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Changes in Preterm Birth and Stillbirth During Covid-19 Lockdowns in 26 Countries Publisher Pubmed



Calvert C1 ; Brockway MM2 ; Zoega H3, 4 ; Miller JE5, 6 ; Been JV7 ; Amegah AK11 ; Racinepoon A12 ; Oskoui SE1 ; Abok II13 ; Aghaeepour N14 ; Akwaowo CD15, 16 ; Alshaikh BN17 ; Ayede AI18 ; Bacchini F19 Show All Authors
Authors
  1. Calvert C1
  2. Brockway MM2
  3. Zoega H3, 4
  4. Miller JE5, 6
  5. Been JV7
  6. Amegah AK11
  7. Racinepoon A12
  8. Oskoui SE1
  9. Abok II13
  10. Aghaeepour N14
  11. Akwaowo CD15, 16
  12. Alshaikh BN17
  13. Ayede AI18
  14. Bacchini F19
  15. Barekatain B20
  16. Barnes R21
  17. Bebak K22
  18. Berard A23, 24, 25
  19. Bhutta ZA26, 27
  20. Brook JR28
  21. Bryan LR29
  22. Cajachaguatorres KN30, 31, 32
  23. Campbellyeo M33
  24. Chu DT34
  25. Connor KL35
  26. Cornette L36
  27. Cortes S37
  28. Daly M38
  29. Debauche C39, 40
  30. Dedeke IOF41
  31. Einarsdottir K4, 42
  32. Engjom H43
  33. Estradagutierrez G44
  34. Fantasia I45
  35. Fiorentino NM2
  36. Franklin M46
  37. Fraser A47
  38. Gachuno OW48
  39. Gallo LA49
  40. Gissler M50, 51, 52
  41. Haberg SE53
  42. Habibelahi A54
  43. Haggstrom J55
  44. Hookham L56
  45. Hui L57
  46. Huicho L58
  47. Hunter KJ1
  48. Huq S59
  49. Kc A60
  50. Kadambari S61
  51. Kelishadi R62
  52. Khalili N63
  53. Kippen J22
  54. Le Doare K64, 65
  55. Llorca J66, 67
  56. Magee LA68
  57. Magnus MC53
  58. Man KKC69, 70, 71
  59. Mburugu PM72
  60. Mediratta RP73
  61. Morris AD74
  62. Muhajarine N75
  63. Mulholland RH1
  64. Bonnard LN76
  65. Nakibuuka V77
  66. Nassar N78
  67. Nyadanu SD42, 79
  68. Oakley L53, 80
  69. Oladokun A81
  70. Olayemi OO81
  71. Olutekunbi OA82
  72. Oluwafemi RO83
  73. Ogunkunle TO84
  74. Orton C85
  75. Ortqvist AK86, 87
  76. Ouma J88
  77. Oyapero O89
  78. Palmer KR90
  79. Pedersen LH91
  80. Pereira G53, 92
  81. Pereyra I93
  82. Philip RK94
  83. Pruski D22
  84. Przybylski M22
  85. Quezadapinedo HG30, 31, 32
  86. Regan AK95
  87. Rhoda NR96, 97
  88. Rihs TA98
  89. Riley T99
  90. Rocha TAH100
  91. Rolnik DL90
  92. Saner C5, 101, 102
  93. Schneuer FJ103
  94. Souter VL104
  95. Stephansson O86
  96. Sun S105
  97. Swift EM106
  98. Szabo M107
  99. Temmerman M108
  100. Tooke L109
  101. Urquia ML110
  102. Von Dadelszen P68
  103. Wellenius GA105
  104. Whitehead C111
  105. Wong ICK69, 70, 71
  106. Wood R1, 112
  107. Wroblewskaseniuk K113
  108. Yeboahantwi K114
  109. Yilgwan CS115
  110. Zawiejska A116
  111. Sheikh A1
  112. Rodriguez N2
  113. Burgner D5, 6
  114. Stock SJ1
  115. Azad MB2, 117

Source: Nature Human Behaviour Published:2023


Abstract

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. © 2023, The Author(s).
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