VP31.01: The impact of the COVID‐19 lockdowns on the global rates of preterm deliveries: a systematic review

Abstract

On 11th March 2020, COVID-19 was declared a pandemic by the World Health Organization (WHO). As a result, many countries entered harsh lockdowns in order to restrict the spread of the virus. Several studies were conducted to assess the implication of the lockdowns on the rates of preterm birth, stillbirths and other maternal and perinatal outcomes, with inconsistent results. We have conducted a systematic review to report the current evidence of the Indirect impacts of COVID-19 on rates of preterm birth and perinatal mortality & morbidity. We conducted a systematic review following the PRISMA guidelines. We searched electronic databases MEDLINE, Embase, PubMed for potentially relevant published and preprint studies. Two independent reviewers conducted title/abstract screening, full text screening, and data extraction using a pre-specified form. Conflicts were resolved by consensus or consultation with a third reviewer. The primary outcome was the rate of preterm births following the introduction of the COVID-19 restrictions, compared to the rate before these restrictions. Secondary outcomes included stillbirth and neonatal death rates, neonatal birthweight, NICU admissions and rates of Caesarean deliveries. We have excluded studies assessing the direct effect of COVID-19. Our initial search has retrieved a total of 485 studies, of which 20 met inclusion criteria after screening. We didn't find a statistically significant change in the rates of preterm births (OR 0.95 [0.88-1.02]) or stillbirths (OR 0.91 [0.76-1.09]). COVID-19 mitigation policies vary between regions which may have led to the inconsistencies in the reported effects on preterm birth and perinatal mortality across studies. It is vital to interrogate these differences to identify risk factors for preterm birth that may be potentially modifiable at the patient (reduced exposure to infection/inflammation), clinician (decision making) and societal levels (public health measures) to enable new strategies to prevent preterm birth in non-pandemic times.