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IntroductionThe 400 000 residents of the Illawarra Shoalhaven Local Health District (ISLHD) experienced two distinct lockdowns aimed at mitigating the transmission of severe acute respiratory syndrome coronavirus 2 infection. Analysing effects of these lockdowns on maternal and neonatal outcomes presents a valuable opportunity to assess the impact of pandemic‐level restrictions on maternal and neonatal outcomes.AimEvaluate the impacts of restrictions from two lockdown periods on maternal, birthing, and neonatal outcomes within a regional local health district.Materials and MethodsThe study included 22 166 women who gave birth within ISLHD between 2017 and 2022. Groups included for analysis: Control Group – mothers pregnant before the pandemic (conception before 3 April 2019); Exposure Group 1 – mothers pregnant during the first lockdown (conception date 22 January 2020 to 5 May 2020); and Exposure Group 2 – mothers pregnant during the second lockdown (conception date 30 April 2021 to 13 Sep 2021).ResultsOdds of adverse birthing outcomes including non‐reassuring fetal status (odds ratio (OR) 1.34; 95% CI 1.14–1.56 and OR 1.20; 95% CI 1.03–1.40), and postpartum haemorrhage (OR 2.04; 95% CI 1.73–2.41 and OR 1.74; 95% CI 1.48–2.05) were substantially increased in Exposure Groups 1 and 2, respectively. Gestational diabetes, gestational hypertension, low birth weight and admission to neonatal intensive care rates improved.ConclusionsPregnant women exposed to pandemic restrictions within ISLHD had decreased odds of adverse antenatal and neonatal outcomes, but increased odds of poor peripartum outcomes.
IntroductionThe 400 000 residents of the Illawarra Shoalhaven Local Health District (ISLHD) experienced two distinct lockdowns aimed at mitigating the transmission of severe acute respiratory syndrome coronavirus 2 infection. Analysing effects of these lockdowns on maternal and neonatal outcomes presents a valuable opportunity to assess the impact of pandemic‐level restrictions on maternal and neonatal outcomes.AimEvaluate the impacts of restrictions from two lockdown periods on maternal, birthing, and neonatal outcomes within a regional local health district.Materials and MethodsThe study included 22 166 women who gave birth within ISLHD between 2017 and 2022. Groups included for analysis: Control Group – mothers pregnant before the pandemic (conception before 3 April 2019); Exposure Group 1 – mothers pregnant during the first lockdown (conception date 22 January 2020 to 5 May 2020); and Exposure Group 2 – mothers pregnant during the second lockdown (conception date 30 April 2021 to 13 Sep 2021).ResultsOdds of adverse birthing outcomes including non‐reassuring fetal status (odds ratio (OR) 1.34; 95% CI 1.14–1.56 and OR 1.20; 95% CI 1.03–1.40), and postpartum haemorrhage (OR 2.04; 95% CI 1.73–2.41 and OR 1.74; 95% CI 1.48–2.05) were substantially increased in Exposure Groups 1 and 2, respectively. Gestational diabetes, gestational hypertension, low birth weight and admission to neonatal intensive care rates improved.ConclusionsPregnant women exposed to pandemic restrictions within ISLHD had decreased odds of adverse antenatal and neonatal outcomes, but increased odds of poor peripartum outcomes.
We aimed to review the evidence on the impact of lockdowns on adverse birth and pregnancy outcomes (ABPOs) and related inequalities in high-income countries (HICs). Databases were searched from Jan 1, 2019-June 22, 2023, for original observational studies based in HICs which compared the rates of ABPOs, before and during lockdowns. We ran random effects meta-analyses and subgroup analyses per region, lockdown period, ethnicity group, and deprivation level, we also adjusted for underlying temporal trends. 132 studies were meta-analysed. Preterm birth (PTB) decreased in the first lockdown (RR = 0·96[95%CI:0·93 − 0·99]), when only considering studies that adjusted for long-term trends, this reduction in PTB remained (0·97[0·95 − 0·99]). The reduction was larger in Europe (0·94[0·92 − 0·96]) and Australia (0·94[0·90 − 0·99]), and only observed in white ethnicity groups (0·94[0·89 − 0·98]), and in those living in low deprivation (0·95[0·91 − 0·98]). More women screened positive for possible depression antenatally during lockdown (1·37[1·06 − 1·78]). Lockdowns affected advantaged and disadvantaged subgroups in an unequal manner.
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