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Modest reduction in adverse birth outcomes following the COVID-19 lockdown

BACKGROUND: Widespread lockdowns imposed during the coronavirus disease 2019 crisis may impact birth outcomes. OBJECTIVE: This study aimed to evaluate the association between the COVID-19 lockdown and the risk of adverse birth outcomes in Botswana. STUDY DESIGN: In response to the coronavirus diseas...

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Autores principales: Caniglia, Ellen C., Magosi, Lerato E., Zash, Rebecca, Diseko, Modiegi, Mayondi, Gloria, Mabuta, Judith, Powis, Kathleen, Dryden-Peterson, Scott, Mosepele, Mosepele, Luckett, Rebecca, Makhema, Joseph, Mmalane, Mompati, Lockman, Shahin, Shapiro, Roger
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817370/
https://www.ncbi.nlm.nih.gov/pubmed/33347842
http://dx.doi.org/10.1016/j.ajog.2020.12.1198
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author Caniglia, Ellen C.
Magosi, Lerato E.
Zash, Rebecca
Diseko, Modiegi
Mayondi, Gloria
Mabuta, Judith
Powis, Kathleen
Dryden-Peterson, Scott
Mosepele, Mosepele
Luckett, Rebecca
Makhema, Joseph
Mmalane, Mompati
Lockman, Shahin
Shapiro, Roger
author_facet Caniglia, Ellen C.
Magosi, Lerato E.
Zash, Rebecca
Diseko, Modiegi
Mayondi, Gloria
Mabuta, Judith
Powis, Kathleen
Dryden-Peterson, Scott
Mosepele, Mosepele
Luckett, Rebecca
Makhema, Joseph
Mmalane, Mompati
Lockman, Shahin
Shapiro, Roger
author_sort Caniglia, Ellen C.
collection PubMed
description BACKGROUND: Widespread lockdowns imposed during the coronavirus disease 2019 crisis may impact birth outcomes. OBJECTIVE: This study aimed to evaluate the association between the COVID-19 lockdown and the risk of adverse birth outcomes in Botswana. STUDY DESIGN: In response to the coronavirus disease 2019 crisis, Botswana enforced a lockdown that restricted movement within the country. We used data from an ongoing nationwide birth outcomes surveillance study to evaluate adverse outcomes (stillbirth, preterm birth, small-for-gestational-age fetuses, and neonatal death) and severe adverse outcomes (stillbirth, very preterm birth, very-small-for-gestational-age fetuses, and neonatal death) recorded prelockdown (January 1, 2020–April 2, 2020), during lockdown (April 3, 2020–May 7, 2020), and postlockdown (May 8, 2020–July 20, 2020). Using difference-in-differences analyses, we compared the net change in each outcome from the prelockdown to lockdown periods in 2020 relative to the same 2 periods in 2017–2019 with the net change in each outcome from the prelockdown to postlockdown periods in 2020 relative to the same 2 periods in 2017–2019. RESULTS: In this study, 68,448 women delivered a singleton infant in 2017–2020 between January 1 and July 20 and were included in our analysis (mean [interquartile range] age of mothers, 26 [22–32] years). Across the included calendar years and periods, the risk of any adverse outcome ranged from 27.92% to 31.70%, and the risk of any severe adverse outcome ranged from 8.40% to 11.38%. The lockdown period was associated with a 0.81 percentage point reduction (95% confidence interval, −2.95% to 1.30%) in the risk of any adverse outcome (3% relative reduction) and a 0.02 percentage point reduction (95% confidence interval, −0.79% to 0.75%) in the risk of any severe adverse outcome (0% relative reduction). The postlockdown period was associated with a 1.72 percentage point reduction (95% confidence, −3.42% to 0.02%) in the risk of any adverse outcome (5% relative reduction) and a 1.62 percentage point reduction (95% confidence interval, −2.69% to −0.55%) in the risk of any severe adverse outcome (14% relative reduction). Reductions in adverse outcomes were largest among women with human immunodeficiency virus and among women delivering at urban delivery sites, driven primarily by reductions in preterm birth and small-for-gestational-age fetuses. CONCLUSION: Adverse birth outcomes decreased from the prelockdown to postlockdown periods in 2020, relative to the change during the same periods in 2017–2019. Our findings may provide insights into associations between mobility and birth outcomes in Botswana and other low- and middle-income countries.
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spelling pubmed-78173702021-01-21 Modest reduction in adverse birth outcomes following the COVID-19 lockdown Caniglia, Ellen C. Magosi, Lerato E. Zash, Rebecca Diseko, Modiegi Mayondi, Gloria Mabuta, Judith Powis, Kathleen Dryden-Peterson, Scott Mosepele, Mosepele Luckett, Rebecca Makhema, Joseph Mmalane, Mompati Lockman, Shahin Shapiro, Roger Am J Obstet Gynecol Original Research BACKGROUND: Widespread lockdowns imposed during the coronavirus disease 2019 crisis may impact birth outcomes. OBJECTIVE: This study aimed to evaluate the association between the COVID-19 lockdown and the risk of adverse birth outcomes in Botswana. STUDY DESIGN: In response to the coronavirus disease 2019 crisis, Botswana enforced a lockdown that restricted movement within the country. We used data from an ongoing nationwide birth outcomes surveillance study to evaluate adverse outcomes (stillbirth, preterm birth, small-for-gestational-age fetuses, and neonatal death) and severe adverse outcomes (stillbirth, very preterm birth, very-small-for-gestational-age fetuses, and neonatal death) recorded prelockdown (January 1, 2020–April 2, 2020), during lockdown (April 3, 2020–May 7, 2020), and postlockdown (May 8, 2020–July 20, 2020). Using difference-in-differences analyses, we compared the net change in each outcome from the prelockdown to lockdown periods in 2020 relative to the same 2 periods in 2017–2019 with the net change in each outcome from the prelockdown to postlockdown periods in 2020 relative to the same 2 periods in 2017–2019. RESULTS: In this study, 68,448 women delivered a singleton infant in 2017–2020 between January 1 and July 20 and were included in our analysis (mean [interquartile range] age of mothers, 26 [22–32] years). Across the included calendar years and periods, the risk of any adverse outcome ranged from 27.92% to 31.70%, and the risk of any severe adverse outcome ranged from 8.40% to 11.38%. The lockdown period was associated with a 0.81 percentage point reduction (95% confidence interval, −2.95% to 1.30%) in the risk of any adverse outcome (3% relative reduction) and a 0.02 percentage point reduction (95% confidence interval, −0.79% to 0.75%) in the risk of any severe adverse outcome (0% relative reduction). The postlockdown period was associated with a 1.72 percentage point reduction (95% confidence, −3.42% to 0.02%) in the risk of any adverse outcome (5% relative reduction) and a 1.62 percentage point reduction (95% confidence interval, −2.69% to −0.55%) in the risk of any severe adverse outcome (14% relative reduction). Reductions in adverse outcomes were largest among women with human immunodeficiency virus and among women delivering at urban delivery sites, driven primarily by reductions in preterm birth and small-for-gestational-age fetuses. CONCLUSION: Adverse birth outcomes decreased from the prelockdown to postlockdown periods in 2020, relative to the change during the same periods in 2017–2019. Our findings may provide insights into associations between mobility and birth outcomes in Botswana and other low- and middle-income countries. Elsevier Inc. 2021-06 2020-12-24 /pmc/articles/PMC7817370/ /pubmed/33347842 http://dx.doi.org/10.1016/j.ajog.2020.12.1198 Text en © 2020 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Research
Caniglia, Ellen C.
Magosi, Lerato E.
Zash, Rebecca
Diseko, Modiegi
Mayondi, Gloria
Mabuta, Judith
Powis, Kathleen
Dryden-Peterson, Scott
Mosepele, Mosepele
Luckett, Rebecca
Makhema, Joseph
Mmalane, Mompati
Lockman, Shahin
Shapiro, Roger
Modest reduction in adverse birth outcomes following the COVID-19 lockdown
title Modest reduction in adverse birth outcomes following the COVID-19 lockdown
title_full Modest reduction in adverse birth outcomes following the COVID-19 lockdown
title_fullStr Modest reduction in adverse birth outcomes following the COVID-19 lockdown
title_full_unstemmed Modest reduction in adverse birth outcomes following the COVID-19 lockdown
title_short Modest reduction in adverse birth outcomes following the COVID-19 lockdown
title_sort modest reduction in adverse birth outcomes following the covid-19 lockdown
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817370/
https://www.ncbi.nlm.nih.gov/pubmed/33347842
http://dx.doi.org/10.1016/j.ajog.2020.12.1198
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