Impact of COVID-19 mitigation measures on the incidence of preterm birth: a national quasi-experimental study.
Impact of COVID-19 mitigation measures on the incidence of preterm birth: a national quasi-experimental study.
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DOI：
10.1016/s2468-2667(20)30223-1
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发表时间：
2020-11
期刊：
影响因子：
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通讯作者：
Reiss IKM
中科院分区：
文献类型：
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作者：
Been JV;Burgos Ochoa L;Bertens LCM;Schoenmakers S;Steegers EAP;Reiss IKM
早产是全球儿童死亡的主要原因，许多幸存者经历了长期的不利后果。初步证据表明，在实施旨在减轻新冠肺炎疫情影响的政策措施后，早产数量大大减少。本研究旨在研究荷兰于2020年3月9日、3月15日和3月23日分阶段实施的新冠肺炎缓解措施对早产发生率的影响。我们使用了国家准实验回归不连续差分方法。我们使用了新生儿干血斑点筛查计划(2010-2020年)的数据，并与国家围产期登记数据进行了交叉验证。根据胎龄亚组进行分层分析，并进行敏感性分析以评估结果的稳健性。我们探讨了邻里社会经济地位、性别和小于胎龄儿地位的潜在影响修正。可以获得1个 599个 547个单身新生儿的数据，包括2020年3月9日新冠肺炎缓解措施实施后发生的56个 720出生。在3月9日前后的不同时间窗口，早产发生率持续下降(± 2个月[n=5 31 823]优势比[OR]0·77，95%CI 0·66-0·91，p=0·0026；± 3个月[n=796 5 31]或0·85，0·73-0·98，p=0·028；± 4个月[n=1 066 872]或0·84，0·73-0·97，p=0·023)。在3月15日的措施之后，观察到的发病率下降幅度较小，但在统计上并不显著。3月23日之后，没有观察到任何变化。3月9日以后早产发生率的下降在不同胎龄层次上是一致的，在敏感性分析中也是强劲的。它们似乎仅限于社会经济地位较高的社区，但效果修正在统计上并不显著。在这项全国性准实验研究中，新冠肺炎缓解措施的初步实施与随后几个月早产发生率的大幅下降相关，这与其他地方的初步观察结果一致。需要整合来自全球各地的可比数据，以进一步证实这些发现并开始探索潜在的机制。没有。
Preterm birth is the leading cause of child mortality globally, with many survivors experiencing long-term adverse consequences. Preliminary evidence suggests that numbers of preterm births greatly reduced following implementation of policy measures aimed at mitigating the effects of the COVID-19 pandemic. We aimed to study the impact of the COVID-19 mitigation measures implemented in the Netherlands in a stepwise fashion on March 9, March 15, and March 23, 2020, on the incidence of preterm birth. We used a national quasi-experimental difference-in-regression-discontinuity approach. We used data from the neonatal dried blood spot screening programme (2010–20) cross-validated against national perinatal registry data. Stratified analyses were done according to gestational age subgroups, and sensitivity analyses were done to assess robustness of the findings. We explored potential effect modification by neighbourhood socioeconomic status, sex, and small-for-gestational-age status. Data on 1 599 547 singleton neonates were available, including 56 720 births that occurred after implementation of COVID-19 mitigation measures on March 9, 2020. Consistent reductions in the incidence of preterm birth were seen across various time windows surrounding March 9 (± 2 months [n=531 823] odds ratio [OR] 0·77, 95% CI 0·66–0·91, p=0·0026; ± 3 months [n=796 531] OR 0·85, 0·73–0·98, p=0·028; ± 4 months [n=1 066 872] OR 0·84, 0·73–0·97, p=0·023). Decreases in incidence observed following the March 15 measures were of smaller magnitude, but not statistically significant. No changes were observed after March 23. Reductions in the incidence of preterm births after March 9 were consistent across gestational age strata and robust in sensitivity analyses. They appeared confined to neighbourhoods of high socioeconomic status, but effect modification was not statistically significant. In this national quasi-experimental study, initial implementation of COVID-19 mitigation measures was associated with a substantial reduction in the incidence of preterm births in the following months, in agreement with preliminary observations elsewhere. Integration of comparable data from across the globe is needed to further substantiate these findings and start exploring underlying mechanisms. None.