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Pregnancy outcomes in Italy during COVID‐19 pandemic: A population‐based cohort study
Author(s) -
Rusconi Franca,
Puglia Monia,
Pacifici Martina,
Brescianini Sonia,
Gagliardi Luigi,
Nannavecchia Anna Maria,
Buono Pietro,
Cantoira Sara,
Farchi Sara,
Gobbato Michele,
Pellegrini Edda,
Perrone Enrica,
Pertile Riccardo,
Tavormina Elisa Eleonora,
Visonà Dalla Pozza Laura,
Zambri Francesca
Publication year - 2023
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.17315
Subject(s) - medicine , poisson regression , pandemic , confidence interval , gestational age , cohort study , population , pregnancy , cohort , demography , obstetrics , covid-19 , rate ratio , pediatrics , disease , infectious disease (medical specialty) , environmental health , genetics , sociology , biology
Abstract Objective To compare the estimates of preterm birth (PTB; 22–36 weeks' gestational age, GA) and stillbirth rates during COVID‐19 pandemic in Italy with those recorded in the three previous years. Design A population‐based cohort study of live‐ and stillborn infants was conducted using data from Regional Health Systems and comparing the pandemic period (1 March 2020–31 March 2021, n = 362 129) to an historical period (January 2017–February 2020, n = 1 117 172). The cohort covered 84.3% of the births in Italy. Methods Poisson regressions were run in each Region and meta‐analyses were performed centrally. We used an interrupted time series regression analysis to study the trend of preterm births from 2017 to 2021. Main outcome measures The primary outcomes were PTB and stillbirths. Secondary outcomes were late PTB (32–36 weeks' GA), very PTB (<32 weeks' GA), and extremely PTB (<28 weeks' GA), overall and stratified into singleton and multiples. Results The pandemic period compared with the historical one was associated with a reduced risk for PTB (risk ratio [RR] 0.91, 95% confidence interval [CI] 0.88–0.93), late PTB (RR 0.91, 95% CI 0.88–0.94), very PTB (RR 0.88, 95% CI 0.84–0.91) and extremely PTB (RR 0.88, 95% CI 0.82–0.95). In multiples, point estimates were not very different, but had wider CIs. No association was found for stillbirths (RR 1.01, 95% CI 0.90–1.13). A linear decreasing trend in PTB rate was present in the historical period, with a further reduction after the lockdown. Conclusions We demonstrated a decrease in PTB rate after the introduction of COVID‐19 restriction measures, without an increase in stillbirths.