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Journal article
Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries
Nature Human Behaviour, Vol.7(4), pp.529-544
2023
PMID: 36849590
Appears in COVID-19 Research
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.
Details
- Title
- Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries
- Authors
- Clara Calvert - University of EdinburghMeredith Brockway - University of ManitobaHelga Zoega - UNSW SydneyJessica E Miller - Royal Children's HospitalJasper V Been - Sophia Children's HospitalAdeladza Kofi Amegah - University of Cape CoastAmy Racine-Poon - NovartisSolmaz Eradat Oskoui - University of EdinburghIshaya I Abok - University of JosNima Aghaeepour - Stanford University School of MedicineSee article text for complete list of authors (Author)Linda Gallo - The University of Queensland
- Publication details
- Nature Human Behaviour, Vol.7(4), pp.529-544
- Publisher
- Nature Publishing Group
- Date published
- 2023
- DOI
- 10.1038/s41562-023-01522-y
- ISSN
- 2397-3374
- PMID
- 36849590
- Copyright note
- This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
- Organisation Unit
- School of Health - Biomedicine
- Language
- English
- Record Identifier
- 991041198802621
- Output Type
- Journal article
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- Industry collaboration
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- Web Of Science research areas
- Neurosciences
- Psychology, Biological
- Psychology, Experimental