Danish premature birth rates during the COVID-19 lockdown
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Abstract
To explore the impact of COVID-19 lockdown on premature birth rates in Denmark, a nationwide register-based prevalence proportion study was conducted on all 31 180 live singleton infants born in Denmark between 12 March and 14 April during 2015–2020.
The distribution of gestational ages (GAs) was significantly different (p=0.004) during the lockdown period compared with the previous 5 years and was driven by a significantly lower rate of extremely premature children during the lockdown compared with the corresponding mean rate for the same dates in the previous years (OR 0.09, 95% CI 0.01 to 0.40, p<0.001). No significant difference between the lockdown and previous years was found for other GA categories.
The reasons for this decrease are unclear. However, the lockdown has provided a unique opportunity to examine possible factors related to prematurity. Identification of possible causal mechanisms might stimulate changes in clinical practice.
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SciScore for 10.1101/2020.05.22.20109793: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: Studies based solely on register data do not require further ethics committee approval as per Danish laws and regulations. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not 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:Strengths and limitations: Our study has several strengths. As Denmark has excellent registers with a very high …
SciScore for 10.1101/2020.05.22.20109793: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: Studies based solely on register data do not require further ethics committee approval as per Danish laws and regulations. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not 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:Strengths and limitations: Our study has several strengths. As Denmark has excellent registers with a very high coverage,28 we believe the data accurately reflects the current prematurity rates in Denmark. It is based on reliable mandatorily reported data from the entire country. Because exposure (the lockdown) is independent of the recorded outcome, differential misclassification is not considered to be an issue. Although it is possible that a larger number of pregnancies resulted in intrauterine death and that these pregnancies were classified as late abortions, this seems unlikely to explain our observations as it collides with reports from obstetric departments.29 Importantly, this study is observational and the association between the decreased number of extremely premature births and nationwide lockdown is not necessarily causal. As such, this data needs to be confirmed in other countries, although international discrepancies regarding changes in premature birth rates could reflect the variation in baseline premature birth rates as well as differences in implementation of national lockdowns around the world. Future studies should also aim to elucidate potential causalities. Conclusions: Our data indicates that the occurrence of extreme prematurity may be further reduced through preventive measures. If this tendency is confirmed, future studies may even identify causal mechanisms that may be applicable outside a lockdown. Possibly, lessons learned during the COVID-19 pan...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).
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.
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SciScore for 10.1101/2020.05.22.20109793: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Studies based solely on register data do not require further ethics committee approval as per Danish laws and regulations. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable 24 It is possible that the increased focus on hygiene, strict physical distancing, and home confinement during the lockdown period have influenced the overall inflammatory state of pregnant women. Table 2: Resources
Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may …
SciScore for 10.1101/2020.05.22.20109793: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Studies based solely on register data do not require further ethics committee approval as per Danish laws and regulations. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable 24 It is possible that the increased focus on hygiene, strict physical distancing, and home confinement during the lockdown period have influenced the overall inflammatory state of pregnant women. Table 2: Resources
Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).
Results from OddPub: We did not find a statement about open data. We also did not find a statement about open code. Researchers are encouraged to share open data when possible (see Nature blog).
About SciScore
SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.
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