The impact of COVID-19 lockdown on maternal and neonatal outcomes of uninfected woman in late pregnancy: A multicenter study in China

Abstract

Abstract Background COVID-19 pandemic has had direct and indirect impacts on health-care system and maternal and neonatal health, but no multicenter evidence from China of this effects has been undertaken. The purpose of this study was to investigate the impacts of COVID-19 lockdown on maternal and fetal outcomes in China. Methods This retrospective cohort study included 3540 women in their late pregnancy without COVID-19 who received perinatal healthcare in three hospitals in Wuhan, Shanghai and Haikou during COVID-19 lockdown period in 2020 or the non-lockdown period in 2019. Propensity-score matching was used to compare preterm birth (< 37 weeks) and its classification, very preterm birth (< 34 weeks), caesarean section and its indications, the length of hospital stay, birth weight and other pregnancy outcomes between two groups. Results Preterm births before 37 weeks’ gestation (5.4% vs. 5.3%, P = 0.83) and very preterm birth (0.7% vs. 0.8%, P = 0.58) were not significantly changed overall. But medical-induced preterm birth before 37 weeks’ gestation in Wuhan was decreased (0.8% vs. 1.7%, P = 0.04). The cesarean section for maternal factors was decreased (21.4% vs. 24.3%, P = 0.003). The length of maternal (4.2d vs 4.5d, P < 0.001) and neonatal (3.4d vs 3.7d, P < 0.001) hospital stay was shortened. No overall significant effects were identified for other outcomes included in the quantitative analysis: maternal gestational diabetes; pregnancy-induced hypertension; preterm birth with premature rupture of membranes; low birthweight (< 2500 g); neonatal intensive care unit admission; or abnormal Apgar score. Conclusions This study demonstrated that there was protective impact of the COVID-19 lockdown on maternal and neonatal outcomes among women in their late pregnancy in China.