Impact of Lockdown Measures during COVID-19 Pandemic on Pregnancy and Preterm Birth

2021 ◽  
Author(s):  
Belal Alshaikh ◽  
Po-Yin Cheung ◽  
Nancy Soliman ◽  
Marie-Anne Brundler ◽  
Kamran Yusuf
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnancy Outcomes ◽  
Very Low Birth Weight ◽  
Gestational Hypertension ◽  
Cohort Analysis ◽  
Preterm Births ◽  
Live Births ◽  
Very Preterm

Objective The objective of this study is to assess the effect of the lockdown measures during the coronavirus disease 2019 (COVID-19) pandemic on pregnancy outcomes of women who were not affected by severe acute respiratory syndrome coronavirus 2 infection. Study Design We used data from the perinatal health program and neonatal databases to conduct a cohort analysis of pregnancy outcomes during the COVID-19 lockdown in the Calgary region, Canada. Rates of preterm birth were compared between the lockdown period (March 16 to June 15, 2020) and the corresponding pre-COVID period of 2015 to 2019. We also compared maternal and neonatal characteristics of preterm infants admitted to neonatal intensive care units (NICUs) in Calgary between the two periods. Findings A total of 4,357 and 24,160 live births occurred in the lockdown and corresponding pre-COVID period, respectively. There were 366 (84.0 per 1,000 live births) and 2,240 (92.7 per 1,000 live births) preterm births in the lockdown and corresponding pre-COVID period, respectively (p = 0.07). Rates of very preterm and very-low-birth-weight births were lower in the lockdown period compared with the corresponding pre-COVID period (11.0 vs. 15.6 and 9.0 vs. 14.4 per 1,000 live births, p = 0.02 and p = 0.005, respectively). There was no difference in spontaneous stillbirth between the two periods (3.7 vs. 4.1 per 1,000 live birth, p = 0.71). During the lockdown period, the likelihood of multiple births was lower (risk ratio [RR] 0.73, 95% confidence interval [CI]: 0.60–0.88), while gestational hypertension and clinical chorioamnionitis increased (RR 1.24, 95%CI: 1.10–1.40; RR 1.33, 95%CI 1.10–1.61, respectively). Conclusion Observed rates of very preterm and very-low-birth-weight births decreased during the COVID-19 lockdown. Pregnant women who delivered during the lockdown period were diagnosed with gestational hypertension and chorioamnionitis more frequently than mothers in the corresponding pre-COVID period. Key Points

scholarly journals Reduction in preterm births during the COVID-19 lockdown in Ireland: a natural experiment allowing analysis of data from the prior two decades

2020 ◽  
Author(s):  
RK Philip ◽  
H Purtill ◽  
E Reidy ◽  
M Daly ◽  
M Imcha ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Rate Ratio ◽  
Birth Rate ◽  
Very Low Birth Weight ◽  
Preterm Births ◽  
List Type ◽  
Live Births ◽  
New Findings

AbstractBackgroundAetiology of preterm birth (PTB) is heterogeneous and preventive strategies remain elusive. Socio-environmental measures implemented as Ireland’s prudent response to the SARS-CoV-2 virus (COVID-19) pandemic represented, in effect, a national lockdown and have possibly influenced the health and wellbeing of pregnant women and unborn infants. Cumulative impact of such socio-environmental factors operating contemporaneously on PTB has never been assessed before.MethodsRegional PTB trends of very low birth weight (VLBW) infants in one designated health area of Ireland over two decades were analysed. Poisson regression and rate ratio analyses with 95% CI were conducted. Observed regional data from January – April 2020 were compared to historical regional and national data and forecasted national figures for 2020.ResultsPoisson regression analysis found that the regional historical VLBW rate per 1000 live births for January to April, 2001-2019 was 8.18 (95% CI: 7.21, 9.29). During January to April 2020, an unusually low VLBW rate of just 2.17 per 1000 live births was observed. The rate ratio of 3.77 (95% CI: 1.21, 11.75), p = 0.022, estimates that for the last two decades there was, on average, 3.77 times the rate of VLBW, compared to the period January to April 2020 during which there is a 73% reduction. National Irish VLBW rate for 2020 is forecasted to be reduced to 400 per 60,000 births compared to the historical 500-600 range.ConclusionAn unprecedented reduction in PTB of VLBW infants was observed in one health region of Ireland during the COVID-19 lockdown. Potential determinants of this unique temporal trend reside in the summative socio-environmental impact of the COVID-19 dictated lockdown. Our findings, if mirrored in other regions that have adopted similar measures to combat the pandemic, demonstrate the potential to evaluate these implicated interdependent behavioural and socio-environmental modifiers to positively influence PTB rates globally.Key QuestionsWhat is already known?Premature birth is an important contributor for under-five mortality globally.Currently there is no broadly accepted and effective strategy to prevent the birth of premature very low birth weight infants.Impact of socio-environmental and maternal behavioural modifications on the incidence of preterm birth has not been assessed.What are the new findings?COVID-19-triggered national lockdown in Ireland created an opportunity to study the cumulative influence of socio-environmental modifications on pregnant mothers.An unprecedented 73% reduction in the rate of very low birth weight deliveries was noted in one designated health region of Ireland during January to April of 2020 in comparison to the preceding 20 year timeframe.Our observations, if nationally mirrored, indicate that birth rate of very low birth weight premature infants in Ireland is forecasted to decrease considerably in 2020.What do the new findings imply?Socially rooted modifiers such as family support, work related stress and commuting, environmental pollution, infection avoidance, sleep and nutritional support, adequate exercise, reduced exposure to tobacco and illicit drugs, avoidance of financial strain, all cumulatively could contribute to reduce preterm birth rate.Our observations, if reflected in other countries that adopted COVID-19-prompted lockdown measures, would redefine the antecedents that trigger the yet poorly understood pathways leading to preterm births.Prematurity rate would be the most important ‘curve to bend’ in the context of reducing infant mortality globally and thus promote the achievement of sustainable development goals for children.

scholarly journals Pregnancy Outcome during the First COVID 19 Lockdown in Vienna, Austria

2021 ◽  
Vol 18 (7) ◽  
pp. 3782
Author(s):  
Sylvia Kirchengast ◽  
Beda Hartmann
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnancy Outcome ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Negative Effects ◽  
Gestational Length ◽  
Live Births

The COVID 19 pandemic represents a major stress factor for non-infected pregnant women. Although maternal stress during pregnancy increases the risk of preterm birth and intrauterine growth restriction, an increasing number of studies yielded no negative effects of COVID 19 lockdowns on pregnancy outcome. The present study focused on pregnancy outcome during the first COVID 19 lockdown phase in Austria. In particular, it was hypothesized that the national lockdown had no negative effects on birth weight, low birth weight rate and preterm birth rate. In a retrospective medical record-based single center study, the outcome of 669 singleton live births in Vienna Austria during the lockdown phase between March and July 2020 was compared with the pregnancy outcome of 277 live births at the same hospital during the pre-lockdown months of January and February 2020 and, in addition, with the outcome of 28,807 live births between 2005 and 2019. The rate of very low gestational age was significantly lower during the lockdown phase than during the pre-lockdown phase. The rate of low gestational age, however, was slightly higher during the lockdown phase. Mean birth weight was significantly higher during the lockdown phase; the rates of low birth weight, very low birth weight and extremely low birth weight were significantly lower during the lockdown phase. In contrast, maternal gestational weight gain was significantly higher during the lockdown phase. The stressful lockdown phase in Austria seems to have no negative affect on gestational length and newborn weight among non-infected mothers.

scholarly journals Changes in live births, preterm birth, low birth weight, and cesarean deliveries in the United States during the SARS-CoV-2 pandemic

2021 ◽  
Author(s):  
Alison Gemmill ◽  
Joan A. Casey ◽  
Ralph Catalano ◽  
Deborah Karasek ◽  
Tim-Allen Bruckner
Keyword(s):  
Time Series ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Cesarean Delivery ◽  
Very Low Birth Weight ◽  
National Level ◽  
Health Indicators ◽  
The United States ◽  
Live Births

Background: The SARS-CoV-2 pandemic and associated social, economic, and clinical disruption have been widely speculated to affect pregnancy decision-making and outcomes. While a few US-based studies have examined subnational changes in fertility, preterm birth, and stillbirth, there remains limited knowledge of how the pandemic impacted childbearing and a broader set of perinatal health indicators at the national-level throughout 2020. Here, we use recently released national-level data to fill this gap. Importantly, we, unlike earlier work, use time-series methods to account for strong temporal patterning (e.g., seasonality, trend) that could otherwise lead to spurious findings. Methods: For the years 2015 to 2020, we obtained national monthly counts of births and rates (per 100 births) for six perinatal indicators: preterm birth (<37 weeks gestation), early preterm birth (<34 weeks gestation), late preterm birth (34-36 weeks gestation), low birth weight birth (<2500 g), very low birth weight birth (<1500 g), and cesarean delivery. We use an interrupted time-series approach to compare the outcomes observed after the pandemic began (March 2020) to those expected had the pandemic not occurred. Results: For total births as well as five of the six indicators (i.e., all but the rate of cesarean delivery), observed values fall well below expected levels (p<.0001 for each test) during the entire pandemic period. Declines in preterm birth and low birth weight were largest in magnitude in both early and later stages of the 2020 pandemic, while those for live births occurred at the end of the year. Discussion: Our findings provide some of the first national evidence of substantial reductions in live births and adverse perinatal outcomes during the SARS-CoV-2 pandemic. Only cesarean delivery appeared unaffected. These declines were not uniform across the pandemic, suggesting that several mechanisms, which require further study, may explain these patterns.

scholarly journals Do emissions from landfill fires affect pregnancy outcomes? A retrospective study after arson at a solid waste facility in Sicily

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027912 ◽  
Author(s):  
Walter Mazzucco ◽  
Elisa Tavormina ◽  
Maurizio Macaluso ◽  
Claudia Marotta ◽  
Rosanna Cusimano ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Maternal Age ◽  
Very Low Birth Weight ◽  
Reference Group ◽  
Study Group ◽  
Live Births ◽  
Very Preterm ◽  
Infant Gender

ObjectivesIn response to public health concern about effects of arson at solid waste management plants in July 2012, we analysed vital statistics data to evaluate any potential effect on pregnancies at different gestational ages of pollutants emitted from the landfill on fire.SettingA community living near the largest landfill plant in Sicily.ParticipantsThe study group comprised 551 births, live births and stillbirths from pregnancies of mothers residing in the extra-urban exposed area, conceived during a 40 week period during which the highest fire’s peak might have influenced pregnancy.Primary and secondary outcome measuresBirth outcomes (gestational age <37 and <32 weeks, low birth weight, very low birth weight and small for gestational age) in the study group were compared with the ones of a reference group of women residing in areas of Sicily with similarly low population density and industrial development.ResultsAmong singleton live births we observed a three-fold increase in risk of very preterm birth between the extra-urban area and the remaining low inhabitants density and unindustrialised areas for births whose pregnancies were in the third trimester (OR adjusted for maternal age and infant gender=3.41; 95% CI 1.04 to 11.16). There was an excess of very low birth weight singleton infants in the study group as compared with the reference group, which was limited to births to mothers exposed during periconception period (OR adjusted for maternal age and infant gender=4.64; 95% CI 1.04 to 20.6) and first trimester (OR adjusted for maternal age and infant gender=3.66; 95% CI 1.11 to 12.1). The association estimates were imprecise due to the small number of outcomes recorded.ConclusionsThe study documented an excess of very preterm and very low birth weight among infants born to mothers exposed to the landfill fire emissions during conception or early pregnancy.

Association of Very Preterm Birth or Very Low Birth Weight With Intelligence in Adulthood

2021 ◽  
Author(s):  
Robert Eves ◽  
Marina Mendonça ◽  
Nicole Baumann ◽  
Yanyan Ni ◽  
Brian A. Darlow ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Very Preterm ◽  
Very Preterm Birth

Prevention of Preterm Births: A Perinatal Study in Haguenau, France

PEDIATRICS ◽  
1985 ◽  
Vol 76 (2) ◽  
pp. 154-158
Author(s):  
E. Papiernik ◽  
J. Bouyer ◽  
J. Dreyfus ◽  
D. Collin ◽  
G. Winisdorffer ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Direct Relationship ◽  
Intervention Study ◽  
Total Duration ◽  
Preterm Births ◽  
Birth Rates ◽  
Live Births ◽  
Mother’S Age

A reduction in preterm births has been observed in Haguenau (Eastern France) during a 12-year intervention study with a program for prevention of preterm deliveries. The Perinatal Study of Haguenau was an observation tool used in a stable population, and it allowed measurement of the way women have progressively responded to the new proposals in prenatal care. It also allowed measurement of the results of the interventions: low birth weight (less than 2,500 g) and preterm birth rates (less than 37 weeks of gestation) among single live births. The total duration of the study was divided into three periods of four years (1971 through 1974, 1975 through 1978, and 1979 through 1982), for which the numbers of single live births are 5,763, 4,957, and 5,919, respectively. For the same periods, the low-birth-weight rates, 4.6%, 4.0%, and 3.8%, respectively, showed a significant decrease (P &lt; .001). Following a similar pattern, the rates of preterm birth were 5.4%, 4.1%, and 3.7% (a significant reduction with P &lt; .001). These improvements in pregnancy outcome do not disappear after standardization of mother's age, high blood pressure, or social class distribution. These findings, which concur with the results of others, enhance the hypothesis of a direct relationship between a prevention program and a reduction in preterm birth rates.

scholarly journals Changes in quality of life into adulthood after very preterm birth and/or very low birth weight in the Netherlands

2013 ◽  
Vol 11 (1) ◽  
pp. 51 ◽  
Author(s):  
Afra van Lunenburg ◽  
Sylvia M van der Pal ◽  
Paula van Dommelen ◽  
Karin M van der Pal – de Bruin ◽  
Jack Bennebroek Gravenhorst ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
The Netherlands ◽  
Very Low Birth Weight ◽  
Very Preterm ◽  
Very Preterm Birth

scholarly journals 435 Changes in Quality of Life into Adulthood after very Preterm Birth and/or Very Low Birth Weight in the Netherlands

2012 ◽  
Vol 97 (Suppl 2) ◽  
pp. A128-A128
Author(s):  
S. v. d. Pal ◽  
A. v. Lunenburg ◽  
C. Lanting ◽  
K. v. d. P. Bruin ◽  
J. B. Gravenhorst ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
The Netherlands ◽  
Very Low Birth Weight ◽  
Very Preterm ◽  
Very Preterm Birth

scholarly journals POS0022 PHARMACOVIGILANCE PREGNANCY DATA IN A LARGE POPULATION OF PATIENTS WITH CHRONIC INFLAMMATORY DISEASE EXPOSED TO CERTOLIZUMAB PEGOL: PREGNANCY OUTCOMES AND CONFOUNDERS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 213.2-213
Author(s):  
M. Clowse ◽  
R. Fischer-Betz ◽  
C. Nelson-Piercy ◽  
A. Scheuerle ◽  
T. Kumke ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnancy Outcomes ◽  
Congenital Malformations ◽  
Certolizumab Pegol ◽  
First Trimester ◽  
Research Support ◽  
Safety Database ◽  
Live Births

Background:Chronic inflammatory diseases (CID) in women of reproductive age are increasingly being treated with tumour necrosis factor inhibitors (TNFi), in line with recent guidelines.1 However, data on TNFi-exposed pregnancy outcomes are still limited. Certolizumab pegol (CZP), a PEGylated, Fc-free TNFi, has no/minimal placental transfer from mother to infant during the third trimester.2Objectives:To assess pregnancy outcomes from the UCB Pharmacovigilance safety database from over 1,300 prospectively reported pregnancies with maternal CZP exposure.Methods:Details of CZP-exposed pregnancies from the UCB Pharmacovigilance safety database were reviewed up to November 1, 2020. Analysis was limited to prospectively reported cases with known pregnancy outcomes to avoid potential reporting bias. Confounders (specific CID, non-biologic medications and maternal infection) were evaluated using a multivariate stepwise regression model; results from the confounders analysis are reported as odds ratios (OR) with 95% confidence intervals (CI). Patients with missing information about presence or absence of confounders were excluded from the model.Results:1,392 prospective pregnancies (1,425 fetuses) with maternal CZP exposure and known outcomes were reported (Figure 1). Mean (SD) maternal age was 31.9 (5.1) years. Of these, 1,021/1,392 (73.3%) pregnancies had at least first-trimester CZP exposure and 547/1,392 (39.3%) were exposed during all trimesters. Overall, there were 1,259/1,425 (88.4%) live births, 150/1,425 (10.5%) abortions (miscarriages and terminations), 11/1,425 (0.8%) stillbirths, and 5/1,425 (0.4%) ectopic pregnancies. Congenital malformations were reported in 35/1,425 fetuses (2.5%) and in 30/1,259 live-born infants (2.4%); 26 (2.1%) congenital malformations were major according to the Metropolitan Atlanta Congenital Defects Program criteria. There was no pattern of specific congenital malformations. Preterm births occurred in 124/1,259 (9.8%) live births, and 101/1,259 (8.0%) of infants had low birth weight (<2.5 kg). In the confounders analysis, reported corticosteroid use was independently associated with increased odds of preterm birth (OR [95% CI]: 2.1 [1.3–3.4]; p<0.005) and low birth weight (OR [95% CI]: 1.7 [1.0–2.9]; p<0.05), but decreased odds of abortion (OR [95% CI]: 0.5 [0.3–0.9]; p<0.05). Reported NSAID use was associated with increased odds of abortion (OR [95% CI]: 2.2 [1.2–4.0]; p<0.05), as was methotrexate/leflunomide use (OR [95% CI]: 3.2 [1.7–6.2]; p<0.0005). Maternal infections were associated with increased odds of preterm birth (OR [95% CI]: 1.9 (1.1–3.5; p<0.05). Finally, there was an association between a diagnosis of Crohn’s disease and odds of abortion (OR [95% CI]: 2.5 [1.5–4.1]; p=0.0005), and between rheumatoid arthritis and low birth weight (OR [95% CI]: 1.9 [1.1–3.3]; p<0.05).Conclusion:This prospective analysis, including more than 1,000 pregnancies with CZP exposure in at least the first trimester, represents one of the largest cohorts of pregnancies with known outcomes in patients with CID. Our data confirm the impact of specific CID, concomitant drugs or comorbidities on pregnancy outcomes. In particular, additional use of corticosteroids was highlighted as a risk factor for preterm birth and low birth weight in our cohort of CZP-treated patients. No increase in adverse pregnancy outcomes or specific congenital malformations was observed in CZP-exposed pregnancies, compared to the general population,3,4 which offers further reassurance for women of childbearing age considering CZP treatment.References:[1]Sammaritano LR. Arthritis Rheum 2020;72:529–56;[2]Mariette X. Ann Rheum Dis 2018;77:228–33;[3]Ventura SJ. Natl Vital Stat Rep 2012;60:1–21;[4]Lee H. BMC Pregnancy Childbirth 2020;20:33.Acknowledgements:This study was funded by UCB Pharma. Editorial services were provided by Costello Medical.Disclosure of Interests:Megan Clowse Consultant of: UCB Pharma, Grant/research support from: Janssen, Pfizer, Rebecca Fischer-Betz Consultant of: AbbVie, BMS, Celgene, Chugai, Eli Lilly, Janssen, Novartis, Pfizer, Sanofi, UCB Pharma, Catherine Nelson-Piercy Consultant of: Alliance Pharma, UCB Pharma, Angela Scheuerle Consultant of: Antiretroviral Pregnancy Registry, Harmony Biosciences, IQVIA, ICON, NovoNordisk, PPD, Roche, Sanofi-Genzyme, Syneos, UCB Pharma, ViiV, Thomas Kumke Shareholder of: UCB Pharma, Employee of: UCB Pharma, Bernard Lauwerys Employee of: UCB Pharma, Rachna Kasliwal Employee of: UCB Pharma, Frauke Förger Speakers bureau: Mepha, Roche, UCB Pharma, Grant/research support from: UCB Pharma.

Sign in / Sign up

Export Citation Format

Share Document