia. Secondary outcomes included gestational weight gain, body mass index (BMI) at delivery, rates of gestational diabetes mellitus (GDM), mode of delivery, postpartum hemorrhage (PPH), and neonatal outcomes reflecting neonatal birth weight and condition at delivery. RESULTS A total of 4,765 women were included, 2,442 in the study group and 2,323 in the control group. The incidence of macrosomia was significantly higher in 2020 (6.2%) than in 2019 (4.9%), (p = .048; OR: 1.29; 95% CI: 1.002- 1.65). Women gained significantly more weight (median 1 kg more), weighed more at delivery (median 1 kg), and had higher BMI at delivery in 2020 compared with those in 2019 (p < .01). The incidence of GDM was 9.5% and 8.5% in the study and control groups respectively (p = .26; OR: 1.12; 95% CI: 0.92-1.37). Greater percentage of women did not perform the glucose challenge test in 2020 (9.9%) compared with those in 2019 (7.5%) (p = .003, OR: 1.36; 95% CI: 1.11-1.67). The incidence of any hypertension related to pregnancy was significantly higher in 2020 compared to 2019 (5.8% vs 4.4% respectively, (p = .042; OR: 1.32; 95% CI: 1.02-1.71). The proportion of women who smoked during pregnancy was also significantly higher in 2020 than in 2019 (5.1% vs 3.7%, respectively, p = .02; OR: 1.40; 95% CI: 1.06-1.86). Delivery mode did not differ, while the incidence of PPH was significantly higher in 2020 than in 2019 (5.6% vs 3.4%, respectively, p = .001; OR: 1.65; 95% CI: 1.25-2.19). Neonatal condition at delivery was comparable. CONCLUSION COVID-19-related lockdown was associated with the increased rate of macrosomic infants. This indirect effect of the pandemic is probably related to poorer maternal antenatal metabolic health status. Long-term consequences should be further examined.
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Affiliation(s)
| | - Gali Garmi
- Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Daniel Malchi
- Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel
| | | | - Shiri Inbar
- Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel
| | - Shabtai Romano
- Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Raed Salim
- Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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11
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Simbar M, Nazarpour S, Sheidaei A. Evaluation of pregnancy outcomes in mothers with COVID-19 infection: a systematic review and meta-analysis. J OBSTET GYNAECOL 2023; 43:2162867. [PMID: 36651606 DOI: 10.1080/01443615.2022.2162867] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Pregnant women are one of the endangered groups who need special attention in the COVID-19 epidemic. We conducted a systematic review and summarised the studies that reported adverse pregnancy outcomes in pregnant women with COVID-19 infection. A literature search was performed in PubMed and Scopus up to 1 September 2022, for retrieving original articles published in the English language assessing the association between COVID-19 infection and adverse pregnancy outcomes. Finally, in this review study, of 1790 articles obtained in the initial search, 141 eligible studies including 1,843,278 pregnant women were reviewed. We also performed a meta-analysis of a total of 74 cohort and case-control studies. In this meta-analysis, both fixed and random effect models were used. Publication bias was also assessed by Egger's test and the trim and fill method was conducted in case of a significant result, to adjust the bias. The result of the meta-analysis showed that the pooled prevalence of preterm delivery, maternal mortality, NICU admission and neonatal death in the group with COVID-19 infection was significantly more than those without COVID-19 infection (p<.01). A meta-regression was conducted using the income level of countries. COVID-19 infection during pregnancy may cause adverse pregnancy outcomes including of preterm delivery, maternal mortality, NICU admission and neonatal death. Pregnancy loss and SARS-CoV2 positive neonates in Lower middle income are higher than in High income. Vertical transmission from mother to foetus may occur, but its immediate and long-term effects on the newborn are unclear.
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Affiliation(s)
- Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sima Nazarpour
- Department of Midwifery, Varamin-Pishva Branch, Islamic Azad University, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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12
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Tessier B, Annesi-Maesano I, Cambonie G, Molinari N, Kalfa N. COVID-19 lockdown related to decrease in premature birth rate and increase in birth weight in metropolitan France. Front Pediatr 2023; 11:1223692. [PMID: 37744451 PMCID: PMC10513386 DOI: 10.3389/fped.2023.1223692] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/14/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction The worldwide rate of preterm birth (PTB) has been increasing over the last two decades. COVID-19 lockdowns provide a unique opportunity to assess the effects of socioenvironmental and lifestyle factors on premature birth and birth weight. We explored the effects of COVID-19 lockdowns on the PTB rate and birth weight at a nationwide scale in France until one year after their occurrence. Material and Methods This national retrospective observational study evaluated the rate of PTB and birth weight in France from January 2016 to December 2020. Data were obtained from the national Programme Médicalisé des Systèmes d'Information database. The rates of global and sub-categories of PTB were tested. The birth weight was studied before and after lockdown for all live births, for term and premature neonates, and for each category of low birth weight (LBW) by a stratified analysis. Results Data from 2,949,372 births from January 2016 to December 2019, including 228,857 PTB, were compared to those of 699,344 births and 51,886 PTB from January to December 2020. The national rate of PTB decreased significantly from 7.7% to 7.3%, when compared with the 2016-2019 period. This decrease was persistent up to 9 months later. It was observed only for moderate PTB, whereas very PTB and extremely PTB remained stable. The national mean birth weight for full-term babies increased after the lockdown and was still observable up to 8 months later (+0.16%, p < 0.0001). The proportion of children with LBW also decreased 2 months after lockdown (-0.15%; p = 0.02). For VLBW, the difference only appeared over the 6-month post-lockdown period (-0.06%; p = 0.006). Conclusion This nationwide study shows a significant reduction in prematurity and a significant increase in birth weight in France after the lockdown for a period of time not limited to the lockdown itself. A more in-depth study of the factors determining these variations may help to drive PTB prevention policies.
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Affiliation(s)
- Benoit Tessier
- Department of Pediatric Surgery and Urology, Lapeyronie Hospital, CHU Montpellier—University of Montpellier, Montpellier, France
- Debrest Institute of Epidemiology and Public Health IDESP, UMR INSERM—University of Montpellier, Montpellier, France
| | - Isabella Annesi-Maesano
- Debrest Institute of Epidemiology and Public Health IDESP, UMR INSERM—University of Montpellier, Montpellier, France
| | - Gilles Cambonie
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, CHU Montpellier–University of Montpellier, Montpellier, France
| | - Nicolas Molinari
- Debrest Institute of Epidemiology and Public Health IDESP, UMR INSERM—University of Montpellier, Montpellier, France
- Department of Biostatistics and Medical Information, CHU Montpellier—University of Montpellier, Montpellier, France
| | - Nicolas Kalfa
- Department of Pediatric Surgery and Urology, Lapeyronie Hospital, CHU Montpellier—University of Montpellier, Montpellier, France
- Debrest Institute of Epidemiology and Public Health IDESP, UMR INSERM—University of Montpellier, Montpellier, France
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McPhail A, Hare ME, Talcott GW, Little MA, Bursac Z, Krukowski RA. Gestational Weight Gain During the COVID-19 Pandemic. Matern Child Health J 2023; 27:1454-1459. [PMID: 37289294 PMCID: PMC10248970 DOI: 10.1007/s10995-023-03730-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Healthy gestational weight gain (GWG) is associated with improved pregnancy and delivery outcomes. The COVID-19 pandemic changed eating behaviours and physical activity, and thus may have impacted GWG. This study examines the impact of the COVID-19 pandemic on GWG. METHODS Participants (N = 371, 86% of the larger study) were part of a study focused on GWG among TRICARE beneficiaries (i.e., active-duty military personnel and other beneficiaries). Participants were randomized to two treatment groups (GWG intervention (n = 149 pre-COVID and n = 98 during COVID), and usual care condition (n = 76 pre-COVID and n = 48 during COVID). GWG was calculated as the difference between screening weight and at 36 weeks gestation. Participants who delivered prior to the COVID-19 pandemic (March 1, 2020, N = 225) were compared to participants whose pregnancies occurred during the pandemic (N = 146). RESULTS We found no significant difference in GWG between those who delivered prior to the pandemic (11.2 ± 4.3 kg) and those whose pregnancies occurred during COVID-19 (10.6 ± 5.4 kg), with no effect of intervention arm. While excessive GWG was higher pre-COVID (62.8%) than during the pandemic (53.7%), this difference was not significant overall or by intervention arm. In addition, we found lower attrition during the pandemic (8.9%) than in the pre-COVID period (18.7%). DISCUSSION In contrast to prior research that indicated challenges with engaging in health behaviors during the COVID-19 pandemic, we found that women did not have increased GWG or higher odds of excessive GWG. This research contributes to our understanding of how the pandemic impacted pregnancy weight gain and engagement in research.
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Affiliation(s)
- Abby McPhail
- Department of Psychology, University of Memphis, Memphis, TN, USA
| | - Marion E Hare
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - G Wayne Talcott
- Wilford Hall Ambulatory Surgical Center, San Antonio, TX, USA
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Melissa A Little
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Zoran Bursac
- Department of Biostatistics, Florida International University, Miami, FL, USA
| | - Rebecca A Krukowski
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
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14
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Lee JY, Park J, Lee M, Han M, Jung I, Lim SM, Baek JY, Kang JM, Park MS, Ahn JG. The impact of non-pharmaceutical interventions on premature births during the COVID-19 pandemic: a nationwide observational study in Korea. Front Pediatr 2023; 11:1140556. [PMID: 37441577 PMCID: PMC10333519 DOI: 10.3389/fped.2023.1140556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Background Non-pharmaceutical interventions (NPIs), such as social distancing and hand washing, have been associated with a decline in the preterm birth rate worldwide. We aimed to evaluate whether the preterm birth rate in Korea during the coronavirus disease 2019 lockdown has changed compared to that in previous years. Method A birth registry from the Korea Statistical Information Service, which is a nationwide official database, was used to include all births claimed to have occurred between 2011 and 2020. Newborns with gestational age (GA) less than 22 weeks and birth weight less than 220 g were excluded. The pre-NPI period was designated as January 2011 to January 2020, and the NPI period was defined as February 2020 to December 2020. We assessed the effect of NPI on the incidence of prematurity per 100 births using an interrupted time-series quasi-experimental design and implementing an autoregressive integrated moving average (ARIMA) model. Results From 2011 to 2020, a total of 3,931,974 live births were registered, among which 11,416 were excluded. Consequently, the final study population included 3,920,558 live births (both singleton and multiple births) among which 275,009 (7.0%) were preterm. The preterm birth rate was significantly higher during the NPI period (8.68%) compared to that in the pre-NPI period (6.92%) (P < 0.001). The ARIMA model showed that in all singleton and multiple births, except those in July (observed 9.24, expected 8.54, [95% prediction interval {PI} 8.13-8.96], percent difference 7.81%), September (observed 7.89, expected 8.35, [95% PI 7.93-8.76], percent difference -5.66%), and December (observed 9.90, expected 9.40, [95% PI 8.98-9.82], percent difference 5.2%), most observed values were within the 95% PI of the expected values and showed an increasing trend. Conclusion In this nationwide observational study, the trend in premature birth rate did not significantly change due to NPI implementation in Korea, as it had been increasing since 2011. The trend of Korea's birth rate appears to be unaffected by the implementation of NPIs; however, further studies with a longer follow-up period are needed.
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Affiliation(s)
- Ji Young Lee
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Joonsik Park
- Division of Neonatology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myeongjee Lee
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minkyung Han
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Min Lim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jee Yeon Baek
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji-Man Kang
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute for Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Soo Park
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Division of Neonatology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Pharmaceutical Medicine and Regulatory Science, Yonsei University Graduate School, Seoul, Republic of Korea
- Department of Clinical Pharmacology, Severance Hospital, Seoul, Republic of Korea
| | - Jong Gyun Ahn
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute for Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, Republic of Korea
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15
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Lorenzi M, Mayerus M, Eleni Dit Trolli S, Hue-Bigé A, Legueult K, Guellec-Renne I, François-Garret B. An evaluation of the association between lockdown during the SARS-CoV-2 pandemic and prematurity at the Nice University Hospital. Front Pediatr 2023; 11:1201423. [PMID: 37334216 PMCID: PMC10272615 DOI: 10.3389/fped.2023.1201423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/15/2023] [Indexed: 06/20/2023] Open
Abstract
Aim To study the association between lockdown in France due to the SARS-CoV-2 pandemic and premature births at the Nice University Hospital. Methods Data concerning neonates born at the level III maternity of the Nice University Hospital and immediately hospitalised in the neonatal reanimation unit or the neonatology department of the hospital with their mothers between the 1st of January 2017 and the 31st of December 2020, included. Results We did not find a significant decrease in the global number of premature births <37 weeks of gestation, in low weight at birth or a significant increase in stillbirths during lockdown compared to a period with no lockdown. The profiles of the mothers and their newborns were compared when birth occurred during lockdown vs. no lockdown. Conclusion We did not find any evidence of an association between lockdown and prematurity at the Nice University Hospital. This result is in agreement with meta-analyses published in the medical literature. The possible decrease in factors of risk of prematurity during lockdown is controversial.
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Affiliation(s)
- Marine Lorenzi
- Department of Neonatology, Nice University Hospital, Nice, France
| | - Mathilde Mayerus
- Department of Neonatology, Nice University Hospital, Nice, France
| | | | | | - Kévin Legueult
- Department of Clinical Research and Innovation (DRCI), Nice University Hospital, Nice, France
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Yao XD, Li Y, Jiang H, Ma J, Wen J. COVID-19 pandemic and neonatal birth weight: a systematic review and meta-analysis. Public Health 2023; 220:10-17. [PMID: 37201437 DOI: 10.1016/j.puhe.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/16/2023] [Accepted: 04/18/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVES Lockdown was implemented in many countries during the pandemic, which led to myriad changes in pregnant women's lives. However, the potential impacts of the COVID-19 pandemic on neonatal outcomes remain unclear. We aimed to evaluate the association between the pandemic and neonatal birth weight. STUDY DESIGN This was a systematic review and meta-analysis of the previous literature. METHODS We searched the MEDLINE and Embase databases up to May 2022 and extracted 36 eligible studies that compared neonatal birth weight between the pandemic and the prepandemic period. The following outcomes were included: mean birth weight, low birth weight (LBW), very low birth weight (VLBW), macrosomia, small for gestational age (SGA), very small for gestational age (VSGA), and large for gestational age (LGA). Statistical heterogeneity among studies was assessed to determine whether a random effects model or fixed effects model was conducted. RESULTS Of the 4514 studies identified, 36 articles were eligible for inclusion. A total of 1,883,936 neonates during the pandemic and 4,667,133 neonates during the prepandemic were reported. We identified a significant increase in mean birth weight (pooled mean difference [95% confidence interval (CI)] = 15.06 [10.36, 19.76], I2 = 0.0%, 12 studies) and a reduction in VLBW (pooled OR [95% CI] = 0.86 [0.77, 0.97], I2 = 55.4%, 12 studies). No overall effect was identified for other outcomes: LBW, macrosomia, SGA, VSGA, and LGA. There was publication bias for mean birth weight with a borderline significance (Egger's P = 0.050). CONCLUSION Pooled results showed the pandemic was significantly associated with an increase in mean birth weight and a reduction in VLBW, but not for other outcomes. This review provided clues about the indirect effects of the pandemic on neonatal birth weight and more healthcare measures needed to improve neonatal long-term health.
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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; Department of Obstetrics and Gynaecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Y Li
- Department of Obstetrics and Gynaecology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - H Jiang
- Department of Obstetrics and Gynaecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - J Ma
- Department of Obstetrics and Gynaecology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - 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.
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17
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Dehaene I, Van Holsbeke C, Roelens K, van Oostrum NN, Nulens K, Smets K, Van Hoestenberghe MR, Naulaers G, Devlieger R. Preterm birth during the COVID-19 pandemic: more, less, or just the same? Acta Clin Belg 2023; 78:140-159. [PMID: 35731600 DOI: 10.1080/17843286.2022.2091321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Coronavirus disease (COVID-19) and its mitigation measures have been associated with changes in preterm birth (PTB) incidences. The objective of this paper is to summarize and comment on the literature on COVID-19 and PTB and to compare PTB incidence between 2019 (pre-COVID-19) and 2020 (COVID-19) in three Belgian tertiary care hospitals. METHODS A non-systematic review on COVID-19 and PTB was performed, and literature was summarized in a table. Preterm birth rates at Ghent University Hospital, Ziekenhuis Oost-Limburg, and University Hospital Leuven in 2019 and 2020 were compared. Chi-square and Fisher's exact tests were used to compare PTB rates between 2019 and 2020, and Kaplan Meier survival analysis was used to compare pregnancy duration. The mean outcome measure was PTB incidence in 2020 (COVID-19) compared with PTB incidence in 2019 (pre-COVID-19). RESULTS Some (parts of) countries report decreases in PTB rates, others report no differences in incidence, and a minority of countries report an increased incidence of PTB. Almost all studies only consider live-births. In three tertiary care hospitals in Flanders, there were no differences in PTB rates before and during the COVID-19 pandemic. CONCLUSION The impact of the (mitigation measures during the) COVID-19 pandemic on PTB incidence is unclear and difficult to explore. To enable a correct interpretation, all conceptions before and during the pandemic should be taken into consideration, as well as all births, still or alive.
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Affiliation(s)
- Isabelle Dehaene
- Department of Obstetrics and Gynaecology, Ghent University Hospital, Ghent, Belgium
| | | | - Kristien Roelens
- Department of Obstetrics and Gynaecology, Ghent University Hospital, Ghent, Belgium
| | | | - Katrien Nulens
- Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - Koenraad Smets
- Neonatal Intensive Care Unit, Ghent University Hospital, Ghent, Belgium
| | | | - Gunnar Naulaers
- Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Roland Devlieger
- Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, GZA Hospitals, St-Augustinus, Belgium
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Esposito G, Rossi M, Favilli A, Franchi M, Corrao G, Parazzini F, La Vecchia C. Impact of the First and Second Lockdown for COVID-19 Pandemic on Preterm Birth, Low Birth Weight, Stillbirth, Mode of Labor, and of Delivery in Lombardy, Italy. J Pers Med 2023; 13:jpm13030499. [PMID: 36983681 PMCID: PMC10052874 DOI: 10.3390/jpm13030499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
We investigated the effect of lockdown measures implemented in Lombardy on selected obstetric and perinatal outcomes. Births that occurred during the two lockdowns imposed (i.e., the first from 16 March to 2 June 2020 and the second from 3 November 2020 to 5 April 2021) and the comparison periods (i.e., the first from 16 March to 2 June 2018 and the second from 3 November 2018 to 5 April 2019) were identified using regional healthcare databases. The distribution of births according to the selected outcomes was computed and the Chi-square test was used for testing differences in the periods compared. During the two lockdowns, we observed a lower proportion of low birth weight, from 6.8% in the comparison period to 6.1% in the first lockdown (p = 0.019), and from 6.5% to 6.1% in the second one (p = 0.109). The proportion of preterm births decreased from 6.8% to 6.3% in the first lockdown (p = 0.097), and from 6.2% to 6.0% in the second one (p = 0.172). No differences in stillbirth rate emerged for both lockdowns. Induction of labor was more frequent during both lockdowns, from 28.6% to 32.7% in the first (p < 0.0001), and from 29.9% to 33.2% in the second one (p < 0.0001). Cesarean section was less frequent during the second lockdown.
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Affiliation(s)
- Giovanna Esposito
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Correspondence:
| | - Marta Rossi
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Alessandro Favilli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06156 Perugia, Italy
| | - Matteo Franchi
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy
| | - Giovanni Corrao
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy
| | - Fabio Parazzini
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
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Hipwell AE, Tung I, Sherlock P, Tang X, McKee K, McGrath M, Alshawabkeh A, Bastain T, Breton CV, Cowell W, Dabelea D, Duarte CS, Dunlop AL, Ferrera A, Herbstman JB, Hockett CW, Karagas MR, Keenan K, Krafty RT, Monk C, Nozadi SS, O'Connor TG, Oken E, Osmundson SS, Schantz S, Wright R, Comstock SS. Impact of sedentary behavior and emotional support on prenatal psychological distress and birth outcomes during the COVID-19 pandemic. Psychol Med 2023; 53:1-14. [PMID: 36883203 PMCID: PMC10485176 DOI: 10.1017/s0033291723000314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/06/2022] [Accepted: 01/30/2023] [Indexed: 03/09/2023]
Abstract
Abstract. BACKGROUND Studies have reported mixed findings regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on pregnant women and birth outcomes. This study used a quasi-experimental design to account for potential confounding by sociodemographic characteristics. METHODS Data were drawn from 16 prenatal cohorts participating in the Environmental influences on Child Health Outcomes (ECHO) program. Women exposed to the pandemic (delivered between 12 March 2020 and 30 May 2021) (n = 501) were propensity-score matched on maternal age, race and ethnicity, and child assigned sex at birth with 501 women who delivered before 11 March 2020. Participants reported on perceived stress, depressive symptoms, sedentary behavior, and emotional support during pregnancy. Infant gestational age (GA) at birth and birthweight were gathered from medical record abstraction or maternal report. RESULTS After adjusting for propensity matching and covariates (maternal education, public assistance, employment status, prepregnancy body mass index), results showed a small effect of pandemic exposure on shorter GA at birth, but no effect on birthweight adjusted for GA. Women who were pregnant during the pandemic reported higher levels of prenatal stress and depressive symptoms, but neither mediated the association between pandemic exposure and GA. Sedentary behavior and emotional support were each associated with prenatal stress and depressive symptoms in opposite directions, but no moderation effects were revealed. CONCLUSIONS There was no strong evidence for an association between pandemic exposure and adverse birth outcomes. Furthermore, results highlight the importance of reducing maternal sedentary behavior and encouraging emotional support for optimizing maternal health regardless of pandemic conditions.
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Affiliation(s)
- Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Irene Tung
- Department of Psychology, California State University Dominguez Hills, Carson, CA, USA
| | - Phillip Sherlock
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Xiaodan Tang
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Kim McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Monica McGrath
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | | | - Tracy Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Whitney Cowell
- Department of Pediatrics, Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Anne L. Dunlop
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Assiamira Ferrera
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Julie B. Herbstman
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, USA
| | - Christine W. Hockett
- Department of Pediatrics, Avera Research Institute, South Dakota School of Medicine, Vermillion, SD, USA
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth, Lebanon, NH, USA
| | - Kate Keenan
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Robert T. Krafty
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Catherine Monk
- Departments of Obstetrics & Gynecology, and Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, NY, USA
| | - Sara S. Nozadi
- Community Environmental Health Program, Health Sciences Center, University of New Mexico, Albuquerque, NM, USA
| | - Thomas G. O'Connor
- Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sarah S. Osmundson
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Susan Schantz
- Beckman Institute for Advanced Science and Technology, Urbana, IL, USA
| | | | - Sarah S. Comstock
- Department of Food Science & Human Nutrition, Michigan State University, East Lansing, MI, USA
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20
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Syböck K, Hartmann B, Kirchengast S. Maternal Prepregnancy Obesity Affects Foetal Growth, Birth Outcome, Mode of Delivery, and Miscarriage Rate in Austrian Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4139. [PMID: 36901147 PMCID: PMC10002339 DOI: 10.3390/ijerph20054139] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
The increasing obesity rates among women of reproductive age create a major obstetrical problem as obesity during pregnancy is associated with many complications, such as a higher rate of caesarean sections. This medical record-based study investigates the effects of maternal prepregnancy obesity on newborn parameters, birth mode, and miscarriage rate. The data of 15,404 singleton births that had taken place between 2009 and 2019 at the public Danube Hospital in Vienna were enrolled in the study. Newborn parameters are birth weight, birth length, head circumference, APGAR scores, as well as pH values of the arterial and venous umbilical cord blood. In addition, maternal age, height, body weight at the beginning and the end of pregnancy, and prepregnancy body mass index (BMI) (kg/m2) have been documented. The gestational week of birth, the mode of delivery, as well as the number of previous pregnancies and births, are included in the analyses. Birth length, birth weight, and head circumference of the newborn increase with increasing maternal BMI. Furthermore, with increasing maternal weight class, there tends to be a decrease in the pH value of the umbilical cord blood. Additionally, obese women have a history of more miscarriages, a higher rate of preterm birth, and a higher rate of emergency caesarean section than their normal-weight counterparts. Consequently, maternal obesity before and during pregnancy has far-reaching consequences for the mother, the child, and thus for the health care system.
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Affiliation(s)
- Katharina Syböck
- Department of Evolutionary Anthropology, University of Vienna, 1030 Wien, Austria
| | | | - Sylvia Kirchengast
- Department of Evolutionary Anthropology, University of Vienna, 1030 Wien, Austria
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21
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Sindiani A, Awadallah E, Alshdaifat E, Melhem S, Kheirallah K. The relationship between maternal health and neonatal low birth weight in Amman, Jordan: a case-control study. J Med Life 2023; 16:290-298. [PMID: 36937486 PMCID: PMC10015569 DOI: 10.25122/jml-2022-0257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 01/30/2023] [Indexed: 03/21/2023] Open
Abstract
This study aimed to examine the relationship between maternal health during pregnancy and low birth weight (LBW), as well as the impact of COVID-19 on the socio-economic status of pregnant women and its effect on LBW. The study was conducted in Amman, Jordan, and included 2260 mothers who visited Abu-Nusair comprehensive health center between January and December 2020. A matched case-control design was used with 72 cases and 148 controls selected for data collection through medical records and face-to-face interviews. Results showed that factors such as a monthly income of 400 JD or less, living with an extended family, exposure to passive smoking, maternal weight gain of 6-10 kg, maternal anemia, maternal hypertension, delivery by cesarean section, and previous history of LBW newborns were positively associated with an increased risk of LBW. Conversely, factors such as a monthly income above 700 JD, living with a core family, daily intake of iron, calcium, and vitamin D, prenatal visits, healthy food intake, and planning for pregnancy were associated with a lower risk of LBW. COVID-19 infection and its effects on work, family finances, antenatal care visits, and food supply were also positively linked with LBW. In conclusion, socioeconomic status, maternal health, COVID-19, and its impacts were significant risk factors for LBW.
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Affiliation(s)
- Amer Sindiani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- Corresponding Author: Amer Sindiani, Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. E-mail:
| | - Ekram Awadallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Eman Alshdaifat
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Shatha Melhem
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid Kheirallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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22
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Nethery E, Hutcheon JA, Kotaska A, Law MR, Janssen P. Weight gain in pregnancy and infant birthweight after the onset of the COVID-19 pandemic: an interrupted time series analysis. Am J Clin Nutr 2023; 117:364-372. [PMID: 36863829 PMCID: PMC9972866 DOI: 10.1016/j.ajcnut.2022.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 09/07/2022] [Accepted: 09/12/2022] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Increased weight gain and decreased physical activity have been reported in some populations since the coronavirus disease 2019 (COVID-19) pandemic, but this has not been well characterized in pregnant populations. OBJECTIVES Our objective was to characterize the impact of the COVID-19 pandemic and associated countermeasures on pregnancy weight gain and infant birthweight in a US cohort. METHODS Washington State pregnancies and births (1 January, 2016 to 28 December, 2020) from a multihospital quality improvement organization were examined for pregnancy weight gain, pregnancy weight gain z-score adjusted for pregestational BMI and gestational age, and infant birthweight z-score, using an interrupted time series design that controls for underlying time trends. We used mixed-effect linear regression models, controlled for seasonality and clustered at the hospital level, to model the weekly time trends and changes on 23 March, 2020, the onset of local COVID-19 countermeasures. RESULTS Our analysis included 77,411 pregnant people and 104,936 infants with complete outcome data. The mean pregnancy weight gain was 12.1 kg (z-score: -0.14) during the prepandemic time period (March to December 2019) and increased to 12.4 kg (z-score: -0.09) after the onset of the pandemic (March to December 2020). Our time series analysis found that after the pandemic onset, the mean weight gain increased by 0.49 kg (95% CI: 0.25, 0.73 kg) and weight gain z-score increased by 0.080 (95% CI: 0.03, 0.13), with no changes in the baseline yearly trend. Infant birthweight z-scores were unchanged (-0.004; 95% CI: -0.04, 0.03). Overall, the results were unchanged in analyses stratified by pregestational BMI categories. CONCLUSIONS We observed a modest increase in weight gain after the onset of the pandemic among pregnant people but no changes in infant birthweights. This weight change could be more important in high BMI subgroups.
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Affiliation(s)
- Elizabeth Nethery
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.
| | - Jennifer A Hutcheon
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada; Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew Kotaska
- Department of Obstetrics & Gynecology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Obstetrics & Gynaecology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael R Law
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada; Centre for Health Services and Policy Research, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Patricia Janssen
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
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23
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Comparison of adverse pregnancy and birth outcomes using archival medical records before and during the first wave of the COVID-19 pandemic in Kinshasa, Democratic Republic of Congo: a facility-based, retrospective cohort study. BMC Pregnancy Childbirth 2023; 23:31. [PMID: 36647021 PMCID: PMC9841139 DOI: 10.1186/s12884-022-05291-w] [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: 06/16/2022] [Accepted: 12/07/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Little research has been conducted on the impact of the coronavirus disease 2019 (COVID-19) pandemic on either birth outcomes or the ability of archival medical records to accurately capture these outcomes. Our study objective is thus to compare the prevalence of preterm birth, stillbirth, low birth weight (LBW), small for gestational age (SGA), congenital microcephaly, and neonatal bloodstream infection (NBSI) before and during the first wave of the COVID-19 pandemic in Kinshasa, Democratic Republic of Congo (DRC). METHODS We conducted a facility-based retrospective cohort study in which identified cases of birth outcomes were tabulated at initial screening and subcategorized according to level of diagnostic certainty using Global Alignment of Immunization Safety Assessment in pregnancy (GAIA) definitions. Documentation of any birth complications, delivery type, and maternal vaccination history were also evaluated. The prevalence of each birth outcome was compared in the pre-COVID-19 (i.e., July 2019 to February 2020) and intra-COVID-19 (i.e., March to August 2020) periods via two-sample z-test for equality of proportions. RESULTS In total, 14,300 birth records were abstracted. Adverse birth outcomes were identified among 22.0% and 14.3% of pregnancies in the pre-COVID-19 and intra-COVID-19 periods, respectively. For stillbirth, LBW, SGA, microcephaly, and NBSI, prevalence estimates were similar across study periods. However, the prevalence of preterm birth in the intra-COVID-19 period was significantly lower than that reported during the pre-COVID-19 period (8.6% vs. 11.5%, p < 0.0001). Furthermore, the level of diagnostic certainty declined slightly across all outcomes investigated from the pre-COVID-19 to the intra-COVID-19 period. Nonetheless, diagnostic certainty was especially low for certain outcomes (i.e., stillbirth and NBSI) regardless of period; still, other outcomes, such as preterm birth and LBW, had moderate to high levels of diagnostic certainty. Results were mostly consistent when the analysis was focused on the facilities designated for COVID-19 care. CONCLUSION This study succeeded in providing prevalence estimates for key adverse birth outcomes using GAIA criteria during the COVID-19 pandemic in Kinshasa, DRC. Furthermore, our study adds crucial real-world data to the literature surrounding the impact of the COVID-19 pandemic on maternal and neonatal services and outcomes in Africa.
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24
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Maternal and Perinatal Outcomes During the COVID-19 Epidemic in Pregnancies Complicated by Gestational Diabetes. Zdr Varst 2022; 62:22-29. [PMID: 36694793 PMCID: PMC9837814 DOI: 10.2478/sjph-2023-0004] [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: 04/15/2022] [Accepted: 11/14/2022] [Indexed: 12/31/2022] Open
Abstract
Introduction Gestational diabetes (GDM) is one of the most common complications in pregnancy, with a prevalence that continues to rise. At the time of the COVID-19 epidemic, immediate reorganisation and adjustment of the system was needed. Telemedicine support was offered in order to provide high-quality treatment to pregnant women. However, the success of the treatment is unknown. We therefore aimed to evaluate COVID-19 epidemic effects on pregnancy outcomes in GDM. Methods The maternal outcomes (insulin treatment, gestational weight gain, caesarean section, hypertensive disorders) and perinatal outcomes (rates of large and small for gestational age, preterm birth and a composite child outcome) of women visiting a university hospital diabetes clinic from March to December 2020 were compared with those treated in the same period in 2019. Results Women diagnosed with GDM during the COVID-19 epidemic (n=417), were diagnosed earlier (23.9 [11.7-26.0] vs. 25.1 [21.8-26.7] gestational week), had higher fasting glucose (5.2 [5.0-5.4] vs. 5.1 [4.8-5.3] mmol/l) and earlier pharmacological therapy initiation, and had achieved lower HbA1c by the end of followup (5.1% (32.2 mmol/mol) [4.9% (30.1 mmol/mol)-5.4% (35.0 mmol/mol)] vs. 5.2% (33.3 mmol/mol) [5.0% (31.1 mmol/mol) - 5.4%·(35.5 mmol/mol)], p<0.001) compared to a year before (n=430). No significant differences in perinatal outcomes were found. Conclusions Although GDM was diagnosed at an earlier gestational age and higher fasting glucose concentration was present at the time of diagnosis, the COVID-19 epidemic did not result in worse glucose control during pregnancy or worse pregnancy outcomes in Slovenia.
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25
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Balsa AI, Triunfo P. The COVID-19 pandemic and birth outcomes in 2020: The role of prenatal care and other channels. ECONOMICS AND HUMAN BIOLOGY 2022; 47:101167. [PMID: 35930987 PMCID: PMC9338169 DOI: 10.1016/j.ehb.2022.101167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 07/28/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
We use national birth data to assess the associations between the COVID-19 pandemic during 2020 and birth outcomes in Uruguay. Employing interrupted time series difference-in-differences techniques, we find mixed results, with some pregnancies showing increases in the likelihood of very preterm or very-low-weight births, and some others showing decreases in the incidence of moderate prematurity and moderate low birth weight. Adverse outcomes are more likely among women with low education, women with previous children, and with risk factors, such as smoking or being older than 34. We observe improvements in health at birth for children of non-smokers, women younger than 35, and women with no other children. We underscore the role of health care by showing that women in the private sector, who suffered the strongest contraction in face-to-face prenatal care use, experienced more adverse birth outcomes. Our results also suggest that the economic recession and an increased burden of childcare were behind the increases in preterm and very-low-weight births. Because pollution is an unlikely channel for the positive results, we hypothesize that for some pregnancies, the pandemic improved the intrauterine habitat by leading to a quieter and healthier lifestyle.
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Affiliation(s)
- Ana I Balsa
- Department of Economics and Center for Research in Applied Economics, School of Business and Economics, University of Montevideo, Montevideo, Uruguay.
| | - Patricia Triunfo
- Department of Economics, School of Social Sciences, University of the Republic, Montevideo, Uruguay.
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26
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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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27
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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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Wen J. Impact of COVID-19 pandemic on birth outcomes: A retrospective cohort study in Nanjing, China. Front Public Health 2022; 10:923324. [PMID: 35923970 PMCID: PMC9339802 DOI: 10.3389/fpubh.2022.923324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/28/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) pandemic have significantly affected health care systems and daily wellbeing. However, the indirect impacts of the pandemic on birth outcomes are not fully understood. We aimed to examine whether the pandemic altered risk of adverse birth outcomes. Methods This retrospective cohort study included all singleton births during 2016–2020 identified in Women's Hospital of Nanjing Medical University. We compared birth outcomes during COVID-19 pandemic (January–December 2020) with before the pandemic (January–December 2016–2019) using Logstic regression adjusted for confounders. Results A total of 19,792 and 92,750 births occurred during and before the pandemic, respectively. Maternal characteristics were similar between groups, except maternal age was higher in pandemic cohort. We observed a reduction in preterm birth (PTB, <37 weeks) during the pandemic [5.9 vs. 5.1%, OR (95%CI) = 0.86 (0.80, 0.92)], but the difference disappeared after multivariable adjustment [adjusted OR (95%CI) = 1.02 (0.94, 1.11)]. Moreover, full term infants born during the pandemic had lower birth weights than those born before the pandemic [adjusted β (95% CI) = −17.4 (−23.9, −10.8)]. Consistently, the risks of low birthweight (LBW, <2,500 g) and small for gestational age (SGA, < P10) were increased [LBW: adjusted OR (95%CI) = 1.13 (1.02, 1.24); SGA: adjusted OR (95%CI) = 1.11 (1.02, 1.21)], and the risks of macrosomia (≥4,000 g) and large for gestational age (LGA, ≥P90) were decreased in the pandemic cohort [macrosomia: adjusted OR (95%CI) = 0.82 (0.77, 0.88); LGA: adjusted OR (95%CI) = 0.73 (0.69, 0.77)]. Conclusion In this study, we observed no change in preterm birth and a decrease in birth weight of full term infants during the pandemic in Nanjing, China.
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Melov SJ, Elhindi J, McGee TM, Lee VW, Cheung NW, Chua SC, McNab J, Alahakoon TI, Pasupathy D. Investigating service delivery and perinatal outcomes during the low prevalence first year of COVID-19 in a multiethnic Australian population: a cohort study. BMJ Open 2022; 12:e062409. [PMID: 35820747 PMCID: PMC9277027 DOI: 10.1136/bmjopen-2022-062409] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Investigate the impact of the COVID-19 pandemic on perinatal outcomes in an Australian high migrant and low COVID-19 prevalent population to identify if COVID-19 driven health service changes and societal influences impact obstetric and perinatal outcomes. DESIGN Retrospective cohort study with pre COVID-19 period 1 January 2018-31 January 2020, and first year of global COVID-19 period 1 February 2020-31 January 2021. Multivariate logistic regression analysis was conducted adjusting for confounders including age, area-level socioeconomic status, gestation, parity, ethnicity and body mass index. SETTING Obstetric population attending three public hospitals including a major tertiary referral centre in Western Sydney, Australia. PARTICIPANTS Women who delivered with singleton pregnancies over 20 weeks gestation. Ethnically diverse women, 66% overseas born. There were 34 103 births in the district that met inclusion criteria: before COVID-19 n=23 722, during COVID-19 n=10 381. MAIN OUTCOME MEASURES Induction of labour, caesarean section delivery, iatrogenic and spontaneous preterm birth, small for gestational age (SGA), composite neonatal adverse outcome and full breastfeeding at hospital discharge. RESULTS During the first year of COVID-19, there was no change for induction of labour (adjusted OR, aOR 0.97; 95% CI 0.92 to 1.02, p=0.26) and a 25% increase in caesarean section births (aOR 1.25; 95% CI 1.19 to 1.32, p<0.001). During the COVID-19 period, we found no change in iatrogenic preterm births (aOR 0.94; 95% CI 0.80 to 1.09) but a 15% reduction in spontaneous preterm birth (aOR 0.85; 95% CI 0.75 to 0.97, p=0.02) and a 10% reduction in SGA infants at birth (aOR 0.90; 95% CI 0.82 to 0.99, p=0.02). Composite adverse neonatal outcomes were marginally higher (aOR 1.08; 95% CI 1.00 to 1.15, p=0.04) and full breastfeeding rates at hospital discharge reduced by 15% (aOR 0.85; 95% CI 0.80 to 0.90, p<0.001). CONCLUSION Despite a low prevalence of COVID-19, both positive and adverse obstetric outcomes were observed that may be related to changes in service delivery and interaction with healthcare providers. Further research is suggested to understand the drivers for these changes.
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Affiliation(s)
- Sarah J Melov
- Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Westmead Institute for Maternal and Fetal Medicine, Women's and Newborn Health, Westmead Hospital, Westmead, New South Wales, Australia
| | - James Elhindi
- Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Therese M McGee
- Women's and Newborn Health, Westmead Hospital, Westmead, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Vincent W Lee
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Renal Medicine, Westmead Hospital, Westmead, New South Wales, Australia
| | - N Wah Cheung
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Diabetes & Endocrinology, Westmead Hospital, Westmead, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Seng Chai Chua
- Women's and Newborn Health, Westmead Hospital, Westmead, New South Wales, Australia
| | - Justin McNab
- Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Thushari I Alahakoon
- Westmead Institute for Maternal and Fetal Medicine, Women's and Newborn Health, Westmead Hospital, Westmead, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Dharmintra Pasupathy
- Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Westmead Institute for Maternal & Fetal Medicine, Westmead Hospital, Westmead, New South Wales, Australia
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Hawco S, Rolnik DL, Woolner A, Cameron NJ, Wyness V, Mol BW, Black M. The impact of mitigation measures on perinatal outcomes during the first nine months of the COVID-19 pandemic: A systematic review with meta-analysis. Eur J Obstet Gynecol Reprod Biol 2022; 274:117-127. [PMID: 35640440 PMCID: PMC9106593 DOI: 10.1016/j.ejogrb.2022.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/15/2022] [Accepted: 05/11/2022] [Indexed: 11/29/2022]
Abstract
Worldwide reports have produced conflicting data on perinatal outcomes during the COVID-19 pandemic. This systematic review and meta-analysis addressed the effect of mitigation measures against COVID-19 on preterm birth, stillbirth, low birth weight, and NICU admission during the first nine months of the pandemic. A search was performed using MEDLINE, Embase and SCOPUS for manuscripts published up until 24th May 2021. Studies that reported perinatal outcomes (preterm birth, stillbirth, low birth weight, NICU admission) during the COVID-19 pandemic with a pre-pandemic control period were included. Risk of bias assessment was performed using ROBINS-I tool. RevMan5 was used to perform meta-analysis with random-effects models. A score of the stringency of mitigation measures was calculated from the Oxford COVID-19 Government Response Tracker. Thirty-eight studies of moderate to serious risk of bias were included, with varied methodology, analysis and regional mitigation measures, using stringency index scores. There was no overall effect on preterm birth at less than 37 weeks (OR 0.96, 95% CI 0.92–1.00). However, there was a reduction in preterm birth at less than 37 weeks (OR 0.89, 95% CI 0.81–0.98) and 34 weeks (OR 0.56, 95% CI 0.37–0.83) for iatrogenic births and in singleton pregnancies. There was also a significant reduction in preterm births at less than 34 weeks in studies with above median stringency index scores (OR 0.71, 95% CI 0.58–0.88). There was no effect on risk of stillbirth (OR 1.04, 95% CI 0.90–1.19) or birth weight. NICU admission rates were significantly reduced in studies with above median stringency index scores (OR 0.87, 95% CI 0.78–0.97). The reduction in preterm births in regions with high mitigation measures against SARS-CoV-2 infection is likely driven by a reduction in iatrogenic births. Variability in study design and cohort characteristics need to be considered for future studies to allow further investigation of population level health measures of perinatal outcomes.
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Affiliation(s)
- Sarah Hawco
- Aberdeen Centre for Women's Health Research, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
| | - Daniel L Rolnik
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC 3168, Australia
| | - Andrea Woolner
- Aberdeen Centre for Women's Health Research, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Natalie J Cameron
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | | | - Ben W Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC 3168, Australia; Aberdeen Centre for Women's Health Research, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Mairead Black
- Aberdeen Centre for Women's Health Research, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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La Verde M, Torella M, Riemma G, Narciso G, Iavarone I, Gliubizzi L, Palma M, Morlando M, Colacurci N, De Franciscis P. Incidence of gestational diabetes mellitus before and after the Covid-19 lockdown: A retrospective cohort study. J Obstet Gynaecol Res 2022; 48:1126-1131. [PMID: 35199420 PMCID: PMC9115303 DOI: 10.1111/jog.15205] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/09/2022] [Accepted: 02/14/2022] [Indexed: 01/04/2023]
Abstract
AIM To evaluate whether the first Covid-19 lockdown for Italian citizens (March to July 2021) might have altered the incidence of gestational diabetes mellitus (GDM). METHODS A retrospective single-center study in a tertiary referral center. Primary outcome was the incidence of GDM among pregnant women. GDM incidence, from June 11, 2019 to December 4, 2020, was compared by dividing the study time as follows: from the beginning of the study to before Covid-19 lockdown (from June 11, 2019, to March 9, 2020) and lockdown period (from March 10, 2020, to December 4, 2020). GDM was diagnosed with a 75-g, 2-h oral glucose tolerance test (OGTT) at 24-28 gestational weeks. RESULTS Concerning 1295 women, GDM incidence increased during the lockdown period (9.3% vs. 3.4%, p < 0.001). Higher pregnancy weight gain with an increased body mass index (BMI) at the delivery was reported during the lockdown (31.3 vs. 28.4 kg/m2 , p = 0.02 and mean weight gain of 9.3 vs. 6.6 kg, p = 0.007). There was no difference in other comorbidity incidence and OGTT values between the two groups. CONCLUSIONS Pregnant women during the Covid-19 lockdown might have experienced higher BMI and pregnancy weight gain with increased GDM diagnoses. This may be related to physical limitations and emotional distress experienced during the lockdown. However, evidence is limited due to restricted study duration and random variations of outcomes across time. More studies are needed to understand the dietary patterns and the physical activity changes during the Covid-19 lockdown and its impact on fetal outcomes.
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Affiliation(s)
- Marco La Verde
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology UnitUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Marco Torella
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology UnitUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Gaetano Riemma
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology UnitUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Giuliana Narciso
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology UnitUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Irene Iavarone
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology UnitUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Ligia Gliubizzi
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology UnitUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Marica Palma
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology UnitUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Maddalena Morlando
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology UnitUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Nicola Colacurci
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology UnitUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology UnitUniversity of Campania “Luigi Vanvitelli”NaplesItaly
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Kocherlakota P, Lin L, Gill H, Joseph J, Trydal L. Effect of the COVID-19 Pandemic on Well-Baby Nursery. Am J Perinatol 2022; 39:683-690. [PMID: 34666385 DOI: 10.1055/a-1673-0708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is associated with fewer deliveries and premature births; however, the impact of this pandemic on the well-baby nursery (WBN) is unknown. OBJECTIVE The aim of the study is to evaluate the impact of the COVID-19 pandemic on infants admitted to the WBN by comparing pandemic and pre-pandemic cohorts. STUDY DESIGN We performed a retrospective study of infants admitted to a WBN during the pandemic period (March 18, 2020 to March 17, 2021) and compared them to those during the pre-pandemic period (March 18, 2019 to March 17, 2020). Maternal (age, parity, gestation, method of delivery, and COVID-19 status) and neonatal (sex, weight, Apgar score, feeding pattern, urine toxicology, and neonatal intensive care unit [NICU] admission) data were collected and compared between the two periods. The results were statistically analyzed, and significance was set at p <0.05. RESULTS There were 824 and 859 WBN admissions during the pandemic and pre-pandemic periods, respectively, a 4% decrease in WBN admissions during the pandemic period. During the pandemic period, the number of deliveries among nulliparous women increased (From 40.3% to 45.1% p = 0.01), and deliveries among multiparous women decreased (From 59.2% to 53.1% p = 0.01). The number of infants exposed to marijuana in utero increased (From 8.2% to 16.1% p = 0.035), and transfers from WBN to NICU decreased (From 9% to 6.3% p = 0.044) during the pandemic period. CONCLUSION Compared with the pre-pandemic period, the number of WBN admissions, multiparous deliveries, and NICU admissions decreased, while the number of nulliparous deliveries and infants exposed to marijuana in-utero increased during the pandemic period. KEY POINTS · COVID-19 Pandemic is associated with decreased number of deliveries, preterm births, and NICU admissions.. · We observed decreased admissions to WBN, deliveries by multiparous women, and transfers from WBN.. · More nulliparous women delivered, and more infants were exposed to marijuana in-utero during the Pandemic..
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Affiliation(s)
- Prabhakar Kocherlakota
- Department of Pediatrics, Montefiore St. Luke's Cornwall Hospital, Newburgh, New York.,The Regional Neonatal Intensive Care Unit, Department of Pediatrics, Maria Ferrari Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Lin Lin
- Department of Pediatrics, Montefiore St. Luke's Cornwall Hospital, Newburgh, New York
| | - Harsangeet Gill
- Department of Pediatrics, Montefiore St. Luke's Cornwall Hospital, Newburgh, New York
| | - Janice Joseph
- Department of Pediatrics, Montefiore St. Luke's Cornwall Hospital, Newburgh, New York
| | - Leandra Trydal
- Department of Pediatrics, Montefiore St. Luke's Cornwall Hospital, Newburgh, New York
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Yang J, D'Souza R, Kharrat A, Fell DB, Snelgrove JW, Shah PS. COVID-19 pandemic and population-level pregnancy and neonatal outcomes in general population: A living systematic review and meta-analysis (Update#2: November 20, 2021). Acta Obstet Gynecol Scand 2022; 101:273-292. [PMID: 35088409 DOI: 10.1111/aogs.14318] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 12/30/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Conflicting reports of increases and decreases in rates of preterm birth (PTB) and stillbirth in the general population during the coronavirus disease 2019 (COVID-19) pandemic have surfaced. The objective of our study was to conduct a living systematic review and meta-analyses of studies reporting pregnancy and neonatal outcomes by comparing the pandemic and pre-pandemic periods. MATERIAL AND METHODS We searched the PubMed and Embase databases and reference lists of articles published up until November 20, 2021, and included English language studies that compared outcomes between the COVID-19 pandemic time period with pre-pandemic time periods. Risk of bias was assessed using the Newcastle-Ottawa scale. We conducted random-effects meta-analysis using the inverse variance method. RESULTS Fifty-two studies with low-to-moderate risk of bias, reporting on 2 372 521 pregnancies during the pandemic period and 28 518 300 pregnancies during the pre-pandemic period, were included. There was significant reduction in unadjusted estimates of PTB (43 studies, unadjusted odds ratio [uaOR] 0.95, 95% CI 0.93-0.98), but not in adjusted estimates (five studies, adjusted OR [aOR] 0.94, 95% CI 0.74-1.19). This reduction was noted in studies from single centers/health areas (29 studies, uaOR 0.90, 95% CI 0.85-0.94) but not in regional/national studies (14 studies, uaOR 0.99, 95% CI 0.99-1.01). There was reduction in spontaneous PTB (nine studies, uaOR 0.91, 95% CI 0.88-0.94) but not in induced PTB (eight studies, uaOR 0.90, 95% CI 0.79-1.01). There was no difference in the odds of stillbirth between the pandemic and pre-pandemic time periods (32 studies, uaOR 1.07, 95% CI 0.97-1.18 and three studies, aOR 1.18, 95% CI 0.86-1.63). There was an increase in mean birthweight during the pandemic period compared with the pre-pandemic period (nine studies, mean difference 21 g, 95% CI 13-30 g). The odds of maternal mortality were increased (five studies, uaOR 1.15, 95% CI 1.05-1.26); however, only unadjusted estimates were available, and the result was mostly influenced by one study from Mexico. There was significant publication bias for the outcome of PTB. CONCLUSIONS The COVID-19 pandemic may be associated with a reduction in PTB; however, referral bias cannot be excluded. There was no statistically significant difference in stillbirths between pandemic and pre-pandemic periods.
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Affiliation(s)
- Jie Yang
- Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Rohan D'Souza
- Department of Obstetrics and Gynaecology and Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.,Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Ashraf Kharrat
- Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Deshayne B Fell
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - John W Snelgrove
- Department of Obstetrics and Gynaecology and Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Prakesh S Shah
- Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.,Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Yalçin SS, Boran P, Tezel B, Şahlar TE, Özdemir P, Keskinkiliç B, Kara F. Effects of the COVID-19 pandemic on perinatal outcomes: a retrospective cohort study from Turkey. BMC Pregnancy Childbirth 2022; 22:51. [PMID: 35057751 PMCID: PMC8772535 DOI: 10.1186/s12884-021-04349-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/20/2021] [Indexed: 12/29/2022] Open
Abstract
Background Lockdowns, pregnant women’s fear from hospitalization in addition to uncertainties about appropriate birthing practices at the beginning of the pandemic may have affected the health outcomes of mother-infant couples. We aimed to explore whether pregnancy outcomes including the rates of cesarean delivery (CS), preterm, and low birth weight (LBW) births have changed during the pandemic period compared with the pre-pandemic period. Methods We applied a population-based retrospective cohort, before-after approach in 2020 vs. similar calendar months in 2019 for five periods [Jan-Feb (pre-pandemic); March–May (1st wave and lockdown); June–August; September–October; November–December (2nd wave and lockdown)]. The data was modelled through multiple logistic regressions using key outcomes; CS, preterm, and LBW births as the dependent variables, and adjustments were made for independent variables in SPSS software. We evaluated the modification of years by periods by adding interaction term (yearXperiod) to the model. Results The rate of CS in hospital births increased from 57.7% in 2019 to 60.2% in 2020. CS rates were significantly increased during the 3rd and 4th periods. The overall preterm rate was 11%. When singleton pregnancies were considered, adjusted multivariable analyses showed a decrease in preterm proportions during all time periods with respect to the pre-pandemic period. The percentage of LBW was 7.7% during the pandemic period and was found to be significantly reduced compared to the pre-pandemic period. There was a significant reduction in LBW rates in all periods except the second lockdown period. Conclusions Our findings suggested significant reductions in preterm and LBW births possibly due to the indirect effects of the pandemic. Moreover, strategies need to be considered to address the increased CS rates and shifting of maternity service utilization to private facilities. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04349-5.
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Yang J, D'Souza R, Kharrat A, Fell DB, Snelgrove JW, Murphy KE, Shah PS. Coronavirus disease 2019 pandemic and pregnancy and neonatal outcomes in general population: A living systematic review and meta-analysis (updated Aug 14, 2021). Acta Obstet Gynecol Scand 2021; 101:7-24. [PMID: 34730232 PMCID: PMC8653307 DOI: 10.1111/aogs.14277] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 12/13/2022]
Abstract
Introduction Conflicting reports of increases and decreases in rates of preterm birth (PTB) and stillbirth in the general population during the coronavirus disease 2019 (COVID‐19) pandemic have surfaced. The objective of our study was to conduct a living systematic review and meta‐analyses of studies reporting pregnancy and neonatal outcomes by comparing the pandemic and pre‐pandemic periods. Material and methods We searched PubMed and Embase databases, reference lists of articles published up until August 14, 2021 and included English language studies that compared outcomes between the COVID‐19 pandemic time period and the pre‐pandemic time periods. Risk of bias was assessed using the Newcastle–Ottawa scale. We conducted random‐effects meta‐analysis using the inverse variance method. Results Forty‐five studies with low‐to‐moderate risk of bias, reporting on 1 843 665 pregnancies during the pandemic period and 23 564 552 pregnancies during the pre‐pandemic period, were included. There was significant reduction in unadjusted estimates of PTB (35 studies, unadjusted odds ratio [uaOR] 0.95, 95% CI 0.92–0.98), but not in adjusted estimates (six studies, adjusted OR [aOR] 0.95, 95% CI 0.80–1.13). This reduction was noted in studies from single centers/health areas (25 studies, uaOR 0.90, 95% CI 0.86–0.96) but not in regional/national studies (10 studies, uaOR 0.99, 95% CI 0.95–1.02). There was reduction in spontaneous PTB (six studies, uaOR 0.89, 95% CI 0.81–0.96) and induced PTB (five studies, uaOR 0.89, 95% CI 0.81–0.97). There was no difference in the odds of stillbirth between the pandemic and pre‐pandemic time periods (24 studies, uaOR 1.11, 95% CI 0.97–1.26 and four studies, aOR 1.06, 95% CI 0.81–1.38). There was an increase in mean birthweight during the pandemic period compared with the pre‐pandemic period (six studies, mean difference 17 g, 95% CI 7–28 g). The odds of maternal mortality were increased (four studies, uaOR 1.15, 95% CI 1.05–1.26); however, only unadjusted estimates were available and the result was mostly influenced by one study from Mexico. There was significant publication bias for the outcome of PTB. Conclusions The COVID‐19 pandemic may be associated with a reduction in PTB; however, referral bias cannot be excluded. There was no statistically significant difference in stillbirth between pandemic and pre‐pandemic periods.
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Affiliation(s)
- Jie Yang
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Rohan D'Souza
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.,Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Ashraf Kharrat
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Deshayne B Fell
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - John W Snelgrove
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Kellie E Murphy
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.,Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Prakesh S Shah
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.,Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Vaccaro C, Mahmoud F, Aboulatta L, Aloud B, Eltonsy S. The impact of COVID-19 first wave national lockdowns on perinatal outcomes: a rapid review and meta-analysis. BMC Pregnancy Childbirth 2021; 21:676. [PMID: 34615505 PMCID: PMC8532086 DOI: 10.1186/s12884-021-04156-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 09/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since the emergence of COVID-19, preventative public health measures, including lockdown strategies, were declared in most countries to control viral transmission. Recent studies and anecdotes have reported changes in the prevalence of perinatal outcomes during national COVID-19lockdowns.The objective of this rapid review was to evaluate the impact of COVID-19 lockdowns on the incidence of low birth weight (LBW), preterm birth (PTB), and stillbirth. METHODS Two reviewers searched EMBASE, CORD-19, LitCovid (PubMed), WHO Global research on corona virus disease (COVID-19), and MedRxiv for studies published in English from the first reports on COVID-19 until 17 July 2021. Perinatal outcomes of interest included LBW (< 2500 g), PTB (< 37 weeks), and stillbirth. RESULTS Of the 1967 screened articles, 17 publications met the inclusion criteria (14 cohort studies, 1 case control and 2 cross-sectional studies). Studies included data from Denmark, UK, Ireland, Nepal, Italy, Israel, Botswana, Australia, China, Netherlands, Saudi Arabia, Austria, Zimbabwe, India, and Spain. The total sample size ranged from 3399 to 1,599,547 pregnant women. Thirteen studies examined PTB with conflicting results, reporting both an increase and a decrease in PTB incidence, with odds ratios [95% CI] ranging from 0.09 [0.01, 0.40] to 1.93 [0.76, 4.79]. Three studies found a decrease in LBW rates during lockdowns, one of which was statistically significant, with a rate ratio of 3.77 [1.21, 11.75]. Ten studies examined stillbirth rates, including four studies reporting a statistically significant increase in stillbirth rates, with adjusted relative risk ranging from 1.46 [1.13, 1.89] to 3.9 [1.83, 12.0]. Fourteen studies contained data that could be combined in a meta-analysis comparing perinatal outcomes before and during lockdown. We found that lockdown measures were associated with a significant risk of stillbirth with RR = 1.33 [95% CI 1.04, 1.69] when compared to before lockdown period. However, lockdown measures were not associated with a significant risk of PTB, LBW and VLBW compared to prepandemic periods. CONCLUSIONS This review provides clues about the severity of the indirect influence of COVID-19 lockdown implementation; however, the criteria that lead to unexpected changes in LBW, PTB, and stillbirth remains unclear. Large studies showed conflicting results, reporting both increases and decreases in selected perinatal outcomes. Pooled results show a significant association between lockdown measures and stillbirth rates, but not low birth weight rates. Further studies examining the differences in other countries' lockdowns and sociodemographic groups from low to middle-income countries are needed. Exploration of perinatal outcomes during COVID-19 lockdown poses an opportunity to learn from and make changes to promote the reduction of the leading causes of childhood mortality worldwide.
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Affiliation(s)
- Christine Vaccaro
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Farida Mahmoud
- Faculty of Pharmacy, Universite de Montreal, Montréal, Canada
| | - Laila Aboulatta
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Basma Aloud
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Sherif Eltonsy
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. .,The Children's Hospital Research Institute of Manitoba, Winnipeg, Canada.
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Cuestas E, Gómez-Flores ME, Charras MD, Peyrano AJ, Montenegro C, Sosa-Boye I, Burgos V, Giusti G, Espósito M, Blanco-Pool SS, Gurevich DP, Ahumada LA, Pontoriero RD, Rizzotti A, Bas JI, Vaca MB, Miranda MJ, Ferreyra ME, Moreno GC, Pedicino H, Rojas-Rios M. Socioeconomic inequalities in low birth weight risk before and during the COVID-19 pandemic in Argentina: A cross-sectional study. THE LANCET REGIONAL HEALTH - AMERICAS 2021; 2:100049. [PMID: 34642686 PMCID: PMC8495179 DOI: 10.1016/j.lana.2021.100049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/25/2021] [Accepted: 08/03/2021] [Indexed: 10/30/2022]
Abstract
Background Methods Findings Interpretation Funding
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38
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Taseen S, Abbas M. Incidence of preterm birth in low- and middle-income countries during COVID-19 pandemic: Recommendations. J Obstet Gynaecol Res 2021; 47:3418. [PMID: 34254408 PMCID: PMC8446987 DOI: 10.1111/jog.14918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 06/23/2021] [Indexed: 11/26/2022]
Affiliation(s)
| | - Munib Abbas
- Karachi Medical and Dental CollegeKarachiPakistan
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Folch Ayora A, Salas-Medina P, Collado-Boira E, Ropero-Padilla C, Rodriguez-Arrastia M, Bernat-Adell MD. Pregnancy during the COVID-19 pandemic: A cross-sectional observational descriptive study. Nurs Open 2021; 8:3016-3023. [PMID: 34405570 PMCID: PMC8441794 DOI: 10.1002/nop2.1014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/05/2021] [Accepted: 07/19/2021] [Indexed: 12/23/2022] Open
Abstract
Aim To provide data on the fears of pregnant women during the confinement period and to learn about the factors, which may have exacerbated fear in Spanish pregnant women during the pandemic. Design A cross‐sectional observational and descriptive study. Methods An anonymous survey was carried out using virtual media in a pregnant population (aged ≥18 years) during the confinement period from 1 April to 1 May 2020. Results The total sample comprised of 62 individuals, with a mean age of 33.6 ± 3.6 years and a mean gestation time of 23.6 ± 9.8 weeks. All of the women used preventive measures against SARS‐CoV‐2. The most common preventive measures were social isolation (82.3%, n = 51) and frequent handwashing (69.4%, n = 43). The most common feeling was fear (29%, n = 18). The main fears were related to transplacental infection (27%, n = 16), loneliness during childbirth, and being separated from the newborn (27%, n = 16). In addition, 59.7% (n = 37) considered changing their child‐rearing practices after the pandemic.
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Affiliation(s)
- Ana Folch Ayora
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, Castellon de la Plana, Spain.,Research Group CYS, Faculty of Health Sciences, Jaume I University, Castello de la Plana, Spain
| | - Pablo Salas-Medina
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, Castellon de la Plana, Spain.,Research Group CYS, Faculty of Health Sciences, Jaume I University, Castello de la Plana, Spain
| | - Eladio Collado-Boira
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, Castellon de la Plana, Spain.,Research Group CYS, Faculty of Health Sciences, Jaume I University, Castello de la Plana, Spain
| | - Carmen Ropero-Padilla
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, Castellon de la Plana, Spain.,Research Group CYS, Faculty of Health Sciences, Jaume I University, Castello de la Plana, Spain
| | - Miguel Rodriguez-Arrastia
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, Castellon de la Plana, Spain.,Research Group CYS, Faculty of Health Sciences, Jaume I University, Castello de la Plana, Spain
| | - María Desamparados Bernat-Adell
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, Castellon de la Plana, Spain.,Research Group CYS, Faculty of Health Sciences, Jaume I University, Castello de la Plana, Spain
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40
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Yang J, D'Souza R, Kharrat A, Fell DB, Snelgrove JW, Murphy KE, Shah PS. COVID-19 pandemic and population-level pregnancy and neonatal outcomes: a living systematic review and meta-analysis. Acta Obstet Gynecol Scand 2021; 100:1756-1770. [PMID: 34096034 PMCID: PMC8222877 DOI: 10.1111/aogs.14206] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/28/2021] [Accepted: 06/01/2021] [Indexed: 12/14/2022]
Abstract
Introduction Conflicting reports of increases and decreases in rates of preterm birth (PTB) and stillbirth in the general population during the COVID‐19 pandemic have surfaced. The objective of our study was to conduct a living systematic review and meta‐analyses of studies reporting pregnancy and neonatal outcomes by comparing the pandemic and pre‐pandemic periods. Material and methods We searched PubMed and Embase databases, reference lists of articles published up until 14 May 2021 and included English language studies that compared outcomes between the COVID‐19 pandemic time period and pre‐pandemic time periods. Risk of bias was assessed using the Newcastle–Ottawa scale. We conducted random‐effects meta‐analysis using the inverse variance method. Results Thirty‐seven studies with low‐to‐moderate risk of bias, reporting on 1 677 858 pregnancies during the pandemic period and 21 028 650 pregnancies during the pre‐pandemic period, were included. There was a significant reduction in unadjusted estimates of PTB (28 studies, unadjusted odds ratio [uaOR] 0.94, 95% confidence [CI] 0.91–0.98) but not in adjusted estimates (six studies, adjusted OR [aOR] 0.95, 95% CI 0.80–1.13). The reduction was noted in studies from single centers/health areas (uaOR 0.90, 95% CI 0.86–0.94) but not in regional/national studies (uaOR 0.99, 95% CI 0.95–1.03). There was reduction in spontaneous PTB (five studies, uaOR 0.89, 95% CI 0.82–0.98) and induced PTB (four studies, uaOR 0.90, 95% CI 0.81–1.00). There was no reduction in PTB when stratified by gestational age <34, <32 or <28 weeks. There was no difference in stillbirths between the pandemic and pre‐pandemic time periods (21 studies, uaOR 1.08, 95% CI 0.94–1.23; four studies, aOR 1.06, 95% CI 0.81–1.38). There was an increase in birthweight (six studies, mean difference 17 g, 95% CI 7–28 g) during the pandemic period. There was an increase in maternal mortality (four studies, uaOR 1.15, 95% CI 1.05–1.26), which was mostly influenced by one study from Mexico. There was significant publication bias for the outcome of PTB. Conclusions The COVID‐19 pandemic time period may be associated with a reduction in PTB; however, referral bias cannot be excluded. There was no difference in stillbirth between the pandemic and pre‐pandemic period.
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Affiliation(s)
- Jie Yang
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Rohan D'Souza
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.,Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Ashraf Kharrat
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Deshayne B Fell
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - John W Snelgrove
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Kellie E Murphy
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.,Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Prakesh S Shah
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.,Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Association between COVID-19 mandatory lockdown and decreased incidence of preterm births and neonatal mortality. J Perinatol 2021; 41:2566-2569. [PMID: 34050246 PMCID: PMC8162487 DOI: 10.1038/s41372-021-01116-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/10/2021] [Accepted: 05/18/2021] [Indexed: 02/02/2023]
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