COVID-19 lockdowns affected birthing outcomes in a regional New South Wales Health District

Pierre Hofstee; Bridie Mulholland; Megan Kelly; Warren Davis; Kate Curtis

doi:10.1111/ajo.13812

COVID-19 lockdowns affected birthing outcomes in a regional New South Wales Health District

Aust N Z J Obstet Gynaecol. 2024 Apr 2. doi: 10.1111/ajo.13812. Online ahead of print.

Authors

Pierre Hofstee^{1

2}, Bridie Mulholland^{1

3}, Megan Kelly^{1

4}, Warren Davis¹, Kate Curtis^{5

6}

Affiliations

¹ Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.
² The Tweed Hospital, Northern New South Wales Local Health District, Tweed Heads, New South Wales, Australia.
³ Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.
⁴ School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia.
⁵ Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
⁶ Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia.

PMID: 38566470
DOI: 10.1111/ajo.13812

Abstract

Introduction: The 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.

Aim: Evaluate the impacts of restrictions from two lockdown periods on maternal, birthing, and neonatal outcomes within a regional local health district.

Materials and methods: The 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).

Results: Odds 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.

Conclusions: Pregnant women exposed to pandemic restrictions within ISLHD had decreased odds of adverse antenatal and neonatal outcomes, but increased odds of poor peripartum outcomes.

Keywords: SARS‐CoV‐2; maternal; neonatal; obstetrics; pregnancy.

© 2024 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists.