Reduction in preterm birth rates during and after the COVID-19 lockdown in Queensland Australia

BACKGROUND

Preventative strategies for preterm birth are lacking. Recent evidence proposed COVID-19 lockdowns may have contributed to changes in preterm birth.

AIMS

To determine the prevalence of preterm birth and birth outcomes during and after the COVID-19 lockdown at the Sunshine Coast University Hospital and the overall state of Queensland, Australia.

METHODS

Retrospective cohort analysis of all births in Queensland including the Sunshine Coast University Hospital, during two epochs, April 1-May 31, 2020 (lockdown) and June 1-July 31, 2020 (post-lockdown), compared to antecedent calendar-matched periods in 2018-2019. Prevalence of preterm birth, stillbirth, and late terminations were examined.

RESULTS

There were 64 989 births in Queensland from April to July 2018-2020. At the Sunshine Coast University Hospital, there was a significantly higher chance of birth at term during both lockdown (odds ratio (OR) 1.81, 95% CI 1.17, 2.79; P = 0.007) and post-lockdown (OR 2.01, 95% CI 1.27, 3.18; P = 0.003). At the same centre, prevalence of preterm birth was 5.5% (30/547) during lockdown, compared to 9.1% (100/1095) in previous years, a 40.0% relative reduction (P = 0.016). At this centre during lockdown, emergency caesareans concurrently decreased (P < 0.01) and instrumental vaginal births increased (P < 0.01). In Queensland overall, there was a nonsignificant decrease in the prevalence of preterm birth during lockdown.

CONCLUSIONS

There is a link between lockdown and a reduction in the prevalence of preterm birth on the Sunshine Coast. The cause is speculative at present, although increased influenza vaccination rates, decreased transmission of infections, and improved air quality may have been favourable in reducing preterm birth. Further research is needed to determine a causal link.

Impact of deep brain stimulation on people with Parkinson's disease: A mixed methods feasibility study exploring lifespace and community outcomes

Background

Deep brain stimulation is a surgical treatment for Parkinson’s disease. Its impacts on motor symptoms are widely reported; however, little is known about the broader impact of deep brain stimulation on the community lives of people with Parkinson’s disease. Lifespace is a measure of lived community mobility, providing an indication of community access and participation.

Aims

This pilot study explored the feasibility of remotely monitoring the qualitative and quantitative community outcomes related to deep brain stimulation.

Methods

A longitudinal mixed methods study with a convergent design was undertaken exploring the lifespace, quality of life, life satisfaction and lived experiences of people with Parkinson’s disease before and after deep brain stimulation. Data were collected through questionnaires, semi-structured interviews and a smartphone-based application which collected geolocation data.

Results

Quantitative and qualitative data from eight participants living with Parkinson’s disease were analysed and integrated. At baseline, participants had a median age of 68 years and a median Hoehn and Yahr score of 2. Measuring a range of community-based outcomes indicated different change trajectories for individuals across outcomes. Key content areas were developed from the qualitative data: participation in occupations and travel and home. This study indicates the potential value of including geolocation data-based lifespace collection in metropolitan and regional areas.

Conclusions

Monitoring lifespace in conjunction with subjective measures provides insights into the complex and individually varied experiences. Further research could explore the impacts of deep brain stimulation on occupations and community participation to gain a deeper understanding of the related needs and support clinical approaches.

Comparing activity engagement of people aged 18 to 64 years with and without Parkinson’s disease

Introduction

Measuring activity engagement using the Activity Card Sort Australia (18–64) supports occupational therapists and clients to identify goals for therapeutic interventions. The aim of this study was to investigate activity engagement for people aged 18 to 64 years with and without Parkinson’s disease.

Method

Thirty-two participants, 16 people with Parkinson’s disease (mean age 57.8) and 16 healthy adults (mean age 53.1), were required to sort 85 visual activity cards into one of five categories: ‘never done’, ‘do not do now’, ‘do now’, ‘do less now’ and ‘given up’. The retained activity values were calculated and compared using the Mann–Whitney U Test.

Results

The overall retained activity scores were not significantly different ( p = .81); however, the group with Parkinson’s disease had higher retained scores in the physical activities domain ( p = .04)

Conclusion

The preventative exercise regimes of people with Parkinson’s disease seems to influence activity engagement patterns. A more detailed understanding of activity engagement may further help form the basis of meaningful interventions.