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.

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 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.

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.

Prematurity: Impact on Neurodevelopmental and Behavioral Outcomes

2010 ◽  
Author(s):  
Betty R. Vohr
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Birth Rate ◽  
Very Low Birth Weight ◽  
Public Health Problem ◽  
Multiple Births ◽  
Major Public Health Problem ◽  
Neurodevelopmental Outcomes ◽  
Antenatal Steroids

Prematurity continues to be a major public health problem and, despite advances in antenatal care, prematurity rates continue to rise in the United States. Preterm and low-birth-weight (LBW) rates increased in 2006 to 12.8% and 8.3%, respectively. The very low birth weight (VLBW) (<1500 g) rate rose to 1.46% (62,283 of 4,265,996 births in 2006). In addition, the birth rate for women aged 40–44 years rose 3% to 9.4 per 1,000 between 2005 and 2006 (Martin et al. 2008). A component of the increase in the preterm birth rate remains attributed to older maternal childbearing, multiple births, and increasing rates of assisted reproductive technology (Heck et al. 1997). The increase in the number of multiple births is a concern because of the associated increased risk of death, preterm birth, low birth weight, and long-term adverse neurodevelopmental outcomes. Major therapeutic advances in perinatal and neonatal care in the past 20 years, including surfactant therapy, antenatal steroids for both pulmonary maturation and central nervous system protection, improved ventilation techniques, and parenteral nutritional support have resulted in a significant improvement in survival of extremely low-birth-weight infants (ELBW) (<1000 g) (National Institutes of Health [NIH] 1995; El-Metwally, Vohr, and Tucker 2000; Fanaroff, Hack, and Walsh 2003; Fanaroff et al. 2007; Hintz et al. 2005a; Hintz et al. 2005b). These infants have increased complex neonatal medical morbidities affecting all organ systems including lungs, gastrointestinal tract, kidneys, and brain, and increased growth, neurological, developmental, and behavioral morbidities both in the neonatal intensive care unit (NICU) and after discharge (Blakely et al. 2005; Ehrenkranz, 2000; Ehrenkranz et al. 2005; Laptook et al. 2005; Shankaran et al. 2004; Schmidt et al. 2003; Vohr et al. 2003; Vohr et al. 2004;Vohr et al. 2005; Walsh et al. 2005). Predicting the survival and neurodevelopmental outcomes of preterm infants becomes a challenge since outcomes are dependent on a combination of biologic factors including gender, gestational age, birth weight, singleton versus multiple, neonatal morbidities, neonatal interventions, and post-discharge environment.

scholarly journals Investigation of Metronidazole Use during Pregnancy and Adverse Birth Outcomes

2012 ◽  
Vol 56 (9) ◽  
pp. 4800-4805 ◽  
Author(s):  
Catherine A. Koss ◽  
Dana C. Baras ◽  
Sandra D. Lane ◽  
Richard Aubry ◽  
Michele Marcus ◽  
...  
Keyword(s):  
New York ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Congenital Anomalies ◽  
New York State ◽  
Multivariable Analysis ◽  
Preterm Births ◽  
First Trimester ◽  
First Trimester Of Pregnancy

ABSTRACTTo assess whether treatment with metronidazole during pregnancy is associated with preterm birth, low birth weight, or major congenital anomalies, we conducted chart reviews and an analysis of electronic data from a cohort of women delivering at an urban New York State hospital. Of 2,829 singleton/mother pairs, 922 (32.6%) mothers were treated with metronidazole for clinical indications, 348 (12.3%) during the first trimester of pregnancy and 553 (19.5%) in the second or third trimester. There were 333 (11.8%) preterm births, 262 (9.3%) infants of low birth weight, and 52 infants (1.8%) with congenital anomalies. In multivariable analysis, no association was found between metronidazole treatment and preterm birth (odds ratio [OR], 1.02 [95% confidence interval [CI], 0.80 to 1.32]), low birth weight (OR, 1.05 [95% CI, 0.77 to 1.43]), or treatment in the first trimester and congenital anomalies (OR, 0.86 [0.30 to 2.45]). We found no association between metronidazole treatment during the first or later trimesters of pregnancy and preterm birth, low birth weight, or congenital anomalies.

scholarly journals Anatomic accuracy, physiologic characteristics, and fidelity of very low birth weight infant airway simulators

2021 ◽  
Author(s):  
Patricia Lengua Hinojosa ◽  
Frank Eifinger ◽  
Michael Wagner ◽  
Jochen Herrmann ◽  
Monika Wolf ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Reference Values ◽  
Very Low Birth Weight ◽  
List Type ◽  
Preterm Baby ◽  
Low Birth Weight Infants ◽  
Low Birth Weight Infant ◽  
Ventilation Technique ◽  
One Simulator

Abstract Background Medical simulation training requires realistic simulators with high fidelity. This prospective multi-center study investigated anatomic precision, physiologic characteristics, and fidelity of four commercially available very low birth weight infant simulators. Methods We measured airway angles and distances in the simulators Premature AirwayPaul (SIMCharacters), Premature Anne (Laerdal Medical), Premie HAL S2209 (Gaumard), and Preterm Baby (Lifecast Body Simulation) using computer tomography and compared these to human cadavers of premature stillbirths. The simulators’ physiologic characteristics were tested, and highly experienced experts rated their physical and functional fidelity. Results The airway angles corresponded to those of the reference cadavers in three simulators. The nasal inlet to glottis distance and the mouth aperture to glottis distance were only accurate in one simulator. All simulators had airway resistances up to 20 times higher and compliances up to 19 times lower than published reference values. Fifty-six highly experienced experts gave three simulators (Premature AirwayPaul: 5.1 ± 1.0, Premature Anne 4.9 ± 1.1, Preterm Baby 5.0 ± 1.0) good overall ratings and one simulator (Premie HAL S2209: 2.8 ± 1.0) an unfavorable rating. Conclusion The simulator physiology deviated significantly from preterm infants’ reference values concerning resistance and compliance, potentially promoting a wrong ventilation technique. Impact Very low birth weight infant simulators showed physiological properties far deviating from corresponding patient reference values. Only ventilation with very high peak pressure achieved tidal volumes in the simulators, as aimed at in very low birth weight infants, potentially promoting a wrong ventilation technique. Compared to very low birth weight infant cadavers, most tested simulators accurately reproduced the anatomic angular relationships, but their airway dimensions were relatively too large for the represented body. The more professional experience the experts had, the lower they rated the very low birth weight infant simulators.

Low Birth Weight, Vital Records, and Infant Mortality

PEDIATRICS ◽  
1986 ◽  
Vol 78 (6) ◽  
pp. 1143-1145
Author(s):  
MYRON E. WEGMAN
Keyword(s):  
Birth Weight ◽  
Infant Mortality ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
The United States ◽  
Low Birth Weight Infants ◽  
Neonatal Deaths ◽  
Live Births ◽  
Order Of Magnitude ◽  
Almost All

About one tenth of all infant deaths occur in babies weighing less than 500 g at birth, almost all of whom die very shortly thereafter. In 1983, when the United States reported 3,638,933 live births, 4,368 of them were less than 500 g; that year there were 26,507 neonatal deaths. This means that slightly more than 0.1% of all live births contributed to 17% of neonatal mortality. Given this order of magnitude, any change in the numbers relating to these tiny babies can have a disproportionate influence on reported infant mortality and on interstate comparisons. Two questions promptly arise. How accurate and meaningful are the data regarding babies born weighing less than 500 g? What can be done to decrease the deaths in this category? Wilson et al1 call attention to how the number of very low birth weight infants reported by a state may be affected by the state's definition of a live birth.

Analysis of selected perinatological indicators in the Slovak Republic in the years 2007–2018

2021 ◽  
Vol 86 (2) ◽  
pp. 102-109
Author(s):  
Miroslav Korbeľ ◽  
◽  
Pavel Kaščák ◽  
zuzana Nižňanská
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Perinatal Mortality ◽  
Total Fertility Rate ◽  
Very Low Birth Weight ◽  
Slovak Republic ◽  
In Utero ◽  
Fertility Rate ◽  
Live Births

Overview Objective: Analysis of perinatal mortality in the Slovak Republic during the years 2007–2018. Methods: Analysis of prospectively collected selected perinatal data in the years 2007–2018. Results: In the year 2007, there were 63 obstetrics units, 51,146 deliveries and that of live births 51,650 in the Slovak Republic. The number of obstetrics units decreased to 51 in the years 2018, the total number of deliveries increased to 57,085 and that of live births increased to 57,773. The total fertility rate in the years 2007–2018 increased from 1.27 to 1.54. The preterm deliveries rate increased from 7.3% in the year 2007 to 8.5% in the year 2010 and decreased to 7% in the year 2018. The perinatal mortality rate decreased from 6.2 in the year 2007 to 4.4 in the year 2017, increased again in the years 2018 to 5.0 and according to the criteria of WHO (World Health Organization) to 6.6 per 1,000 still- and live-births. During the years 2007–2018 at perinatal mortality stillbirth participate with 65%, low birth weight with 63% and severe congenital anomalies with 19%. Transport in utero to perinatological centers in the years 2007–2018 has decreased from 57 to 56% for infants 1,000–1,499 g and from 75 to 73% for infants below 1,000 g. Conclusion: In the year 2017, perinatology in the Slovak Republic reached the best result in the perinatal mortality rate – 4.4‰ (0.44%), but has increased to over 5‰ next year. To further reduce perinatal mortality in the Slovak Republic, it is necessary to improve the prenatal dia­gnosis of severe congenital abnormalities, transport in utero of very low birth weight fetuses, centralization of high-risk pregnancies, obstetric personnel and material-technical equipment of obstetricians and neonatal intensive care units. Keywords: perinatal mortality – preterm delivery – multiple pregnancy – low birth weight – very low birth weight – total fertility rate

Regional Birth Outcomes after the 2011 Great East Japan Earthquake and Tsunami in Miyagi Prefecture

2018 ◽  
Vol 33 (2) ◽  
pp. 215-219 ◽  
Author(s):  
Junichi Sugawara ◽  
Noriyuki Iwama ◽  
Tetsuro Hoshiai ◽  
Hideki Tokunaga ◽  
Hidekazu Nishigori ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Risk Analysis ◽  
Birth Outcomes ◽  
Birth Rate ◽  
Great East Japan Earthquake ◽  
Miyagi Prefecture ◽  
Preterm Birth Rate ◽  
Regional Risk Analysis

AbstractObjectivesThis study was aimed to analyze post-disaster birth outcomes in coastal and inland regions of Miyagi Prefecture, Japan.MethodsPrimary data sets were compiled from birth records of obstetric facilities and 12,808 patients were analyzed for baseline birth outcomes by region. Regional risk analysis of the low-birth-weight rate and premature birth rate were conducted using multi-level logistic regression analysis.ResultsFrom overall baseline birth outcomes, a preterm birth rate was 4.6% and low-birth-weight rate was 8.8%. Regional analysis revealed that a preterm birth rate was 3.2% (coastal) and 5.0% (inland), respectively, and the rate of low birth weight was 6.5% in the coastal and 8.5% in the inland region. In the risk analysis of low-birth-weight rate and preterm birth rate, the risk in the coastal region could not be considered any higher than in the inland region (adjusted odds ratio 0.91 [0.73-1.14] and 0.85 [0.46-1.59], respectively).ConclusionsThe incidence of preterm birth and low birth weight were not adversely affected by the disaster. Early transfer and intensive medical intervention may have led to those findings. Further survey will be necessary to determine the long-term effects in both mothers and children.SugawaraJ, IwamaN, HoshiaiT, TokunagaH, NishigoriH, MetokiH, OkamuraK, YaegashiN. Regional birth outcomes after the 2011 Great East Japan Earthquake and tsunami in Miyagi Prefecture. Prehosp Disaster Med. 2018;33(2):215–219.

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