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Dong M, Qian R, Wang J, Fan J, Ye Y, Zhou H, Win B, Reid E, Zheng S, Lv Y, Pu Y, Chen H, Jin J, Lin Q, Luo X, Chen G, Chen Y, He Z, He G, Cheng S, Hu J, Xiao J, Ma W, Liu T, Wen X. Associations of COVID-19 lockdown with gestational length and preterm birth in China. BMC Pregnancy Childbirth 2021; 21:795. [PMID: 34837991 PMCID: PMC8626761 DOI: 10.1186/s12884-021-04268-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/11/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The effects of COVID-19 lockdown measures on maternal and fetal health remain unclear. We examined the associations of COVID-19 lockdown with gestational length and preterm birth (PTB) in a Chinese population. METHODS We obtained medical records of 595,396 singleton live infants born between 2015 and 2020 in 5 cities in Guangdong Province, South China. The exposed group (N = 101,900) included women who experienced the COVID-19 Level I lockdown (1/23-2/24/2020) during pregnancy, while the unexposed group (N = 493,496) included women who were pregnant during the same calendar months in 2015-2019. Cumulative exposure was calculated based on days exposed to different levels of emergency responses with different weighting. Generalized linear regression models were applied to estimate the associations of lockdown exposure with gestational length and risk of PTB (< 37 weeks). RESULTS The exposed group had a shorter mean gestational length than the unexposed group (38.66 vs 38.74 weeks: adjusted β = - 0.06 week [95%CI, - 0.07, - 0.05 week]). The exposed group also had a higher risk of PTB (5.7% vs 5.3%; adjusted OR = 1.08 [95%CI, 1.05, 1.11]). These associations seemed to be stronger when exposure occurred before or during the 23rd gestational week (GW) than during or after the 24th GW. Similarly, higher cumulative lockdown exposure was associated with a shorter gestational length and a higher risk of PTB. CONCLUSIONS The COVID-19 lockdown measures were associated with a slightly shorter gestational length and a moderately higher risk of PTB. Early and middle pregnancy periods may be a more susceptible exposure window.
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Affiliation(s)
- Moran Dong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
- School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Rui Qian
- Statistical Information Center for Health and Family Planning Bureau of Foshan, Foshan, 528000, China
| | - Jiaqi Wang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510080, China
| | - Jingjie Fan
- Department of Prevention and Health Care, Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
| | - Yufeng Ye
- Guangzhou Panyu Central Hospital, Guangzhou, 511400, China
| | - He Zhou
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510080, China
| | - Brian Win
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14214, USA
| | - Eve Reid
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14214, USA
| | - Suijin Zheng
- The Affiliated Houjie Hospital, Guangdong Medical University, Dongguan, 523945, China
| | - Yanyun Lv
- Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, 529030, China
| | - Yudong Pu
- Songshan Lake Central Hospital of Dongguan City, Dongguan, 523808, China
| | - Hanwei Chen
- Guangzhou Panyu Central Hospital, Guangzhou, 511400, China
| | - Juan Jin
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510080, China
| | - Qingmei Lin
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, 528000, China
| | - Xiaoyang Luo
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangzhou, 510000, China
| | - Guimin Chen
- School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Yumeng Chen
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510080, China
| | - Zhongrong He
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Guanhao He
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Shouzhen Cheng
- Nursing Department, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 West, Huangpu Road, Tianhe District, Guangzhou, 510632, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 West, Huangpu Road, Tianhe District, Guangzhou, 510632, China.
| | - Xiaozhong Wen
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14214, USA
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