The impact of COVID-19 first wave national lockdowns on perinatal outcomes: a rapid review and meta-analysis

Abstract Background Since the emergence of COVID-19, preventative public health measures, including lockdown strategies, were declared in most countries to control viral transmission. Recent studies and anecdotes have reported changes in the prevalence of perinatal outcomes during national COVID-19lockdowns.The objective of this rapid review was to evaluate the impact of COVID-19 lockdowns on the incidence of low birth weight (LBW), preterm birth (PTB), and stillbirth. Methods Two reviewers searched EMBASE, CORD-19, LitCovid (PubMed), WHO Global research on corona virus disease (COVID-19), and MedRxiv for studies published in English from the first reports on COVID-19 until 17 July 2021. Perinatal outcomes of interest included LBW (< 2500 g), PTB (< 37 weeks), and stillbirth. Results Of the 1967 screened articles, 17 publications met the inclusion criteria (14 cohort studies, 1 case control and 2 cross-sectional studies). Studies included data from Denmark, UK, Ireland, Nepal, Italy, Israel, Botswana, Australia, China, Netherlands, Saudi Arabia, Austria, Zimbabwe, India, and Spain. The total sample size ranged from 3399 to 1,599,547 pregnant women. Thirteen studies examined PTB with conflicting results, reporting both an increase and a decrease in PTB incidence, with odds ratios [95% CI] ranging from 0.09 [0.01, 0.40] to 1.93 [0.76, 4.79]. Three studies found a decrease in LBW rates during lockdowns, one of which was statistically significant, with a rate ratio of 3.77 [1.21, 11.75]. Ten studies examined stillbirth rates, including four studies reporting a statistically significant increase in stillbirth rates, with adjusted relative risk ranging from 1.46 [1.13, 1.89] to 3.9 [1.83, 12.0]. Fourteen studies contained data that could be combined in a meta-analysis comparing perinatal outcomes before and during lockdown. We found that lockdown measures were associated with a significant risk of stillbirth with RR = 1.33 [95% CI 1.04, 1.69] when compared to before lockdown period. However, lockdown measures were not associated with a significant risk of PTB, LBW and VLBW compared to prepandemic periods. Conclusions This review provides clues about the severity of the indirect influence of COVID-19 lockdown implementation; however, the criteria that lead to unexpected changes in LBW, PTB, and stillbirth remains unclear. Large studies showed conflicting results, reporting both increases and decreases in selected perinatal outcomes. Pooled results show a significant association between lockdown measures and stillbirth rates, but not low birth weight rates. Further studies examining the differences in other countries’ lockdowns and sociodemographic groups from low to middle-income countries are needed. Exploration of perinatal outcomes during COVID-19 lockdown poses an opportunity to learn from and make changes to promote the reduction of the leading causes of childhood mortality worldwide.

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Prevalence and Determinants of Low Birth Weight in Ethiopia: A Systematic Review and Meta-Analysis

Advances in Public Health ◽

10.1155/2020/7589483 ◽

2020 ◽

Vol 2020 ◽

pp. 1-13

Author(s):

Nuradin Abusha Katiso ◽

Getachew Mullu Kassa ◽

Gedefaw Abeje Fekadu ◽

Abadi Kidanemariam Berhe ◽

Achenef Asmamaw Muche

Keyword(s):

Birth Weight ◽

Prenatal Care ◽

Low Birth Weight ◽

Rural Areas ◽

Meta Analysis ◽

Significant Risk ◽

Significant Risk Factor ◽

Pooled Prevalence ◽

Unpublished Studies ◽

Meta Analyses

Introduction. Low birth weight (LBW) is the most significant risk factor for neonatal and infant mortality. It is one of the major public health problems in developing countries. Although there are various studies on low birth weight, findings were inconsistent and inconclusive. Therefore, this study was conducted to estimate the national-pooled prevalence of low birth weight and its associated factors in Ethiopia. Method. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. This meta-analysis employed a review of both published and unpublished studies conducted in Ethiopia. The databases used were PubMed, Google Scholar, CINAHL, and African Journals Online. Relevant search terms for prevalence and determinants of LBW were used to retrieve articles. The meta-analysis was conducted using STATA 14 software. Forest plots were used to present the findings. The Cochran Q test and I2 test statistics were used to test heterogeneity across studies. Egger’s test was used to assess the publication bias of included studies. The pooled prevalence and the odds ratios (OR) with 95% confidence intervals (CI) were computed and were presented using forest plots. Results. A total of 28 studies, 50,110 newborn babies, were included in this meta-analysis. The pooled prevalence of LBW in Ethiopia was 14.1% (95% CI = 11.2, 17.1). Higher variation in the prevalence of LBW in different regions across the country was observed. Significant association of LBW with sex of the newborn baby, higher odds among female babies (OR = 1.5 (95% CI = 1.2, 1.7)), prematurity (OR = 4.7 (95% CI = 1.5, 14.5)), not attending prenatal care (OR = 1.7 (95% CI = 1.4, 2.2)), pregnancy-induced hypertension (OR = 6.7 (95% CI = 3.5, 12.9)), and newborn babies whose mothers were from rural areas (OR = 1.8 (95% CI = 1.2, 2.6) were the factors associated with low birth weight. Conclusions. The prevalence of LBW in Ethiopia was high. LBW was associated with several maternal and newborn characteristics. The large disparity of LBW among the different regions in the country needs targeted intervention in areas with higher prevalence. Particular emphasis should be given to mothers residing in rural areas. Community-based programs are important to increase the use of prenatal care.

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Meta-Analysis Finds Use of Inhaled Corticosteroids During Pregnancy Safe: A Systematic Meta-Analysis Review

Human & Experimental Toxicology ◽

10.1191/0960327106het647oa ◽

2006 ◽

Vol 25 (8) ◽

pp. 447-452 ◽

Cited By ~ 39

Author(s):

R Rahimi ◽

S Nikfar ◽

M Abdollahi

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Inhaled Corticosteroids ◽

Birth Outcome ◽

Meta Analysis ◽

Perinatal Outcomes ◽

Pregnancy Induced Hypertension ◽

Drug Of Choice ◽

Term Delivery ◽

Induced Hypertension

Inhaled corticosteroids (ICs) are the drug of choice for asthmatic women during pregnancy, but the results on the effects of these medications on obstetrical and perinatal outcomes are not conclusive. Meta-analysis is the statistical analysis of a collection of analysis results from individual studies for the purpose of integrating the findings. Meta-analysis techniques are necessary because only summary statistics are available in the literature. In order to determine the risk of exposure to ICs, we pooled data from all clinical studies that evaluated the pregnancy and perinatal outcomes in women exposed to this group of drugs during pregnancy by the meta-analytic technique. PUBMED, OVID, EMBASE and SCOPUS databases were searched for studies that investigated birth outcome following exposure to ICs during pregnancy. Data were collected from 1997 to 2005 (up to 31 December). Types of outcome investigated were major malformations, pre-term delivery, low birth weight and pregnancy-induced hypertension. The criteria for inclusion of studies in this meta-analysis were exposure of women to any therapeutic dosage of any ICs (fluticasone, beclomethasone, budesonide, triamcinolone and flunisolide) during pregnancy. The results showed that ICs do not increase the risk of major malformations, preterm delivery, low birth weight and pregnancy-induced hypertension. In conclusion, ICs do not increase the rates of any obstetrical outcomes investigated in the present study and interestingly improve the symptoms and are helpful in the management of asthma and thus can be used comfortably during pregnancy.

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Prevalence of perinatal asphyxia and its associated factors in Ethiopia; A systematic review and meta-Analysis

10.21203/rs.2.17346/v2 ◽

2020 ◽

Author(s):

Moges Agazhe Assemie ◽

Getaye Tizazu ◽

Busha Gamachu Labata ◽

Simegn Alemu ◽

Daniel Bekele Ketema ◽

...

Keyword(s):

Systematic Review ◽

Birth Weight ◽

Low Birth Weight ◽

Perinatal Asphyxia ◽

Meta Analysis ◽

Significant Risk ◽

Neonatal Resuscitation ◽

Birth Asphyxia ◽

Associated Factor ◽

Prolonged Labour

Abstract Background: Perinatal asphyxia(PNA) is a severe health problem and main cause of neonatal mortality and morbidity worldwide. In Ethiopia, there are many studies conducted on PNA characterized by replete of inconsistent; unavailability of nation wide study to determines the prevalence of PNA and its determinants is an important gap. The aim of this study is to develop national consensus on pooled prevalence and associated factor key reports to enhance the quality and consistency of the evidence on perinatal asphyxia. Method : Systematic review and meta-analysis using computerized databases; searches were performed to locate all articles on the prevalence of perinatal asphyxia. Databases included were Pub Med, Cochran library, Google Scholar, Scopus and Science Direct systematically between 2014 and April 2019. All identified studies reporting the prevalence of PNA in Ethiopia were pooled. Two independent authors extracted the data using a standardized data extraction tool. The Cochrane Q test statistics and I 2 tests were used to assess the heterogeneity of the studies. Random-effects model was used to calculate pooled estimates and determinant factor of PNA in Stata/se version-14. Result : The prevalence of PNA reported from fifteen studies was in the range of 3.1 to 47.5%. The pooled occurrence of PNA in Ethiopia based on 15 articles with a sample size of 17,091 was 21.1% (95% CI: 14, 28). There was high heterogeneity observed ( I 2 = 99.4%, p <0.001). Thus, Subgroup analysis in the study area was computed .Thus, the highest prevalence (40.4%) was observed from Oromia region and the lowest 8% noted from Dire Dawa city administration. Pooled odd ratio estimates from included studies revealed prolonged labour (OR=3.7, 95% CI 2.4, 5.7), low birth weight (OR=6.5, 95% CI 4.0, 10.3), and Meconium stained liquor (OR=6.6, 95% CI: 4.4, 10.1) are significant risk factors of perinatal asphyxia. Conclusion : In this review, prolonged labour, meconium stained liquor and low birth weight are significantly associated with perinatal asphyxia. Therefore, improve facility-based intra partum care and quality neonatal resuscitation service through capacity building for health professionals is needed. Keywords: Birth asphyxia; perinatal asphyxia; associated factor; systematic review; Ethiopia

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The Relationship between Maternal Personality Disorder and Early Birth Outcomes: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165778 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5778

Author(s):

Claire A. Marshall ◽

Julie Jomeen ◽

Chao Huang ◽

Colin R. Martin

Keyword(s):

Systematic Review ◽

Birth Weight ◽

Preterm Birth ◽

Personality Disorder ◽

Low Birth Weight ◽

Apgar Score ◽

Meta Analysis ◽

Child Outcomes ◽

Significant Risk ◽

Everyday Functioning

(1) Background: Women with personality disorder are at risk of social and emotional problems which impact deleteriously on everyday functioning. Moreover, a personality disorder diagnosis has been established to have an adverse impact upon pregnancy outcomes and child health. Understanding this impact is critical to improving both maternal and child outcomes. This systematic review and meta-analysis will evaluate the contemporary evidence regarding these relationships. (2) Methods: Prospero and Cochrane were searched for any systematic reviews already completed on this topic. Academic Search Premier, CINAHL Complete, MEDLINE, PsycARTICLES, PsycINFO via the EBSCO host, and the Web of Science Core Collection were searched to include research articles published between 1980 and 2019. A total of 158 records were identified; 105 records were screened by reviewing the abstract; 99 records were excluded; 6 full text articles were assessed for eligibility; 5 records were included in the review. (3) Results: All the included studies reported on preterm birth. The meta-analysis indicates significant risk of preterm birth in women with personality disorder (overall odds ratio (OR) 2.62; CI 2.24–3.06; p < 0.01). Three studies reported on low birth weight, with the meta-analysis indicating a raised risk of low birth weight of the babies born to women with personality disorder (overall OR 2.00 CI 1.12–3.57 (p = 0.02)). Three studies reported on appearance, pulse, grimace, activity, and respiration (APGAR) score, with the meta-analysis of OR’s indicating a risk of low APGAR score in women with personality disorder (overall OR 2.31; CI 1.17–4.55; p = 0.02). (4) Conclusions: The infants of women with personality disorder are at elevated risk of preterm birth, low birth weight and low APGAR score.

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The impact of pregnancy induced hypertension on low birth weight in Ethiopia: systematic review and meta-analysis

Italian Journal of Pediatrics ◽

10.1186/s13052-020-00926-0 ◽

2020 ◽

Vol 46 (1) ◽

Author(s):

Temesgen Getaneh ◽

Ayenew Negesse ◽

Getenet Dessie ◽

Melaku Desta

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Neonatal Mortality ◽

Meta Analysis ◽

Cochrane Library ◽

Significant Heterogeneity ◽

Pregnancy Induced Hypertension ◽

Pooled Prevalence ◽

Induced Hypertension ◽

The Impact

Abstract Background Even though neonatal mortality reduction is the major goal needed to be achieved by 2030, it is still unacceptably high especially in Ethiopia. In the other hand, low birth weight is the major cause of neonatal mortality and morbidity. More than 10 millions of low birth weight infants occurred as a result of pregnancy induced hypertension. However, in Ethiopia the association between low birth weight and pregnancy induced hypertension was represented with un-updated, inconclusive and different studies. Therefore, this review aimed to estimate the overall pooled impact of pregnancy induced hypertension on low birth weight and its association in Ethiopia. Methods articles searched on PubMed/Medline, EMBASE, CINAHL, Cochrane library, Google, Google Scholar and local shelves. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was applied for critical appraisal. The I2 statistic was computed to check the presence of heterogeneity. Publication bias was evaluated using funnel plot asymmetry and Egger’s test. A random effect model was used to estimate the pooled prevalence of low birth weight. Result From the total 131 identified original articles, 25 were eligible and included for the final analysis. The overall pooled prevalence of low birth weight among women who had pregnancy induced hypertension in Ethiopia was 39.7% (95% CI: 33.3, 46.2). But, I2 statistic estimation evidenced significant heterogeneity across included studies (I2 = 89.4, p < 0.001). In addition, the odds of having low birth weight newborns among women who had pregnancy induced hypertension was 3.89 times higher compared to their counterparts (OR = 3.89, 95% CI: 2.66, 5.69). Conclusion The pooled prevalence of low birth weight among women who had pregnancy induced hypertension was more than two times higher than the pooled estimate of low birth weight among all reproductive aged women. The odds of low birth weight also increased nearly four times among women with pregnancy induced hypertension than normotensive women. Therefore, health policies which provide better and quality antenatal care with more oriented on importance of early detection and management of pregnancy induced hypertension should be implemented.

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Impact of Different Types of Nosocomial Infection on the Neurodevelopmental Outcome of Very Low Birth Weight Infants

Children ◽

10.3390/children8030207 ◽

2021 ◽

Vol 8 (3) ◽

pp. 207

Author(s):

Karin Pichler ◽

Vito Giordano ◽

Gereon Tropf ◽

Renate Fuiko ◽

Angelika Berger ◽

...

Keyword(s):

Risk Factor ◽

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Neurodevelopmental Outcome ◽

Significant Risk ◽

Significant Risk Factor ◽

Low Birth Weight Infants ◽

Neurodevelopmental Outcomes ◽

The Impact

Nosocomial infections (NIs) are important conditions associated with mortality and morbidity in very low birth weight infants (VLBWIs). The aim of this study was to investigate the impact of NIs and the different subtypes on neurodevelopmental outcomes in a cohort of VLBWIs. VLBWIs born with a gestational age between 23 0/7 and 31 6/7 weeks in a level III neonatal center were enrolled. Neonatal morbidities as well as the neurodevelopmental outcome at 2 years of corrected age were analyzed. Six-hundred infants completed the study successfully. Of these, 38% experienced an NI episode. NIs were associated with an increased risk of neonatal complications, such as brain injury, bronchopulmonary dysplasia (BPD) and death, and were a significant risk factor for adverse motor development at 2 years of corrected age in our cohort of VLBWIs. The negative impact of NIs on neurodevelopmental outcomes was particularly associated with necrotizing enterocolitis (NEC), suspected NIs and Gram-positive NIs. This study demonstrated that NIs are a significant risk factor for both morbidity and mortality as well as adverse neurodevelopmental outcomes in VLBWIs.

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The Impact of Down-Regulation on Obstetrics and Perinatal Outcomes in Singleton Pregnancies After In Vitro Fertilization

Frontiers in Endocrinology ◽

10.3389/fendo.2021.622081 ◽

2021 ◽

Vol 12 ◽

Author(s):

Lei Jin ◽

Jihui Ai ◽

Yu Zheng ◽

Biao Chen ◽

Lan Wang ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Live Birth ◽

Lower Risk ◽

Birth Rate ◽

Perinatal Outcomes ◽

Live Birth Rate ◽

Clinical Pregnancy ◽

Down Regulation ◽

The Impact

Backgrounddown-regulation has been widely used in IVF treatment; however, it lacks reports on the impact of down-regulation on obstetrics and perinatal outcomes. The purpose of this study was to compare the obstetrics and perinatal outcomes among different down-regulation conditions.Methodsthis is a retrospective cohort study on 3578 patients achieving cumulative singleton clinical pregnancy after their first oocytes retrieval cycle. Patients were grouped according to the serum estradiol after down-regulation (E2D) into three groups: <30, 30-55, >55 pg/ml. The obstetrics and perinatal outcomes, and live-birth rate per clinical pregnancy were main outcome measures. In the subgroup analysis, patients were further divided according to the mode of transfer. ANOVA, chi-square test, multivariate logistic regression, and multivariate general linear model were performed for statistical analysis.Resultsthe patients with E2D <30, 30-55, >55 pg/ml had similar live-birth rates. The patients with E2D <30 pg/ml had a lower risk of hypertension disorders than those with E2D 30-55 pg/ml. No difference was found in the risks of placenta previa, placenta abruption, premature rupture of membrane, hemorrhage, gestational diabetes mellitus, or intrauterine growth restriction. The newborns in the group with E2D <30 pg/ml had a lower risk of PICU admission than those in the group with E2D >55 pg/ml. There was no difference in the risks of congenital anomalies or mortality among the three groups. No differences were found in the gestational week, percentages of preterm birth and very preterm birth, birth weight, percentages of low birth weight and very low birth weight, delivery mode, or sex of newborn. Subgroup analysis showed that E2D 30-55 pg/ml was associated with a higher risk of low birth weight in patients with one fresh transfer + frozen transfer(s).ConclusionDown-regulation has no effect on the live-birth rate per clinical pregnancy. Patients with E2D <30 pg/ml may have advantages regarding lower risks of both maternal hypertension and newborn PICU admission. E2D 30-55 pg/ml may be associated with low birth weight in patients with relatively low quality embryos.

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Prevalence of perinatal asphyxia and its associated factors in Ethiopia; A systematic review and meta-Analysis

10.21203/rs.2.17346/v1 ◽

2019 ◽

Author(s):

Moges Agazhe Assemie ◽

Getaye Tizazu ◽

Busha Gamachu Labata ◽

Alemu Simegn

Keyword(s):

Systematic Review ◽

Birth Weight ◽

Low Birth Weight ◽

Perinatal Asphyxia ◽

Data Extraction ◽

Meta Analysis ◽

Significant Risk ◽

Neonatal Resuscitation ◽

Mortality And Morbidity ◽

Prolonged Labour

Abstract Background: Perinatal asphyxia(PNA) is a severe health problem and main cause of neonatal mortality and morbidity worldwide. In Ethiopia, there are many studies conducted on PNA characterized by replete of inconsistent; unavailability of nation wide study to determines the prevalence of PNA and its determinants is an important gap. The aim of this study is to develop national consensus on pooled prevalence and associated factor key reports to enhance the quality and consistency of the evidence on perinatal asphyxia. Method: Systematic review and meta-analysis using computerized databases; searches were performed to locate all articles on the prevalence of perinatal asphyxia. Databases included were Pub Med, Cochran library, Google Scholar, Scopus and Science Direct systematically between 2014 and April 2019. All identified studies reporting the prevalence of PNA in Ethiopia were pooled. Two independent authors extracted the data using a standardized data extraction tool. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the studies. Random-effects model was used to calculate pooled estimates and determinant factor of PNA in Stata/se version-14. Result: The prevalence of PNA reported from fifteen studies was in the range of 3.1 to 47.5%. The pooled occurrence of PNA in Ethiopia based on 15 articles with a sample size of 17,091 was 21.1% (95% CI: 14, 28). There was high heterogeneity observed (I2 = 99.4%, p <0.001). Thus, Subgroup analysis in the study area was computed .Thus, the highest prevalence (40.4%) was observed from Oromia region and the lowest 8% noted from Dire Dawa city administration. Pooled odd ratio estimates from included studies revealed prolonged labour (OR=3.7, 95% CI 2.4, 5.7), low birth weight (OR=6.5, 95% CI 4.0, 10.3), and Meconium stained liquor (OR=6.6, 95% CI: 4.4, 10.1) are significant risk factors of perinatal asphyxia. Conclusion: In this review, prolonged labour, meconium stained liquor and low birth weight are significantly associated with perinatal asphyxia. Therefore, improve facility-based intra partum care and quality neonatal resuscitation service through capacity building for health professionals is needed.

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HPV Prevalence and its Association with Perinatal Outcomes among Singleton Mothers: Analysis of Pregnancy Risk Assessment and Monitoring System (PRAMS) Data, 2004-2011

Current Women s Health Reviews ◽

10.2174/1573404814666180517085022 ◽

2019 ◽

Vol 15 (2) ◽

pp. 143-149 ◽

Cited By ~ 1

Author(s):

Harpriya Kaur ◽

Delf Schmidt-Grimminger ◽

Baojiang Chen ◽

K.M. Monirul Islam ◽

Steven W. Remmenga ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Pregnant Women ◽

Monitoring System ◽

Large Population ◽

Perinatal Outcomes ◽

Hpv Infection ◽

Adverse Outcomes ◽

P Value ◽

Pregnancy Risk

Background: Pregnancy may increase the risk of Human Papillomavirus (HPV) infection because of pregnancy induced immune suppression. The objective of this study was to use a large population-based dataset to estimate the prevalence of HPV infection and its association with adverse outcomes among pregnant women. Methods: We analyzed Pregnancy Risk Monitoring System data from 2004-2011 (N=26,085) to estimate the self-reported HPV infection. Survey logistic procedures were used to examine the relationship between HPV infection and adverse perinatal outcomes. Results: Approximately 1.4% of women were estimated to have HPV infection during their pregnancy. The prevalence of adverse outcomes in this sample was preterm birth (8.4%), preeclampsia (7.5%), low birth weight (6.3%) and premature rupture of membranes (2.8%). Compared to women without HPV infection, HPV infection positive women were much more likely to have had other infections such as chlamydia (9.23% vs. 2.12%, p-value <.0001), Group B Strep (21.7% vs. 10.04%, p-value <.0001), and herpes (7.17% vs. 1.07%, p-value <.0001). After adjusting for other risk factors including other infections, HPV infection was significantly associated with low birth weight (OR: 1.94, 95% CI: 1.14-3.30). Conclusion: The study indicated a potential association between HPV infection and low birth weight. Because pregnant women with HPV infection are at higher risk of other infections, future research may focus on the roles of co-infection in the development of adverse perinatal effects.

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