Article Text
PDF
Abstract
Background Aetiology of births involving very low birthweight (VLBW) and extremely low birthweight (ELBW) infants is heterogeneous and preventive strategies remain elusive. Socioenvironmental measures implemented as Ireland’s response to the SARS-CoV-2 virus (COVID-19) pandemic represented a national lockdown, and have possibly influenced the health and well-being of pregnant women and unborn infants.
Methods Regional trends of VLBW and ELBW infants in one designated health area of Ireland over two decades were analysed. Poisson regression and rate ratio analyses with 95% CI were conducted. Regional data covering most of the lockdown period of 2020 were compared with historical regional and national data and forecasted national figures for 2020.
Results Poisson regression analysis found that the regional historical VLBW rate per 1000 live births for January to April, 2001–2019 was 8.18 (95% CI 7.21 to 9.29). During January to April 2020, an unusually low VLBW rate of just 2.17 per 1000 live births was observed, reflecting a rate ratio of 3.77 (95% CI 1.21 to 11.75), p=0.022, representing a 73% reduction of VLBW during the first 4 months of 2020 compared with same period for the preceding two decades. There were no ELBW infants admitted to the regional neonatal intensive care unit. National Irish VLBW rate for 2020 is forecasted to be reduced to approximate 400 per 60 000 births compared with the historical 500–600 range.
Conclusion An unprecedented reduction in regional births of VLBW and ELBW infants was observed in Ireland coinciding with the COVID-19 lockdown. Potential determinants of this unique temporal trend possibly reside in the summative socioenvironmental impact of the COVID-19 lockdown. Our findings, if mirrored in other regions that have adopted a lockdown, demonstrate the potential to evaluate these implicated behavioural and socioenvironmental modifiers to positively influence VLBW and ELBW rates globally.
- child health
- maternal health
- obstetrics
- paediatrics
- public Health
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Statistics from Altmetric.com
Footnotes
Handling editor Sanni Yaya
Twitter @roykphilip
Contributors RKP conceptualised and designed the study, extracted the VLBW and ELBW data, drafted the initial draft, reviewed and revised the manuscript. ER collected the neonatal activity data and contributed to the nursing and midwifery sections. HP developed the data analysis instruments, conducted the statistical analysis and reviewed and revised the relevant sections. MI contributed to the obstetric data, verified the termination of pregnancy register and reviewed the relevant sections. MD contributed as the patient and public representative, contributed to the relevant sections and developed the search strings. NHO co-supervised the research and critically reviewed the infection and microbiology sections. DM cosupervised the research, reviewed and edited the relevant sections. CPD coordinated and supervised the research, advised on methodology and manuscript structure and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for the work. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Disclaimer The views expressed are those of the authors and not necessarily those of employing authorities of authors such as Health Service Executive (HSE), University of Limerick or Irish Neonatal Health Alliance (INHA).
Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.
Patient consent for publication Not required.
Ethics approval University Hospital Limerick Research Ethics Committee approval was granted for the study (No: 048/2020 dated 6 May 2020).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as online supplemental information.