The impact of mitigation measures on perinatal outcomes during the first nine months of the COVID-19 pandemic: A systematic review with meta-analysis.
The impact of mitigation measures on perinatal outcomes during the first nine months of the COVID-19 pandemic: A systematic review with meta-analysis.
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在COVID-19大流行的前九个月中，缓解措施对围产期结局的影响：进行荟萃分析的系统综述。
DOI：
10.1016/j.ejogrb.2022.05.007
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发表时间：
2022-07
影响因子：
2.6
通讯作者：
Black, Mairead
中科院分区：
文献类型：
--
作者：
Hawco, Sarah;Rolnik, Daniel L.;Woolner, Andrea;Cameron, Natalie J.;Wyness, Victoria;Mol, Ben W.;Black, Mairead
关于2019冠状病毒病大流行期间围产期结局的全球报告产生了相互矛盾的数据。本系统综述和荟萃分析探讨了COVID-19缓解措施对大流行前9个月早产、死胎、低出生体重和新生儿重症监护病房入住的影响。使用MEDLINE、Embase和SCOPUS检索截至2021年5月24日发表的稿件。纳入了在COVID-19大流行期间报告围产期结局（早产、死产、低出生体重、新生儿重症监护病房入院）的研究，并纳入了大流行前控制期。采用ROBINS-I工具进行偏倚风险评估。采用RevMan5随机效应模型进行meta分析。缓解措施的严格程度是根据牛津COVID-19政府反应追踪器计算的。纳入了38项中度至严重偏倚风险的研究，采用了不同的方法、分析和区域缓解措施，采用了严格性指数得分。对小于37周的早产没有总体影响（OR 0.96, 95% CI 0.92-1.00）。然而，在医源性分娩和单胎妊娠中，少于37周的早产（OR 0.89, 95% CI 0.81-0.98）和34周的早产（OR 0.56, 95% CI 0.37-0.83）有所减少。在严格指数评分中位数以上的研究中，小于34周的早产儿也显著减少（OR 0.71, 95% CI 0.58-0.88）。对死产风险（OR 1.04, 95% CI 0.90-1.19）和出生体重没有影响。在严密性指数中位数评分高于中位数的研究中，新生儿重症监护病房入院率显著降低（OR 0.87, 95% CI 0.78-0.97）。在对SARS-CoV-2感染采取高度缓解措施的地区，早产的减少可能是由医源性分娩的减少推动的。未来的研究需要考虑研究设计和队列特征的可变性，以便进一步调查围产期结局的人群水平健康措施。
Worldwide reports have produced conflicting data on perinatal outcomes during the COVID-19 pandemic. This systematic review and meta-analysis addressed the effect of mitigation measures against COVID-19 on preterm birth, stillbirth, low birth weight, and NICU admission during the first nine months of the pandemic. A search was performed using MEDLINE, Embase and SCOPUS for manuscripts published up until 24th May 2021. Studies that reported perinatal outcomes (preterm birth, stillbirth, low birth weight, NICU admission) during the COVID-19 pandemic with a pre-pandemic control period were included. Risk of bias assessment was performed using ROBINS-I tool. RevMan5 was used to perform meta-analysis with random-effects models. A score of the stringency of mitigation measures was calculated from the Oxford COVID-19 Government Response Tracker. Thirty-eight studies of moderate to serious risk of bias were included, with varied methodology, analysis and regional mitigation measures, using stringency index scores. There was no overall effect on preterm birth at less than 37 weeks (OR 0.96, 95% CI 0.92–1.00). However, there was a reduction in preterm birth at less than 37 weeks (OR 0.89, 95% CI 0.81–0.98) and 34 weeks (OR 0.56, 95% CI 0.37–0.83) for iatrogenic births and in singleton pregnancies. There was also a significant reduction in preterm births at less than 34 weeks in studies with above median stringency index scores (OR 0.71, 95% CI 0.58–0.88). There was no effect on risk of stillbirth (OR 1.04, 95% CI 0.90–1.19) or birth weight. NICU admission rates were significantly reduced in studies with above median stringency index scores (OR 0.87, 95% CI 0.78–0.97). The reduction in preterm births in regions with high mitigation measures against SARS-CoV-2 infection is likely driven by a reduction in iatrogenic births. Variability in study design and cohort characteristics need to be considered for future studies to allow further investigation of population level health measures of perinatal outcomes.
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DOI：
10.3390/ijerph18073782
发表时间：
2021-04-05
影响因子：
--
作者：
Kirchengast S;Hartmann B
通讯作者：
Hartmann B
影响因子：
6.3
作者：
Greene NH;Kilpatrick SJ;Wong MS;Ozimek JA;Naqvi M
通讯作者：
Naqvi M
DOI：
10.1016/s2214-109x(21)00079-6
发表时间：
2021-06
期刊：
The Lancet. Global health
影响因子：
--
作者：
Chmielewska B;Barratt I;Townsend R;Kalafat E;van der Meulen J;Gurol-Urganci I;O'Brien P;Morris E;Draycott T;Thangaratinam S;Le Doare K;Ladhani S;von Dadelszen P;Magee L;Khalil A
通讯作者：
Khalil A
影响因子：
13.8
作者：
Duryea EL;Adhikari EH;Ambia A;Spong C;McIntire D;Nelson DB
通讯作者：
Nelson DB
影响因子：
3.8
作者：
Kumar, Manisha;Puri, Manju;Meena, Deepika
通讯作者：
Meena, Deepika