Preterm Infant Outcomes Following COVID-19 Lockdowns in Melbourne, Australia.

Brendan Mulcahy,Yizhen Liu,Alexia Matheson,Kirsten R. Palmer,Ben W. Mol,Daniel L. Rolnik,Atul Malhotra

doi:10.3390/children8121169

Abstract

Background Community lockdowns during the coronavirus disease 2019 (COVID-19) pandemic may influence preterm birth rates, but mechanisms are unclear. Methods We compared neonatal outcomes of preterm infants born to mothers exposed to community lockdowns in 2020 (exposed group) to those born in 2019 (control group). Main outcome studied was composite of significant neonatal morbidity or death. Results Median gestational age was 35 + 4 weeks (295 infants, exposed group) vs. 35 + 0 weeks (347 infants, control group) (p = 0.108). The main outcome occurred in 36/295 (12.2%) infants in exposed group vs. 46/347 (13.3%) in control group (p = 0.69). Continuous positive airway pressure (CPAP) use, jaundice requiring phototherapy, hypoglycaemia requiring treatment, early neonatal white cell and neutrophil counts were significantly reduced in the exposed group. Conclusions COVID-19 community lockdowns did not alter composite neonatal outcomes in preterm infants, but reduced rates of some common outcomes as well as early neonatal inflammatory markers.

Highlights

The coronavirus disease 2019 (COVID-19) pandemic has had a far-reaching impact on maternal and infant wellbeing [1,2]
The main outcome studied was a composite of death or significant morbidity in preterm infants, including chronic lung disease (CLD), severe intraventricular haemorrhage (IVH), necrotising enterocolitis (NEC), retinopathy of prematurity (ROP) requiring treatment, or culture positive sepsis
When the mother was considered the unit of analysis, the primary outcome due to prematurity occurred in 36/3187 (1.1%) versus 46/3229 (1.4%) of live neonates born before 37 weeks in the exposed group and non-exposed group (RR 0.79, 95% confidence intervals (CI) 0.51 to 1.20)

Summary

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has had a far-reaching impact on maternal and infant wellbeing [1,2]. Very few studies have assessed what impact this has had on neonatal outcomes [10,11], and previous studies are from countries with relatively high COVID-19 community transmission rates. Australia, experienced one of the world’s strictest community transmission mitigation measures during two lockdowns (March–May, July–November) in 2020. These measures coupled with relatively low rates of community transmission make us uniquely placed to examine the effects of lockdown measures on neonatal outcomes. We aimed to explore effects of community lockdowns on neonatal outcomes of preterm infants, with a secondary focus on the underlying rates of systemic inflammation in infants and mothers around the time of birth. Community lockdowns during the coronavirus disease 2019 (COVID-19) pandemic may influence preterm birth rates, but mechanisms are unclear

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