COVID-19 Lockdown Increased the Risk of Preterm Birth.

Ting-Ting Lin,Lei Chen,Li Jin,Xian-Hua Lin,Ben W Mol,Jie-Xue Pan,He-Feng Huang,Yan-Ting Wu,Chen Zhang,Cindy-Lee Dennis

doi:10.3389/fmed.2021.705943

Abstract

Purpose: To estimate whether the city-specific lockdown in Shanghai induced by the COVID-19 pandemic affected preterm birth rates among uninfected pregnant women in different trimesters.Methods: The population-based retrospective cohort study was conducted in the International Peace Maternity and Child Health Hospital (IPMCH) in Shanghai, China. Pregnant women without COVID-19 received perinatal healthcare during lockdown (from January 24, 2020 to March 24, 2020) and non-lockdown (from January 24, 2019 to March 24, 2019) period and giving birth to a live infant at IPMCH were enrolled. 1:1 propensity score matching and Inverse probability of treatment weighting were used to evaluate preterm birth (<37 weeks), very preterm birth (<34 weeks), preterm birth with premature rupture of membranes (PROM-PTB), spontaneous preterm birth with intact membranes (S-PTB), and medically induced preterm birth (MI-PTB) between two groups.Results: 8,270 pregnant women were in the lockdown group, and 9,815 were in the non-lockdown group. Pregnant women in second trimester during lockdown had a higher risk of PTB than those during the non-lockdown period [OR: 1.43 (CI 1.01–2.02), ARD: 1.7% (CI 0.04–3.4%), p = 0.045]. Furthermore, pregnant women in third trimester during lockdown had a higher risk of PROM-PTB than those during the non-lockdown period [OR: 1.64 (CI 1.09–2.47), ARD: 0.9% (CI 0.2–1.6%), p = 0.02]; no group differences were found related to rates of VPTB, S-PTB or MI-PTB.Conclusion: In this cohort study in China, we found that there was an increased risk in preterm birth for non-infected women in COVID-19 lockdown who were in their second trimester.

Highlights

Coronavirus disease 2019 (COVID-19) is a highly infectious disease with a significant mortality rate that has limited effective treatment options [1]
We further explored the risk of different clinical subtypes of preterm birth (PTB) (PROM-PTB, spontaneous preterm birth with intact membranes (S-PTB), and MI-PTB) associated with COVID19 lockdown in different pregnancy phases
We found that exposure to the COVID-19 lockdown did not reduce, but increased the risk of PTB among pregnant women in their second trimester and increased the risk of PROM-PTB among those in their third trimester

Summary

Introduction

Coronavirus disease 2019 (COVID-19) is a highly infectious disease with a significant mortality rate that has limited effective treatment options [1]. In late 2019, hospitals in Wuhan City in Hubei Province admitted multiple patients with unexplained pneumonia with a history of exposure to the South China Seafood Market, and these cases of pneumonia have since been confirmed as COVID-19 Lockdown and Preterm Birth. COVID-19 was officially identified as a type B infectious disease with human-to-human transmission by the National Health Council on January 20, 2020 [2]. Due to the high contagiousness of COVID-19 and the population’s general susceptibility, a city-wide lockdown was declared in Shanghai on January 24, 2020 and ended on March 24 [3], 2020. Rates of anxiety and depression increased rapidly among the general population [4, 5]

Objectives

Methods

Results

Conclusion