Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries

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Calvert, ClaraUniv Edinburgh, Usher Inst, Edinburgh, Midlothian, Scotland. (author)

Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries

Article/chapterEnglish2023

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2023-02-27
Springer Nature,2023
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LIBRIS-ID:oai:DiVA.org:uu-516025
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-516025URI
https://doi.org/10.1038/s41562-023-01522-yDOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:152992974URI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

Notes

Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from -90% to +30%, were reported in many countries following early COVID-19 pandemic response measures ('lockdowns'). It is unclear whether this variation reflects real differences in lockdown impacts, or perhaps differences in stillbirth rates and/or study designs. Here we present interrupted time series and meta-analyses using harmonized data from 52 million births in 26 countries, 18 of which had representative population-based data, with overall PTB rates ranging from 6% to 12% and stillbirth ranging from 2.5 to 10.5 per 1,000 births. We show small reductions in PTB in the first (odds ratio 0.96, 95% confidence interval 0.95-0.98, P value <0.0001), second (0.96, 0.92-0.99, 0.03) and third (0.97, 0.94-1.00, 0.09) months of lockdown, but not in the fourth month of lockdown (0.99, 0.96-1.01, 0.34), although there were some between-country differences after the first month. For high-income countries in this study, we did not observe an association between lockdown and stillbirths in the second (1.00, 0.88-1.14, 0.98), third (0.99, 0.88-1.12, 0.89) and fourth (1.01, 0.87-1.18, 0.86) months of lockdown, although we have imprecise estimates due to stillbirths being a relatively rare event. We did, however, find evidence of increased risk of stillbirth in the first month of lockdown in high-income countries (1.14, 1.02-1.29, 0.02) and, in Brazil, we found evidence for an association between lockdown and stillbirth in the second (1.09, 1.03-1.15, 0.002), third (1.10, 1.03-1.17, 0.003) and fourth (1.12, 1.05-1.19, <0.001) months of lockdown. With an estimated 14.8 million PTB annually worldwide, the modest reductions observed during early pandemic lockdowns translate into large numbers of PTB averted globally and warrant further research into causal pathways.

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Brockway, Meredith (Merilee)Univ Manitoba, Childrens Hosp Res Inst Manitoba, Dept Pediat & Child Hlth, Winnipeg, MB, Canada. (author)
Zoega, HelgaUniv New South Wales Sydney, Fac Med & Hlth, Sch Populat Hlth, Sydney, NSW, Australia.;Univ Iceland, Ctr Publ Hlth Sci, Fac Med, Reykjavik, Iceland. (author)
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Amegah, Adeladza KofiKarolinska Institutet (author)
Racine-Poon, AmyNovartis, Basel, Switzerland. (author)
Oskoui, Solmaz EradatUniv Edinburgh, Usher Inst, Edinburgh, Midlothian, Scotland. (author)
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Bacchini, FabianaCanadian Premature Babies Fdn, Toronto, ON, Canada. (author)
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Bebak, KarolinaDist Publ Hosp Poznan, Obstetr & Gynaecol Ward, Poznan, Poland. (author)
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Cajachagua-Torres, Kim N.Erasmus MC, Univ Med Ctr Rotterdam, Generat R Study Grp, Rotterdam, Netherlands.;Erasmus MC, Univ Med Ctr Rotterdam, Dept Paediat, Rotterdam, Netherlands.;Univ Peruana Cayetano Heredia, Ctr Invest Salud Materna & Infantil, Lima, Peru.;Univ Peruana Cayetano Heredia, Ctr Invest Desarrollo Integral & Sostenib, Lima, Peru. (author)
Campbell-Yeo, MarshaDalhousie Univ, Sch Nursing, Halifax, NS, Canada.;IWK Hlth, Halifax, NS, Canada. (author)
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Cornette, LucAZ St Jan Bruges Ostend Hosp, Brugge, Belgium. (author)
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Daly, MandyIrish Neonatal Hlth Alliance, Wicklow, Ireland. (author)
Debauche, ChristianUCLouvain, Clin Univ St Luc, IREC, Dept Neonatol, Brussels, Belgium.;CEpiP Ctr Epidemiol Perinatale, Brussels, Belgium. (author)
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Einarsdottir, KristjanaUniv Iceland, Ctr Publ Hlth Sci, Fac Med, Reykjavik, Iceland.;Curtin Univ, Curtin Sch Populat Hlth, Perth, WA, Australia. (author)
Engjom, HildeNorwegian Inst Publ Hlth, Dept Hlth Registry Res & Dev, Oslo, Norway. (author)
Estrada-Gutierrez, GuadalupeNatl Inst Perinatol, Mexico City, DF, Mexico. (author)
Fantasia, IlariaIRCCS Burlo Garofolo Childrens Hosp, Inst Maternal & Child Hlth, Trieste, Italy. (author)
Fiorentino, Nicole M.Univ Manitoba, Childrens Hosp Res Inst Manitoba, Dept Pediat & Child Hlth, Winnipeg, MB, Canada. (author)
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Fraser, AbigailUniv Bristol, Bristol Med Sch, Populat Hlth Sci, Bristol, Avon, England. (author)
Gachuno, Onesmus W.Univ Nairobi, Obstetr & Gynecol Med, Nairobi, Kenya. (author)
Gallo, Linda A.Univ Queensland, Sch Biomed Sci, St Lucia, Qld, Australia. (author)
Gissler, MikaKarolinska Institutet (author)
Haberg, Siri E.Norwegian Inst Publ Hlth, Ctr Fertil & Hlth, Oslo, Norway. (author)
Habibelahi, AbbasMinist Hlth & Med Educ, Neonatol Neonatal Hlth Off, Tehran, Iran. (author)
Haggstrom, JonasCytel, Waltham, MA USA. (author)
Hookham, LaurenMakerere Univ, Johns Hopkins Univ Res Collaborat, London, England. (author)
Hui, LisaUniv Melbourne, Dept Obstet & Gynaecol, Melbourne, Vic, Australia. (author)
Huicho, LuisUniv Peruana Cayetano Heredia, Ctr Invest Salud Materna & Infantil, Ctr Invest Desarrollo Integral & Sostenib, Lima, Peru.;Univ Peruana Cayetano Heredia, Sch Med, Lima, Peru. (author)
Hunter, Karen J.Univ Edinburgh, Usher Inst, Edinburgh, Midlothian, Scotland. (author)
Huq, SayeedaICDDR B Int Ctr Diarrhoeal Dis Res, Nutr & Clin Serv Div, Dhaka, Bangladesh. (author)
KC, Ashish,1982-Uppsala universitet,SWEDESD - Centrum för forskning och utbildning om lärande för hållbar utveckling(Swepub:uu)ashka967 (author)
Kadambari, SeileshUniv Oxford, Oxford Vaccine Grp, Dept Paediat, Oxford, England.;NIHR Oxford Biomed Res Ctr, Oxford, England. (author)
Kelishadi, RoyaIsfahan Univ Med Sci, Res Inst Primordial Prevent Non Commun Dis, Child Growth & Dev Res Ctr, Esfahan, Iran. (author)
Khalili, NarjesIran Univ Med Sci, Prevent Med & Publ Hlth Res Ctr, Psychosocial Hlth Res Inst, Dept Community & Family Med,Sch Med, Tehran, Iran. (author)
Kippen, JoannaDist Publ Hosp Poznan, Obstetr & Gynaecol Ward, Poznan, Poland. (author)
Le Doare, KirstySt Georges Univ London, Int Ctr Neonatal & Paediat Infect, London, England.;MRC, Uganda Virus Res Inst, Entebbe, Uganda.;London Sch Hyg & Trop Med, Uganda Res Unit, London, England. (author)
Llorca, JavierUniv Cantabria, Santander, Spain.;CIBERESP, Consortium Biomed Res Epidemiol & Publ Hlth, Epidemiol Salud Publ, Madrid, Spain. (author)
Magee, Laura A.Kings Coll London, Sch Life Course & Populat Sci, Inst Women & Childrens Hlth, London, England. (author)
Magnus, Maria C.Norwegian Inst Publ Hlth, Ctr Fertil & Hlth, Oslo, Norway. (author)
Man, Kenneth K. C.UCL, Sch Pharm, Res Dept Practice & Policy, London, England.;Univ Hong Kong, Li Ka Shing Fac Med, Dept Pharmacol & Pharm, Hong Kong, Peoples R China.;Hong Kong Sci Pk, Lab Data Discovery Hlth, Hong Kong, Peoples R China. (author)
Mburugu, Patrick M.Jomo Kenyatta Univ Agr & Technol, Sch Med, Dept Child Hlth & Paediat, Nairobi, Kenya. (author)
Mediratta, Rishi P.Stanford Univ, Div Pediat Hosp Med, Sch Med, Dept Pediat, Stanford, CA USA. (author)
Morris, Andrew D.Hlth Data Res UK, London, England. (author)
Muhajarine, NazeemUniv Saskatchewan, Coll Med, Commun Hlth & Epidemiol, Saskatoon, SK, Canada. (author)
Mulholland, Rachel H.Univ Edinburgh, Usher Inst, Edinburgh, Midlothian, Scotland. (author)
Bonnard, Livia NagyRights Beside You Assoc, Melletted helyem Egyesulet, Budapest, Hungary. (author)
Nakibuuka, VictoriaSt Francis Nsambya Hosp, Dept Paediat, Kampala, Uganda. (author)
Nassar, NatashaUniv Sydney, Childrens Hosp, Fac Med & Hlth, Westmead Clin Sch,Child Populat & Translational H, Sydney, NSW, Australia. (author)
Nyadanu, Sylvester D.Educ Culture & Hlth Opportun ECHO Res Grp Int, Aflao, Ghana. (author)
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Olayemi, Oladapo O.Univ Ibadan, Coll Med, Dept Obstet & Gynaecol, Ibadan, Nigeria.;Univ Coll Hosp, Ibadan, Nigeria. (author)
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Oluwafemi, Rosena O.Mother & Child Hosp, Dept Paediat & Child Hlth, Akure, Nigeria. (author)
Ogunkunle, Taofik O.Dalhatu Araf Specialist Hosp, Dept Paediat, Lafia, Nigeria. (author)
Orton, ChrisSwansea Univ, Swansea, W Glam, Wales. (author)
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Ouma, JosephMakerere Univ, Johns Hopkins Univ Res Collaborat, Kampala, Uganda. (author)
Oyapero, OyejokeKarolinska Institutet (author)
Palmer, Kirsten R.Monash Univ, Dept Obstet & Gynaecol, Clayton, Vic, Australia. (author)
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Pereira, GavinNorwegian Inst Publ Hlth, Ctr Fertil & Hlth, Oslo, Norway.;Curtin Univ, Curtin Sch Populat Hlth, Perth, WA, Australia.;Curtin Univ, EnAble Inst, Perth, WA, Australia. (author)
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Pruski, DominikDist Publ Hosp Poznan, Obstetr & Gynaecol Ward, Poznan, Poland. (author)
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Quezada-Pinedo, Hugo G.Erasmus MC, Univ Med Ctr Rotterdam, Generat R Study Grp, Rotterdam, Netherlands.;Erasmus MC, Univ Med Ctr Rotterdam, Dept Paediat, Rotterdam, Netherlands.;Univ Peruana Cayetano Heredia, Ctr Invest Salud Materna & Infantil, Lima, Peru.;Univ Peruana Cayetano Heredia, Ctr Invest Desarrollo Integral & Sostenib, Lima, Peru. (author)
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Saner, ChristophMurdoch Childrens Res Inst, Royal Childrens Hosp, Parkville, Vic, Australia.;Univ Bern, Univ Hosp Bern, Inselspital, Div Pediat Endocrinol Diabetol & Metab,Dept Pedia, Bern, Switzerland.;Univ Bern, Dept Biomed Res, Bern, Switzerland. (author)
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Temmerman, MarleenAga Khan Univ, Ctr Excellence Women & Child Hlth, Nairobi, Kenya. (author)
Tooke, LloydUniv Cape Town, Dept Paediat, Cape Town, South Africa. (author)
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von Dadelszen, PeterKings Coll London, Sch Life Course & Populat Sci, Inst Women & Childrens Hlth, London, England. (author)
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Wood, RachaelUniv Edinburgh, Usher Inst, Edinburgh, Midlothian, Scotland.;Publ Hlth Scotland, Edinburgh, Midlothian, Scotland. (author)
Wroblewska-Seniuk, KatarzynaPoznan Univ Med Sci, Dept Neonatol 2, Poznan, Poland. (author)
Yeboah-Antwi, KojoFather Thomas Alan Rooney Mem Hosp, Publ Hlth Unit Ghana, Asankrangwa, Western Region, Ghana. (author)
Yilgwan, Christopher S.Univ Jos, Dept Paediat, Jos, Nigeria. (author)
Zawiejska, AgnieszkaPoznan Univ Med Sci, Chair Med Educ, Dept Med Simulat, Poznan, Poland. (author)
Sheikh, Aziz (author)
Rodriguez, NatalieUniv Manitoba, Childrens Hosp Res Inst Manitoba, Dept Pediat & Child Hlth, Winnipeg, MB, Canada. (author)
Burgner, DavidMurdoch Childrens Res Inst, Royal Childrens Hosp, Parkville, Vic, Australia.;Univ Melbourne, Dept Paediat, Parkville, Vic, Australia.;Univ Med Ctr Rotterdam, Div Neonatol, Dept Paediat, Rotterdam, Netherlands.;Univ Med Ctr Rotterdam, Dept Obstet & Gynaecol, Rotterdam, Netherlands.;Univ Med Ctr Rotterdam, Dept Publ Hlth, Rotterdam, Netherlands.;Univ Med Ctr Rotterdam, Erasmus MC Sophia Childrens Hosp, Rotterdam, Netherlands.;Univ Manitoba, Dept Community Hlth Sci & Immunol, Winnipeg, MB, Canada. (author)
Stock, Sarah J.Univ Edinburgh, Usher Inst, Edinburgh, Midlothian, Scotland.;Univ Manitoba, Dept Community Hlth Sci & Immunol, Winnipeg, MB, Canada. (author)
Azad, Meghan B.Univ Manitoba, Childrens Hosp Res Inst Manitoba, Dept Pediat & Child Hlth, Winnipeg, MB, Canada.;Univ Manitoba, Dept Pediat & Child Hlth, Winnipeg, MB, Canada.;Univ Manitoba, Dept Community Hlth Sci & Immunol, Winnipeg, MB, Canada. (author)
Univ Edinburgh, Usher Inst, Edinburgh, Midlothian, Scotland.Univ Manitoba, Childrens Hosp Res Inst Manitoba, Dept Pediat & Child Hlth, Winnipeg, MB, Canada. (creator_code:org_t)

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