Reduction in spontaneous and iatrogenic preterm births in twin pregnancies during COVID-19 lockdown in Melbourne, Australia: a multicenter cohort study
Abstract Background Melbourne, Australia, recorded one of the longest and most stringent pandemic lockdowns in 2020, which was associated with an increase in preterm stillbirths among singleton pregnancies. Twin pregnancies may be particularly susceptible to the impacts of pandemic disruptions to ma...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-023-06137-9 |
| _version_ | 1797387976498479104 |
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| author | Juliana M. Manno Melvin B. Marzan Daniel L. Rolnik Stephanie Potenza Natasha Pritchard Joanne M. Said Kirsten R. Palmer Clare L. Whitehead Penelope M. Sheehan Jolyon Ford Ben W. Mol Susan P. Walker Lisa Hui |
| author_facet | Juliana M. Manno Melvin B. Marzan Daniel L. Rolnik Stephanie Potenza Natasha Pritchard Joanne M. Said Kirsten R. Palmer Clare L. Whitehead Penelope M. Sheehan Jolyon Ford Ben W. Mol Susan P. Walker Lisa Hui |
| author_sort | Juliana M. Manno |
| collection | DOAJ |
| description | Abstract Background Melbourne, Australia, recorded one of the longest and most stringent pandemic lockdowns in 2020, which was associated with an increase in preterm stillbirths among singleton pregnancies. Twin pregnancies may be particularly susceptible to the impacts of pandemic disruptions to maternity care due to their higher background risk of adverse perinatal outcomes. Methods Multicenter retrospective cohort study of all twin pregnancies birthing in public maternity hospitals in Melbourne. Multivariable log-binomial regression models were used to compare perinatal outcomes between a pre-pandemic group to women in whom weeks 20+0 to 40+0 of gestation occurred entirely during one of two lockdown-exposure periods: exposure 1 from 22 March 2020 to 21 March 2021 and exposure 2 from 22 March 2021 to 27 March 2022. Results Total preterm births < 37 weeks were significantly lower in exposure 1 compared with the pre-pandemic period (63.1% vs 68.3%; adjusted risk ratio 0.92 95% CI 0.87–0.98, p = 0.01). This was mainly driven by fewer spontaneous preterm births (18.9% vs 20.3%; adjusted risk ratio 0.95 95% CI 0.90–0.99, p = 0.04). There were also lower rates of preterm birth < 34 weeks (19.9% vs 23.0%, adjusted risk ratio 0.93 95% CI 0.89–0.98 p = 0.01) and total iatrogenic births for fetal compromise (13.4% vs 20.4%; adjusted risk ratio 0.94 95% CI 0.89–0.98, p = 0.01). There were fewer special care nursery admissions (38.5% vs 43.4%; adjusted risk ratio 0.91 95% CI 0.87–0.95, p < 0.001) but no significant changes in stillbirth (1.5% vs 1.6%; adjusted risk ratio 1.00 95% CI 0.99–1.01, p = 0.82). Compared with the pre-pandemic period, there were more preterm births < 28 weeks and neonatal intensive care unit admissions in exposure 2. Conclusions Melbourne’s first lockdown-exposure period was associated with lower preterm births in twins without significant differences in adverse newborn outcomes. Our findings provide insights into the influences on preterm birth and the optimal timing of delivery for twins. |
| first_indexed | 2024-03-08T22:34:01Z |
| format | Article |
| id | doaj.art-11a64cf4f7ec431a92b29480b06aa8e9 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-08T22:34:01Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-11a64cf4f7ec431a92b29480b06aa8e92023-12-17T12:33:02ZengBMCBMC Pregnancy and Childbirth1471-23932023-12-0123111310.1186/s12884-023-06137-9Reduction in spontaneous and iatrogenic preterm births in twin pregnancies during COVID-19 lockdown in Melbourne, Australia: a multicenter cohort studyJuliana M. Manno0Melvin B. Marzan1Daniel L. Rolnik2Stephanie Potenza3Natasha Pritchard4Joanne M. Said5Kirsten R. Palmer6Clare L. Whitehead7Penelope M. Sheehan8Jolyon Ford9Ben W. Mol10Susan P. Walker11Lisa Hui12Melbourne Medical School, The University of MelbourneDepartment of Obstetrics and Gynaecology, Melbourne Medical School, The University of MelbourneDepartment of Obstetrics and Gynaecology, Monash HealthDepartment of Obstetrics and Gynaecology, Mercy Hospital for Women, Mercy HealthDepartment of Obstetrics and Gynaecology, Melbourne Medical School, The University of MelbourneDepartment of Obstetrics and Gynaecology, Melbourne Medical School, The University of MelbourneDepartment of Obstetrics and Gynaecology, Monash HealthDepartment of Obstetrics and Gynaecology, Melbourne Medical School, The University of MelbourneDepartment of Obstetrics and Gynaecology, Monash HealthDepartment of Obstetrics and Gynaecology, Peninsula HealthDepartment of Obstetrics and Gynaecology, Monash HealthDepartment of Obstetrics and Gynaecology, Melbourne Medical School, The University of MelbourneDepartment of Obstetrics and Gynaecology, Melbourne Medical School, The University of MelbourneAbstract Background Melbourne, Australia, recorded one of the longest and most stringent pandemic lockdowns in 2020, which was associated with an increase in preterm stillbirths among singleton pregnancies. Twin pregnancies may be particularly susceptible to the impacts of pandemic disruptions to maternity care due to their higher background risk of adverse perinatal outcomes. Methods Multicenter retrospective cohort study of all twin pregnancies birthing in public maternity hospitals in Melbourne. Multivariable log-binomial regression models were used to compare perinatal outcomes between a pre-pandemic group to women in whom weeks 20+0 to 40+0 of gestation occurred entirely during one of two lockdown-exposure periods: exposure 1 from 22 March 2020 to 21 March 2021 and exposure 2 from 22 March 2021 to 27 March 2022. Results Total preterm births < 37 weeks were significantly lower in exposure 1 compared with the pre-pandemic period (63.1% vs 68.3%; adjusted risk ratio 0.92 95% CI 0.87–0.98, p = 0.01). This was mainly driven by fewer spontaneous preterm births (18.9% vs 20.3%; adjusted risk ratio 0.95 95% CI 0.90–0.99, p = 0.04). There were also lower rates of preterm birth < 34 weeks (19.9% vs 23.0%, adjusted risk ratio 0.93 95% CI 0.89–0.98 p = 0.01) and total iatrogenic births for fetal compromise (13.4% vs 20.4%; adjusted risk ratio 0.94 95% CI 0.89–0.98, p = 0.01). There were fewer special care nursery admissions (38.5% vs 43.4%; adjusted risk ratio 0.91 95% CI 0.87–0.95, p < 0.001) but no significant changes in stillbirth (1.5% vs 1.6%; adjusted risk ratio 1.00 95% CI 0.99–1.01, p = 0.82). Compared with the pre-pandemic period, there were more preterm births < 28 weeks and neonatal intensive care unit admissions in exposure 2. Conclusions Melbourne’s first lockdown-exposure period was associated with lower preterm births in twins without significant differences in adverse newborn outcomes. Our findings provide insights into the influences on preterm birth and the optimal timing of delivery for twins.https://doi.org/10.1186/s12884-023-06137-9COVID-19CoronavirusPandemicTwinsPreterm birthPrematurity |
| spellingShingle | Juliana M. Manno Melvin B. Marzan Daniel L. Rolnik Stephanie Potenza Natasha Pritchard Joanne M. Said Kirsten R. Palmer Clare L. Whitehead Penelope M. Sheehan Jolyon Ford Ben W. Mol Susan P. Walker Lisa Hui Reduction in spontaneous and iatrogenic preterm births in twin pregnancies during COVID-19 lockdown in Melbourne, Australia: a multicenter cohort study BMC Pregnancy and Childbirth COVID-19 Coronavirus Pandemic Twins Preterm birth Prematurity |
| title | Reduction in spontaneous and iatrogenic preterm births in twin pregnancies during COVID-19 lockdown in Melbourne, Australia: a multicenter cohort study |
| title_full | Reduction in spontaneous and iatrogenic preterm births in twin pregnancies during COVID-19 lockdown in Melbourne, Australia: a multicenter cohort study |
| title_fullStr | Reduction in spontaneous and iatrogenic preterm births in twin pregnancies during COVID-19 lockdown in Melbourne, Australia: a multicenter cohort study |
| title_full_unstemmed | Reduction in spontaneous and iatrogenic preterm births in twin pregnancies during COVID-19 lockdown in Melbourne, Australia: a multicenter cohort study |
| title_short | Reduction in spontaneous and iatrogenic preterm births in twin pregnancies during COVID-19 lockdown in Melbourne, Australia: a multicenter cohort study |
| title_sort | reduction in spontaneous and iatrogenic preterm births in twin pregnancies during covid 19 lockdown in melbourne australia a multicenter cohort study |
| topic | COVID-19 Coronavirus Pandemic Twins Preterm birth Prematurity |
| url | https://doi.org/10.1186/s12884-023-06137-9 |
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