Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Department of Obstetrics, Gynecology and Neonatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Reprod Biomed Online. 2021 Oct;43(4):765-767. doi: 10.1016/j.rbmo.2021.07.017. Epub 2021 Jul 30.
What effects did the early phase of the COVID-19 pandemic have on natural and assisted reproductive technology (ART)-mediated birth rates?
Regional registries were consulted with permission from the Health Authorities of Lombardy Region, Northern Italy, an area particularly affected by the early phase of the epidemic. Deliveries occurring in the area between 1 January 2019 and 31 December 2020 from women beneficiaries of the National Health System and resident in Lombardy were identified. Comparisons mainly focused on December 2020, when women who conceived after 8 March (the start of the stringent lockdown imposed by the authorities) were expected to deliver.
When comparing the periods January to November in 2019 and 2020, a 5.1% reduction of monthly general birth rate (from 5732 in 2019 to 5438 in 2020) was observed. The contribution of ART births was similar in 2019 and 2020, being 4.4% and 4.5%, respectively. In December 2020, a notable drop in natural (-17.8%), ART-mediated (-86.6%) and overall (-21.0%) births was observed compared with December 2019. After adjusting for the expected 5.1% reduction, the inferred effect of the COVID-19 crisis corresponded to a 16.7% reduction in birth rate, of which 76% was related to natural (707 births) and 24% to ART (218 births) conceptions.
This is the first study providing population-based evidence on the effects of COVID-19 and its related stringent restrictions on birth rates. The birth rate was dramatically reduced following the critical period, and the closure of ART centres played only a marginal role (24%) in the overall detrimental effect.
COVID-19 大流行的早期阶段对自然和辅助生殖技术（ART）介导的出生率有什么影响？
经意大利北部伦巴第大区卫生当局许可，咨询了区域登记处。该地区特别受到疫情早期阶段的影响。确定了在该地区居住的国家卫生系统受益妇女在 2019 年 1 月 1 日至 2020 年 12 月 31 日之间的分娩情况。比较主要集中在 2020 年 12 月，预计在 3 月 8 日（当局实施严格封锁）之后受孕的妇女分娩。
与 2019 年和 2020 年 1 月至 11 月期间相比，每月总出生率下降了 5.1%（从 2019 年的 5732 降至 2020 年的 5438）。2019 年和 2020 年 ART 分娩的贡献相似，分别为 4.4%和 4.5%。与 2019 年 12 月相比，2020 年 12 月自然（下降 17.8%）、ART 介导（下降 86.6%）和整体（下降 21.0%）分娩量明显下降。在调整预期的 5.1%下降后，COVID-19 危机的推断效应相当于出生率下降 16.7%，其中 76%与自然（707 例分娩）有关，24%与 ART（218 例分娩）有关。
这是第一项提供基于人群的证据，证明 COVID-19 及其相关严格限制对出生率的影响的研究。在关键时期之后，出生率大幅下降，而 ART 中心的关闭在整体不利影响中仅发挥了微不足道的作用（24%）。
