Reduction in preterm birth rates during and after the COVID ‐19 lockdown in Queensland Australia

  1. Brittany Jasper
  2. Tereza Stillerova
  3. Christopher Anstey
  4. Edward Weaver

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Abstract

Preventative strategies for preterm birth are lacking. Recent evidence proposed COVID‐19 lockdowns may have contributed to changes in preterm birth.

Aims

To determine the prevalence of preterm birth and birth outcomes during and after the COVID‐19 lockdown at the Sunshine Coast University Hospital and the overall state of Queensland, Australia.

Methods

Retrospective cohort analysis of all births in Queensland including the Sunshine Coast University Hospital, during two epochs, April 1–May 31, 2020 (lockdown) and June 1–July 31, 2020 (post‐lockdown), compared to antecedent calendar‐matched periods in 2018–2019. Prevalence of preterm birth, stillbirth, and late terminations were examined.

Results

There were 64 989 births in Queensland from April to July 2018–2020. At the Sunshine Coast University Hospital, there was a significantly higher chance of birth at term during both lockdown (odds ratio (OR) 1.81, 95% CI 1.17, 2.79; P  = 0.007) and post‐lockdown (OR 2.01, 95% CI 1.27, 3.18; P  = 0.003). At the same centre, prevalence of preterm birth was 5.5% (30/547) during lockdown, compared to 9.1% (100/1095) in previous years, a 40.0% relative reduction ( P  = 0.016). At this centre during lockdown, emergency caesareans concurrently decreased ( P  < 0.01) and instrumental vaginal births increased ( P  < 0.01). In Queensland overall, there was a nonsignificant decrease in the prevalence of preterm birth during lockdown.

Conclusions

There is a link between lockdown and a reduction in the prevalence of preterm birth on the Sunshine Coast. The cause is speculative at present, although increased influenza vaccination rates, decreased transmission of infections, and improved air quality may have been favourable in reducing preterm birth. Further research is needed to determine a causal link.

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  1. Version published to 10.1111/ajo.13538
  2. ScreenIT

    SciScore for 10.1101/2021.08.06.21261711: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethics approval and data collection: This study was reviewed by the Prince Charles Hospital Human Research Ethics Committee and approval was granted as a low or negligible risk project (Project ID 70040; November 3, 2020).
    Sex as a biological variableStudy population: This study focused on pregnant women in two geographical locations in Australia.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study has limitations, which should be considered when interpreting results. As this study was observational, it was not possible to account for unmeasured confounding variables. Although detailed data was collected on all births at SCUH, state-wide data for Queensland was limited to birth outcomes and gestational age, as per the predetermined perinatal data collection format. As our health service opened a new tertiary hospital in April 2017 (SCUH), retrospective analysis was only completed for two years prior from 2018–2019. We acknowledge that longer retrospective analysis would be preferable to further compare year-by-year variations in birth outcomes. Further research is required from ethnically, geographically, and socioeconomically diverse regions and high-risk groups for PTB such as Aboriginal and Torres Strait Islander women in Australia. Qualitative analysis of maternal behaviours during lockdown was beyond the scope of this study but would be highly informative.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2021.08.06.21261711v1 on medRxiv