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Stock SJ, Zoega H, Brockway M, Mulholland RH, Miller JE, Been JV, Wood R, Abok II, Alshaikh B, Ayede AI, Bacchini F, Bhutta ZA, Brew BK, Brook J, Calvert C, Campbell-Yeo M, Chan D, Chirombo J, Connor KL, Daly M, Einarsdóttir K, Fantasia I, Franklin M, Fraser A, Håberg SE, Hui L, Huicho L, Magnus MC, Morris AD, Nagy-Bonnard L, Nassar N, Nyadanu SD, Iyabode Olabisi D, Palmer KR, Pedersen LH, Pereira G, Racine-Poon A, Ranger M, Rihs T, Saner C, Sheikh A, Swift EM, Tooke L, Urquia ML, Whitehead C, Yilgwan C, Rodriguez N, Burgner D, Azad MB. The international Perinatal Outcomes in the Pandemic (iPOP) study: protocol. Wellcome Open Res 2021; 6:21. [PMID: 34722933 PMCID: PMC8524299 DOI: 10.12688/wellcomeopenres.16507.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 11/20/2022] Open
Abstract
Preterm birth is the leading cause of infant death worldwide, but the causes of preterm birth are largely unknown. During the early COVID-19 lockdowns, dramatic reductions in preterm birth were reported; however, these trends may be offset by increases in stillbirth rates. It is important to study these trends globally as the pandemic continues, and to understand the underlying cause(s). Lockdowns have dramatically impacted maternal workload, access to healthcare, hygiene practices, and air pollution - all of which could impact perinatal outcomes and might affect pregnant women differently in different regions of the world. In the international Perinatal Outcomes in the Pandemic (iPOP) Study, we will seize the unique opportunity offered by the COVID-19 pandemic to answer urgent questions about perinatal health. In the first two study phases, we will use population-based aggregate data and standardized outcome definitions to: 1) Determine rates of preterm birth, low birth weight, and stillbirth and describe changes during lockdowns; and assess if these changes are consistent globally, or differ by region and income setting, 2) Determine if the magnitude of changes in adverse perinatal outcomes during lockdown are modified by regional differences in COVID-19 infection rates, lockdown stringency, adherence to lockdown measures, air quality, or other social and economic markers, obtained from publicly available datasets. We will undertake an interrupted time series analysis covering births from January 2015 through July 2020. The iPOP Study will involve at least 121 researchers in 37 countries, including obstetricians, neonatologists, epidemiologists, public health researchers, environmental scientists, and policymakers. We will leverage the most disruptive and widespread “natural experiment” of our lifetime to make rapid discoveries about preterm birth. Whether the COVID-19 pandemic is worsening or unexpectedly improving perinatal outcomes, our research will provide critical new information to shape prenatal care strategies throughout (and well beyond) the pandemic.
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Affiliation(s)
| | - Helga Zoega
- Centre for Big Data Research in Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Meredith Brockway
- Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | | | - Jessica E. Miller
- Infection and Immunity, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Australia
| | - Jasper V. Been
- Division of Neonatology, Department of Paediatrics, Erasmus MC - Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Public Health, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Rachael Wood
- Public Health Scotland, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Ishaya I. Abok
- Department of Paediatrics, University of Jos, Jos, Nigeria
| | - Belal Alshaikh
- Department of Pediatrics, University of Calgary, Calgary, Canada
| | - Adejumoke I. Ayede
- Department of Paediatrics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- University College Hospital, Ibadan, Nigeria
| | | | - Zulfiqar A. Bhutta
- Center of Excellence in Women Child Health, The Aga Khan University South-Central Asia & East Africa, Karachi, Pakistan
| | - Bronwyn K. Brew
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health, UNSW Sydney, Sydney, Australia
| | - Jeffrey Brook
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Canada
| | - Clara Calvert
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | - Deborah Chan
- Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | - James Chirombo
- Malawi-Liverpool-Wellcome Clinical Research Programme, Blantyre, Malawi
| | | | - Mandy Daly
- IWK Health Centre, Halifax, Canada
- Advocacy & Policymaking, Irish Neonatal Health Alliance, Dublin, Ireland
| | - Kristjana Einarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Ilaria Fantasia
- Unit of Fetal Medicine and Prenatal Diagnosis Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Meredith Franklin
- Division of Biostatistics, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit,, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Siri Eldevik Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Lisa Hui
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Luis Huicho
- Centro de Investigación en Salud Materna e Infantil, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maria C. Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | | | - Natasha Nassar
- Children’s Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia
| | - Sylvester Dodzi Nyadanu
- School of Public Health, Curtin University, Perth, Australia
- Education, Culture, and Health Opportunities (ECHO) Research Group International, Aflao, Ghana
| | | | - Kirsten R. Palmer
- Monash Health Department of Obstetrics & Gynaecology, Monash University, Clayton, Australia
| | - Lars Henning Pedersen
- Department of Obstetrics & Gynaecology, Aarhus University Hospital, Aarhus, Denmark
- Clinical Medicine & Biomedicine, Aarhus University, Aarhus, Denmark
| | - Gavin Pereira
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- School of Public Health, Curtin University, Perth, Australia
- Telethon Kids Institute, Nedlands, Australia
| | | | - Manon Ranger
- BC Children’s & Women’s Hospital Research Institute, School of Nursing, University of British Columbia, Vanvouver, Canada
| | - Tonia Rihs
- Federal Statistical Office, Neuchatel, Switzerland
| | - Christoph Saner
- Department of Pediatric Endocrinology, Diabetology, and Metabolism, University Children`s Hospital Bern, Inselspital, Bern, Switzerland
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Emma M. Swift
- Department of Midwifery, Faculty of Nursing, University of Iceland, Reykjavík, Iceland
| | - Lloyd Tooke
- Department of Neonatology, University of Cape Town, Cape Town, South Africa
- Department of Neonatology, Groote Schuur Hospital, Cape Town, South Africa
| | - Marcelo L. Urquia
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Clare Whitehead
- Pregnancy Research Centre, The Royal Women's Hospital, Melbourne, Australia
| | | | - Natalie Rodriguez
- Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | - David Burgner
- Infection and Immunity, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Meghan B. Azad
- Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
- Children’s Hospital Research Institute of Manitoba, The Children’s Hospital Foundation of Manitoba, Winnipeg, Canada
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