Delivery and neonatal outcomes of pregnant women during the Shanghai lockdown: A retrospective analysis

Fang-Yue Zhou; Cheng Li; Kai-Zhou Qin; Chuan Luo; He-Feng Huang; Yan-Ting Wu

doi:10.3389/fped.2023.992908

Delivery and neonatal outcomes of pregnant women during the Shanghai lockdown: A retrospective analysis

Front Pediatr. 2023 Feb 2:11:992908. doi: 10.3389/fped.2023.992908. eCollection 2023.

Authors

Fang-Yue Zhou^{1

2}, Cheng Li¹, Kai-Zhou Qin¹, Chuan Luo¹, He-Feng Huang^{1

2

3}, Yan-Ting Wu¹

Affiliations

¹ Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China.
² International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
³ Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China.

Abstract

Objectives: Shanghai witnessed an unprecedented outbreak of COVID-19 and experienced a strict lockdown from March 28, 2022 to May 31, 2022. Most studies to date are on the first lockdown after the outbreak in December 2019. This study aimed to examine the impact of lockdown on delivery and neonatal outcomes among uninfected pregnant women in the new phase of the COVID-19 outbreak.

Methods: A retrospective analysis was conducted in the Obstetrics and Gynecology Hospital of Fudan University. Pregnant women without COVID-19 who delivered from March 28, 2022 to May 31, 2022 (lockdown group) and the same period in 2021 (non-lockdown group) were recruited for this study. Logistic regression models and 1 : 1 propensity score matching (PSM) were used to assess the effect of lockdown on delivery outcomes.

Results: A total of 2,962 patients were included in this study, 1,339 of whom were from the lockdown group. Compared with the non-lockdown group, pregnant women giving birth during lockdown had an increased risk of term prelabor rupture of membranes (TPROM) (aOR = 1.253, 95% CI: 1.026-1.530), and decreased risks of postpartum hemorrhage (PPH) (aOR = 0.362, 95% CI: 0.216-0.606) and fetal malformation (aOR = 0.309, 95% CI: 0.164-0.582). The risk of large for gestational age (LGA) (aOR = 0.802, 95% CI: 0.648-0.992) and rate of admission to the neonatal intensive care unit (NICU) (aOR = 0.722, 95% CI: 0.589-0.885) also significantly declined. After 1 : 1 PSM, the impact of lockdown on the risk of TPROM (aOR = 1.501, 95% CI: 1.083-2.080), PPH (aOR = 0.371, 95% CI: 0.211-0.654), fetal malformation (aOR = 0.332, 95% CI: 0.161-0.684), LGA (aOR = 0.749, 95% CI: 0.594-0.945) and rate of admission to the NICU (aOR = 0.700, 95% CI: 0.564-0.869) all remained. There were no other delivery or neonatal outcomes affected by the lockdown after the COVID-19 outbreak.

Conclusion: This study indicated a significant increase in the risk of term PROM, significant decreases in the risk of PPH, fetal malformation and LGA, and a marked decline in the rate of admission to the NICU during Shanghai Lockdown.

Keywords: COVID-19; delivery outcomes; lockdown; neonatal outcomes; prelabor rupture of membranes (PROM).

Grants and funding

This research is supported by National Key Research and Development Program of China (2021YFC2700701), National Natural Science Foundation of China (81661128010, 82088102, 82171686), Young Elite Scientists Sponsorship Program by CAST (2021QNRC001), CAMS Innovation Fund for Medical Sciences (2019-I2M-5-064), the International Science and Technology Collaborative Fund of Shanghai (18410711800), Program of Shanghai Academic Research Leader (20XD1424100), Natural Science Foundation of Shanghai (20ZR1463100), the Ministry of Education Key Laboratory of Reproductive Genetics (ZDFY2020-RG-0002), Collaborative Innovation Program of Shanghai Municipal Health Commission (2020CXJQ01), Clinical Research Plan of Shanghai Shenkang Hospital Development Center (SHDC12018X17, SHDC2020CR1008A, SHDC12019107), Science and Technology Innovation Fund of Shanghai Jiao Tong University (YG2019GD04, YG2020YQ29), Outstanding Youth Medical Talents of Shanghai Rising Stars of Medical Talent Youth Development Program, Shanghai Clinical Research Center for Gynecological Diseases (22MC1940200), Shanghai Urogenital System Diseases Research Center (2022ZZ01012) and Shanghai Frontiers Science Research Base of Reproduction and Development.