Unprecedented reduction in births of very low birthweight (VLBW) and extremely low birthweight (ELBW) infants during the COVID-19 lockdown in Ireland: a ‘natural experiment’ allowing analysis of data from the prior two decades

Philip, Roy K; Purtill, Helen; Reidy, Elizabeth; Daly, Mandy; Imcha, Mendinaro; McGrath, Denise; O’Connell, Nuala H.; Dunne, Colum P.

doi:10.1136/bmjgh-2020-003075

Cited by 185 publications

(240 citation statements)

References 30 publications

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“…These results at least suggest that the number of high-risk newborns requiring intensive neonatal care was decreased during this outbreak, even though the possibility of the hospitals' incapability of providing intensive neonatal care remains. Combined with consistent findings in three early reports in Europe, [1][2][3] our study reinforces the hypothesis that changes in lifestyles at the maternal and community levels during the COVID-19 outbreak (movement restriction and the increased focus on infection prevention measures) might have had a positive secondary effect on maternal or fetal conditions, possibly through reduced rates of intrauterine infections or alleviated maternal physical stress. Our findings reappraise the importance of arranging the prenatal living environment to protect newborns and mothers.…”

Section: Discussionsupporting

confidence: 90%

Trends in intensive neonatal care during the COVID-19 outbreak in Japan

Maeda

Nakamura²,

Ninomiya

et al. 2020

Arch Dis Child Fetal Neonatal Ed

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The reduction in the use of neonatal intensive care units (NICUs) during the COVID-19 outbreak has been reported, but whether this phenomenon is widespread across countries is unclear. Using a large-scale inpatient database in Japan, we analysed the intensive neonatal care volume and the number of preterm births for weeks 10–17 vs weeks 2–9 (during and before the outbreak) of 2020 with adjustment for the trends during the same period of 2019. We found statistically significant reductions in the numbers of NICU admissions (adjusted incidence rate ratio (aIRR), 0.76; 95% CI, 0.65 to 0.89) and neonatal resuscitations (aIRR, 0.37; 95% CI, 0.25 to 0.55) during the COVID-19 outbreak. Along with the decrease in the intensive neonatal care volume, preterm births before 34 gestational weeks (aIRR, 0.71) and between 34 0/7 and 36 6/7 gestational weeks (aIRR, 0.85) also showed a significant reduction. Further studies about the mechanism of this phenomenon are warranted.

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Section: Discussionsupporting

confidence: 90%

Trends in intensive neonatal care during the COVID-19 outbreak in Japan

Maeda

Nakamura²,

Ninomiya

et al. 2020

Arch Dis Child Fetal Neonatal Ed

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“…Studies from the Netherlands, Denmark, Ireland, Italy, and Japan demonstrated a reduction in preterm births following the implementation of lockdown measures. [2][3][4][5][6] In contrast, studies from the United States in California and Philadelphia reported no significant change in preterm births after lockdown. [7,8] In this NYC study, we observed comparable rates in prematurity and NICU admissions after the implementation of lockdown measures when compared to those of the same time period in previous years.…”

Section: Discussionmentioning

confidence: 93%

“…Several reports linked COVID-19 lockdown measures to reduced rates of prematurity, providing possible mechanisms for prematurity prevention. [2][3][4][5][6] To date, this link has not been assessed in NYC, one of the hardest hit and most populous, diverse cities in the United States. Furthermore, neonatal intensive care unit (NICU) admissions, which are related but not exclusively modified by prematurity rates, may also be impacted by lockdown measures.…”

Section: Introductionmentioning

confidence: 99%

Neonatal outcomes during the COVID-19 pandemic in New York City

Richter

Strasser

Suárez‐Fariñas

et al. 2020

Preprint

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We explored rates of premature births and neonatal intensive care unit (NICU) admissions at the Mount Sinai Hospital after the implementation of COVID-19 lockdown measures (March 16, 2020) and phase one reopening (June 8, 2020), comparing them to those of the same time periods from 2012-2019. Mount Sinai Hospital is in New York City (NYC), an early epicenter of COVID-19 in the United States, which was heavily impacted by the pandemic during the study period. Among 43,963 singleton births, we observed no difference in either outcome after the implementation of lockdown measures when compared to the same trends in prior years (p=0.09-0.35). Of interest, we observed a statistically significant decrease in premature births after NYC phase one reopening compared to those of the same time period in 2012-2019 across all time windows (p=0.0028-0.049), and a statistically significant decrease in NICU admissions over the largest time window (2.75 months) compared to prior years (p=0.0011).

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“…There is an established body of evidence that anxiety and stress in pregnancy are risk factors for adverse outcomes for mother and baby, including longer term cognitive, emotional, and behavioral development issues in childhood [ 24 ]. Studies have indicated negative affect to be associated with preterm birth and low birth weight [ 24 ], although some surprising data are emerging showing dramatic reductions in preterm births from January to April 2020 compared to previous years [ 25 , 26 ]. Maternal anxiety and stress has also been shown to predict postnatal depression, potentially leading to impaired parenting quality and effectiveness [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Experiences, Attitudes, and Needs of Users of a Pregnancy and Parenting App (Baby Buddy) During the COVID-19 Pandemic: Mixed Methods Study

Rhodes¹,

Kheireddine²,

Smith³

2020

JMIR Mhealth Uhealth

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Background The COVID-19 pandemic has impacted the lives of expectant parents and parents of young babies, with disruptions in health care provision and loss of social support. Objective This study investigated the impact of the COVID-19 pandemic and its associated lockdown on this population through the lens of users of the UK National Health Service–approved pregnancy and parenting smartphone app, Baby Buddy. The study aims were threefold: to gain insights into the attitudes and experiences of expectant and recent parents (with babies under 24 weeks of age) during the COVID-19 pandemic; to investigate whether Baby Buddy is meeting users’ needs during this time; and to identify ways to revise the content of Baby Buddy to better support its users now and in future. Methods A mixed methods study design combining a web-based survey with semistructured telephone interviews among Baby Buddy users in the United Kingdom was applied. Data were collected from April 15 to mid-June 2020, corresponding to weeks 4-13 of the lockdown in the United Kingdom. Results A total of 436 expectant (n=244, 56.0%) and recent (n=192, 44.0%) parents responded to the web-based survey, of which 79.1% (n=345) were aged 25-39 years and 17.2% (n=75) spoke English as their second language. Of the 436 respondents, 88.5% (386/436) reported increased levels of anxiety around pregnancy, birth, and being a new parent, and 58.0% (253/436) were concerned about their emotional and mental health. Of the 244 pregnant respondents, 43.4% (n=106) were concerned about their physical health. Telephone interviews with 13 pregnant women and 19 recent parents revealed similarly increased levels of anxiety due to reduced health care provision and loss of support from friends and family. Although a minority of respondents identified some positive outcomes of lockdown, such as family bonding, many telephone interviewees reported feeling isolated, disregarded, and overwhelmed. Recent parents were particularly anxious about the impact of the lockdown on their baby’s development and socialization. Many interviewees were also concerned about their physical health as a consequence of both limited access to face-to-face medical appointments and their own poorer dietary and physical activity behaviors. Across both samples, 97.0% (423/436) of respondents reported that Baby Buddy was currently helping them, with many commenting that its role was even more important given the lack of face-to-face support from health care and parenting organizations. Greater speed in updating digital content to reflect changes due to the pandemic was suggested. Conclusions The COVID-19 pandemic has created heightened anxiety and stress among expectant parents and those with a young baby, and for many, lockdown has had an adverse impact on their physical and mental well-being. With reductions in health care and social support, expectant and new parents are increasingly relying on web-based resources. As a free, evidence-based app, Baby Buddy is well positioned to meet this need. The app could support its users even more by actively directing them to the wealth of existing content relevant to their concerns and by adding content to give users the knowledge and confidence to meet new challenges.

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Unprecedented reduction in births of very low birthweight (VLBW) and extremely low birthweight (ELBW) infants during the COVID-19 lockdown in Ireland: a ‘natural experiment’ allowing analysis of data from the prior two decades

Cited by 185 publications

References 30 publications

Trends in intensive neonatal care during the COVID-19 outbreak in Japan

Trends in intensive neonatal care during the COVID-19 outbreak in Japan

Neonatal outcomes during the COVID-19 pandemic in New York City

Experiences, Attitudes, and Needs of Users of a Pregnancy and Parenting App (Baby Buddy) During the COVID-19 Pandemic: Mixed Methods Study

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