COVID-19 pandemic and neonatal birth weight: a systematic review and meta-analysis

X D Yao; Y Li; H Jiang; J Ma; J Wen

doi:10.1016/j.puhe.2023.04.009

COVID-19 pandemic and neonatal birth weight: a systematic review and meta-analysis

Public Health. 2023 Jul:220:10-17. doi: 10.1016/j.puhe.2023.04.009. Epub 2023 Apr 21.

Authors

X D Yao¹, Y Li², H Jiang³, J Ma², J Wen⁴

Affiliations

¹ Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China; Department of Obstetrics and Gynaecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
² Department of Obstetrics and Gynaecology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
³ Department of Obstetrics and Gynaecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
⁴ Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China. Electronic address: wenj2010@139.com.

Abstract

Objectives: Lockdown was implemented in many countries during the pandemic, which led to myriad changes in pregnant women's lives. However, the potential impacts of the COVID-19 pandemic on neonatal outcomes remain unclear. We aimed to evaluate the association between the pandemic and neonatal birth weight.

Study design: This was a systematic review and meta-analysis of the previous literature.

Methods: We searched the MEDLINE and Embase databases up to May 2022 and extracted 36 eligible studies that compared neonatal birth weight between the pandemic and the prepandemic period. The following outcomes were included: mean birth weight, low birth weight (LBW), very low birth weight (VLBW), macrosomia, small for gestational age (SGA), very small for gestational age (VSGA), and large for gestational age (LGA). Statistical heterogeneity among studies was assessed to determine whether a random effects model or fixed effects model was conducted.

Results: Of the 4514 studies identified, 36 articles were eligible for inclusion. A total of 1,883,936 neonates during the pandemic and 4,667,133 neonates during the prepandemic were reported. We identified a significant increase in mean birth weight (pooled mean difference [95% confidence interval (CI)] = 15.06 [10.36, 19.76], I² = 0.0%, 12 studies) and a reduction in VLBW (pooled OR [95% CI] = 0.86 [0.77, 0.97], I² = 55.4%, 12 studies). No overall effect was identified for other outcomes: LBW, macrosomia, SGA, VSGA, and LGA. There was publication bias for mean birth weight with a borderline significance (Egger's P = 0.050).

Conclusion: Pooled results showed the pandemic was significantly associated with an increase in mean birth weight and a reduction in VLBW, but not for other outcomes. This review provided clues about the indirect effects of the pandemic on neonatal birth weight and more healthcare measures needed to improve neonatal long-term health.

Keywords: Birth outcomes; Birth weight; COVID-19 pandemic; Meta-analysis.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Birth Weight
COVID-19* / epidemiology
Communicable Disease Control
Female
Fetal Macrosomia / epidemiology
Humans
Infant, Newborn
Pandemics
Pregnancy
Pregnancy Outcome* / epidemiology