COVID-19 Lockdown Increased the Risk of Preterm Birth

Ting-Ting Lin; Chen Zhang; Lei Chen; Li Jin; Xian-Hua Lin; Jie-Xue Pan; Cindy-Lee Dennis; Ben W Mol; He-Feng Huang; Yan-Ting Wu

doi:10.3389/fmed.2021.705943

COVID-19 Lockdown Increased the Risk of Preterm Birth

Front Med (Lausanne). 2021 Sep 27:8:705943. doi: 10.3389/fmed.2021.705943. eCollection 2021.

Authors

Ting-Ting Lin¹, Chen Zhang^{1

2}, Lei Chen¹, Li Jin², Xian-Hua Lin², Jie-Xue Pan², Cindy-Lee Dennis³, Ben W Mol^{4

5}, He-Feng Huang^{1

2}, Yan-Ting Wu²

Affiliations

¹ Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
² Research Department, Institute of Reproduction and Development, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
³ Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
⁴ Monash University Monash Medical Centre, Clayton, VIC, Australia.
⁵ Aberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, United Kingdom.

Abstract

Purpose: To estimate whether the city-specific lockdown in Shanghai induced by the COVID-19 pandemic affected preterm birth rates among uninfected pregnant women in different trimesters. Methods: The population-based retrospective cohort study was conducted in the International Peace Maternity and Child Health Hospital (IPMCH) in Shanghai, China. Pregnant women without COVID-19 received perinatal healthcare during lockdown (from January 24, 2020 to March 24, 2020) and non-lockdown (from January 24, 2019 to March 24, 2019) period and giving birth to a live infant at IPMCH were enrolled. 1:1 propensity score matching and Inverse probability of treatment weighting were used to evaluate preterm birth (<37 weeks), very preterm birth (<34 weeks), preterm birth with premature rupture of membranes (PROM-PTB), spontaneous preterm birth with intact membranes (S-PTB), and medically induced preterm birth (MI-PTB) between two groups. Results: 8,270 pregnant women were in the lockdown group, and 9,815 were in the non-lockdown group. Pregnant women in second trimester during lockdown had a higher risk of PTB than those during the non-lockdown period [OR: 1.43 (CI 1.01-2.02), ARD: 1.7% (CI 0.04-3.4%), p = 0.045]. Furthermore, pregnant women in third trimester during lockdown had a higher risk of PROM-PTB than those during the non-lockdown period [OR: 1.64 (CI 1.09-2.47), ARD: 0.9% (CI 0.2-1.6%), p = 0.02]; no group differences were found related to rates of VPTB, S-PTB or MI-PTB. Conclusion: In this cohort study in China, we found that there was an increased risk in preterm birth for non-infected women in COVID-19 lockdown who were in their second trimester.

Keywords: COVID-19; lockdown; premature rupture of membranes; preterm birth; very preterm birth.