Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries

Clara Calvert, Meredith (Merilee) Brockway, Helga Zoega, Jessica E. Miller, Jasper V. Been, Adeladza Kofi Amegah, Amy Racine-Poon, Solmaz Eradat Oskoui, Ishaya I. Abok, Nima Aghaeepour, Christie D. Akwaowo, Belal N. Alshaikh, Adejumoke I. Ayede, Fabiana Bacchini, Behzad Barekatain, Rodrigo Barnes, Karolina Bebak, Anick Berard, Zulfiqar A. Bhutta, Jeffrey R. Brook, Lenroy R. Bryan, Kim N. Cajachagua-Torres, Marsha Campbell-Yeo, Dinh-Toi Chu, Kristin L. Connor, Luc Cornette, Sandra Cortés, Mandy Daly, Christian Debauche, Iyabode Olabisi F. Dedeke, Kristjana Einarsdóttir, Hilde Engjom, Guadalupe Estrada-Gutierrez, Ilaria Fantasia, Nicole M. Fiorentino, Meredith Franklin, Abigail Fraser, Onesmus W. Gachuno, Linda A. Gallo, Mika Gissler, Siri E. Håberg, Abbas Habibelahi, Jonas Häggström, Lauren Hookham, Lisa Hui, Luis Huicho, Karen J. Hunter, Sayeeda Huq, Ashish Kc, Seilesh Kadambari, Roya Kelishadi, Narjes Khalili, Joanna Kippen, Kirsty Doare, Javier Llorca, Laura A. Magee, Maria C. Magnus, Kenneth K. C. Man, Patrick M. Mburugu, Rishi P. Mediratta, Andrew D. Morris, Nazeem Muhajarine, Rachel H. Mulholland, Livia Nagy Bonnard, Victoria Nakibuuka, Natasha Nassar, Sylvester D. Nyadanu, Laura Oakley, Adesina Oladokun, Oladapo O. Olayemi, Olanike A. Olutekunbi, Rosena O. Oluwafemi, Taofik O. Ogunkunle, Chris Orton, Anne K. Örtqvist, Joseph Ouma, Oyejoke Oyapero, Kirsten R. Palmer, Lars H. Pedersen, Gavin Pereira, Isabel Pereyra, Roy K. Philip, Dominik Pruski, Marcin Przybylski, Hugo G. Quezada-Pinedo, Annette K. Regan, Natasha R. Rhoda, Tonia A. Rihs, Taylor Riley, Thiago Augusto Hernandes Rocha, Daniel L. Rolnik, Christoph Saner, Francisco J. Schneuer, Vivienne L. Souter, Olof Stephansson, Shengzhi Sun, Emma M. Swift, Miklós Szabó, Marleen Temmerman, Lloyd Tooke, Marcelo L. Urquia, Peter Dadelszen, Gregory A. Wellenius, Clare Whitehead, Ian C. K. Wong, Rachael Wood, Katarzyna Wróblewska-Seniuk, Kojo Yeboah-Antwi, Christopher S. Yilgwan, Agnieszka Zawiejska, Aziz Sheikh, Natalie Rodriguez, David Burgner (), Sarah J. Stock () and Meghan B. Azad ()
Additional contact information
Clara Calvert: University of Edinburgh
Meredith (Merilee) Brockway: University of Manitoba
Helga Zoega: University of New South Wales Sydney
Jessica E. Miller: Murdoch Children’s Research Institute, Royal Children’s Hospital
Jasper V. Been: University Medical Centre Rotterdam
Adeladza Kofi Amegah: University of Cape Coast
Amy Racine-Poon: Novartis
Solmaz Eradat Oskoui: University of Edinburgh
Ishaya I. Abok: University of Jos/Jos University Teaching Hospital
Nima Aghaeepour: Stanford University School of Medicine
Christie D. Akwaowo: University of Uyo Teaching Hospital
Belal N. Alshaikh: University of Calgary
Adejumoke I. Ayede: College of Medicine, University of Ibadan and University College Hospital
Fabiana Bacchini: Canadian Premature Babies Foundation
Behzad Barekatain: Isfahan University of Medical Sciences
Rodrigo Barnes: Aridhia Informatics
Karolina Bebak: Obstetrics and Gynaecology Ward, District Public Hospital in Poznań
Anick Berard: University of Montreal
Zulfiqar A. Bhutta: The Aga Khan University
Jeffrey R. Brook: University of Toronto
Lenroy R. Bryan: University of The West MonaIndies
Kim N. Cajachagua-Torres: University Medical Center Rotterdam
Marsha Campbell-Yeo: Dalhousie University and IWK Health
Dinh-Toi Chu: Vietnam National University
Kristin L. Connor: Carleton University
Luc Cornette: AZ St-Jan Bruges-Ostend AV Hospital
Sandra Cortés: Department of Public Health, School of Medicine, Advanced Center for Chronic Diseases Diagonal (ACCDIS)
Mandy Daly: Irish Neonatal Health Alliance
Christian Debauche: Cliniques Universitaires Saint-Luc, IREC, UCLouvain
Iyabode Olabisi F. Dedeke: Department of Paediatrics, Federal Medical Centre
Kristjana Einarsdóttir: University of Iceland
Hilde Engjom: Department of Health Registry Research and Development, Norwegian Institute of Public Health
Guadalupe Estrada-Gutierrez: National Institute of Perinatology
Ilaria Fantasia: Institute for Maternal and Child Health, IRCCS Burlo Garofolo Children’s Hospital
Nicole M. Fiorentino: University of Manitoba
Meredith Franklin: University of Toronto
Abigail Fraser: University of Bristol
Onesmus W. Gachuno: University of Nairobi
Linda A. Gallo: The University of Queensland
Mika Gissler: THL Finnish Institute for Health and Welfare
Siri E. Håberg: Centre for Fertility and Health, Norwegian Institute of Public Health
Abbas Habibelahi: Neonatology, Neonatal Health Office, Ministry of Health and Medical Education
Jonas Häggström: Cytel
Lauren Hookham: St. George’s University, Makerere University - Johns Hopkins University Research Collaboration
Lisa Hui: University of Melbourne
Luis Huicho: Universidad Peruana Cayetano Heredia
Karen J. Hunter: University of Edinburgh
Sayeeda Huq: Nutrition and Clinical Services Division, ICDDR,B (International Centre for Diarrhoeal Disease Research, Bangladesh)
Ashish Kc: Uppsala University
Seilesh Kadambari: University of Oxford and the NIHR Oxford Biomedical Research Centre
Roya Kelishadi: Isfahan University of Medical Sciences
Narjes Khalili: Iran University of Medical Sciences
Joanna Kippen: Obstetrics and Gynaecology Ward, District Public Hospital in Poznań
Kirsty Doare: University of London
Javier Llorca: Universidad de Cantabria
Laura A. Magee: Institute of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London
Maria C. Magnus: Centre for Fertility and Health, Norwegian Institute of Public Health
Kenneth K. C. Man: University College London School of Pharmacy
Patrick M. Mburugu: Jomo Kenyatta University of Agriculture and Technology
Rishi P. Mediratta: Stanford University School of Medicine
Andrew D. Morris: Health Data Research UK
Nazeem Muhajarine: University of Saskatchewan
Rachel H. Mulholland: University of Edinburgh
Livia Nagy Bonnard: Melletted a helyem Egyesület, Right(s) Beside You Association
Victoria Nakibuuka: Department of Paediatrics, St. Francis Nsambya Hospital
Natasha Nassar: University of Sydney
Sylvester D. Nyadanu: Curtin University
Laura Oakley: Centre for Fertility and Health, Norwegian Institute of Public Health
Adesina Oladokun: University of Ibadan and University College Hospital
Oladapo O. Olayemi: University of Ibadan and University College Hospital
Olanike A. Olutekunbi: Lagos Island Maternity Hospital
Rosena O. Oluwafemi: Department of Paediatrics and Child Health, Mother and Child Hospital
Taofik O. Ogunkunle: Department of Paediatrics, Dalhatu Araf Specialist Hospital
Chris Orton: Swansea University
Anne K. Örtqvist: Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet
Joseph Ouma: Makerere University - Johns Hopkins University Research Collaboration
Oyejoke Oyapero: Paediatrics Department, Ikorodu General Hospital
Kirsten R. Palmer: Monash University
Lars H. Pedersen: Aarhus University and Aarhus University Hospital
Gavin Pereira: Centre for Fertility and Health, Norwegian Institute of Public Health
Isabel Pereyra: Catholic University del Maule
Roy K. Philip: University Maternity Hospital Limerick and University of Limerick School of Medicine
Dominik Pruski: Obstetrics and Gynaecology Ward, District Public Hospital in Poznań
Marcin Przybylski: Obstetrics and Gynaecology Ward, District Public Hospital in Poznań
Hugo G. Quezada-Pinedo: University Medical Center Rotterdam
Annette K. Regan: University of San Francisco
Natasha R. Rhoda: University of Cape Town
Tonia A. Rihs: Federal Statistical Office (FSO)
Taylor Riley: University of Washington
Thiago Augusto Hernandes Rocha: Evidence and Intelligence for Action in Health Department, Pan-American Health Organization - World Health Organization
Daniel L. Rolnik: Monash University
Christoph Saner: Murdoch Children’s Research Institute, Royal Children’s Hospital
Francisco J. Schneuer: The University of Sydney
Vivienne L. Souter: Foundation for Health Care Quality
Olof Stephansson: Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet
Shengzhi Sun: Boston University School of Public Health
Emma M. Swift: University of Iceland
Miklós Szabó: Semmelweis University
Marleen Temmerman: Aga Khan University
Lloyd Tooke: University of Cape Town
Marcelo L. Urquia: University of Manitoba
Peter Dadelszen: Institute of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London
Gregory A. Wellenius: Boston University School of Public Health
Clare Whitehead: University of Melbourne
Ian C. K. Wong: University College London School of Pharmacy
Rachael Wood: University of Edinburgh
Katarzyna Wróblewska-Seniuk: Poznań University of Medical Sciences
Kojo Yeboah-Antwi: Public Health Unit, Father Thomas Alan Rooney Memorial Hospital, Asankrangwa
Christopher S. Yilgwan: University of Jos
Agnieszka Zawiejska: Poznań University of Medical Sciences
Aziz Sheikh: University of Edinburgh
Natalie Rodriguez: University of Manitoba
David Burgner: Murdoch Children’s Research Institute, Royal Children’s Hospital
Sarah J. Stock: University of Edinburgh
Meghan B. Azad: University of Manitoba

Nature Human Behaviour, 2023, vol. 7, issue 4, 529-544

Abstract: Abstract Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from −90% to +30%, were reported in many countries following early COVID-19 pandemic response measures (‘lockdowns’). It is unclear whether this variation reflects real differences in lockdown impacts, or perhaps differences in stillbirth rates and/or study designs. Here we present interrupted time series and meta-analyses using harmonized data from 52 million births in 26 countries, 18 of which had representative population-based data, with overall PTB rates ranging from 6% to 12% and stillbirth ranging from 2.5 to 10.5 per 1,000 births. We show small reductions in PTB in the first (odds ratio 0.96, 95% confidence interval 0.95–0.98, P value

Date: 2023
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DOI: 10.1038/s41562-023-01522-y

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