Abstract
BackgroundThe ongoing spread coronavirus disease worldwide has caused major disruptions and led to lockdowns. Everyday lifestyle changes and antenatal care inaccessibility during the coronavirus disease 2019 (COVID-19) pandemic have variable results that affect pregnancy outcomes. This study aimed to assess the alterations in stillbirth, neonatal-perinatal mortality, preterm birth, and birth weight during the COVID-19 national lockdown.MethodsWe used the data from the Jordan stillbirths and neonatal death surveillance system to compare pregnancy outcomes (gestational age, birth weight, small for gestational age, stillbirth, neonatal death, and perinatal death) between two studied periods (11 months before the pandemic (May 2019 to March 2020) vs. 9 months during the pandemic (April 2020 to March 1st 2020). Separate multinomial logistic and binary logistic regression models were used to compare the studied outcomes between the two studied periods after adjusting for the effects of mother’s age, income, education, occupation, nationality, health sector, and multiplicity.ResultsThere were 31106 registered babies during the study period; among them, 15311 (49.2%) and 15795 (50.8%) births occurred before and during the COVID-19 lockdown, respectively. We found no significant differences in preterm birth and stillbirth rates, neonatal mortality, or perinatal mortality before and during the COVID-19 lockdown. Our findings report a significantly lower incidence of extreme low birth weight (ELBW) infants (<1kg) during the COVID-19 lockdown period than that before the lockdown (adjusted OR 0.39, 95% CI 0.3-0.5: P value <0.001)ConclusionsDuring the COVID-19 lockdown period, the number of infants born with extreme low birth weight (ELBW) decreased significantly. More research is needed to determine the impact of cumulative socio-environmental and maternal behavioral changes that occurred during the pandemic on the factors that contribute to ELBW infants.
Highlights
The ongoing spread coronavirus disease worldwide has caused major disruptions and led to lock‐ downs
Stillbirth, neonatalperinatal mortality, gestational age of preterm births, and low birth weight trends were collected from five pilot hospitals in Jordan over the set period during the COVID-19 pandemic
From May 2019 to December 2020, 29592 women were admitted to the five pilot hospitals for delivery, with 31106 babies being born (15311 [49.2%] and 15795 [50.8%] before and during the COVID-19 lockdown, respectively)
Summary
The ongoing spread coronavirus disease worldwide has caused major disruptions and led to lock‐ downs. Everyday lifestyle changes and antenatal care inaccessibility during the coronavirus disease 2019 (COVID-19) pandemic have variable results that affect pregnancy outcomes. The coronavirus disease (COVID-19) pandemic has caused an international outcry, leading to lockdowns, as well as health care and economic crises, in many countries [2]. The reported mechanism is vertical transmission of SARS-CoV-2, either in utero via the hematogenous transplacental route, resulting in an increased rate of decidual arteriopathy and other features of maternal vascular malperfusion. It may be rarely transmitted as intrapartum ascending route with aspiration of amniotic fluid or even the early postnatal period [3,4,5]
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