Modest reduction in adverse birth outcomes following the COVID-19 lockdown.
Modest reduction in adverse birth outcomes following the COVID-19 lockdown.
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DOI：
10.1016/j.ajog.2020.12.1198
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发表时间：
2021-06
影响因子：
9.8
通讯作者：
Shapiro R
中科院分区：
文献类型：
--
作者：
Caniglia EC;Magosi LE;Zash R;Diseko M;Mayondi G;Mabuta J;Powis K;Dryden-Peterson S;Mosepele M;Luckett R;Makhema J;Mmalane M;Lockman S;Shapiro R
2019年冠状病毒病危机期间实施的大范围封锁可能会影响出生结果。这项研究旨在评估博茨瓦纳COVID-19封锁与不良出生结果风险之间的关联。为应对2019年冠状病毒病危机，博茨瓦纳实施了一项封锁措施，限制国内人员流动。我们使用一项正在进行的全国性出生结果监测研究的数据来评估不良结果（死产、早产、小于胎龄胎儿和新生儿死亡）和严重不良后果（死产、极早产、小于胎龄胎儿和新生儿死亡）（2020年1月1日至2020年4月2日），封锁期间（2020年4月3日至2020年5月7日）和封锁后（2020年5月8日至2020年7月20日）。使用差异中的差异分析，我们比较了2020年封锁前至封锁期相对于2017-2019年相同两个时期的每个结果的净变化，以及2020年封锁前至封锁后期间相对于2017-2019年相同两个时期的每个结果的净变化。在这项研究中，68，448名女性在2017年1月1日至7月20日期间分娩了一名单胎婴儿，并被纳入我们的分析（母亲的平均[四分位数范围]年龄为26 [22-32]岁）。在纳入的日历年和期间，任何不良结局的风险范围为27.92%至31.70%，任何重度不良结局的风险范围为8.40%至11.38%。封锁期与任何不良结局风险降低0.81个百分点（95%置信区间，-2.95%至1.30%）（相对降低3%）和任何严重不良结局风险降低0.02个百分点（95%置信区间，-0.79%至0.75%）（相对降低0%）相关。后封锁期与任何不良结局风险降低1.72个百分点（95%置信区间，-3.42%至0.02%）（相对降低5%）和任何严重不良结局风险降低1.62个百分点（95%置信区间，-2.69%至0.55%）（相对降低14%）相关。在感染人类免疫缺陷病毒的妇女和在城市分娩地点分娩的妇女中，不良结局的减少幅度最大，主要是由于早产和小于胎龄胎儿的减少。与2017-2019年同期的变化相比，2020年从封锁前到封锁后期间的不良出生结果有所下降。我们的研究结果可以为博茨瓦纳和其他低收入和中等收入国家的流动性和出生结果之间的关联提供见解。
Widespread lockdowns imposed during the coronavirus disease 2019 crisis may impact birth outcomes. This study aimed to evaluate the association between the COVID-19 lockdown and the risk of adverse birth outcomes in Botswana. 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. 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. 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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影响因子：
7.1
作者：
PRENTICE, AM;COLE, TJ;WHITEHEAD, RG
通讯作者：
WHITEHEAD, RG
影响因子：
105.7
作者：
Ceesay, SM;Prentice, AM;Whitehead, RG
通讯作者：
Whitehead, RG
DOI：
10.1097/qad.0000000000001673
发表时间：
2018-01-02
期刊：
AIDS (London, England)
影响因子：
--
作者：
Caniglia EC;Zash R;Jacobson DL;Diseko M;Mayondi G;Lockman S;Chen JY;Mmalane M;Makhema J;Hernán MA;Shapiro RL
通讯作者：
Shapiro RL
影响因子：
2.8
作者：
Bodnar LM;Simhan HN
通讯作者：
Simhan HN
影响因子：
4.2
作者：
Castillo-Carniglia, Alvaro;Kaufman, Jay S.;Cerda, Magdalena
通讯作者：
Cerda, Magdalena