Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China; Department of Obstetrics and Gynaecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
Department of Obstetrics and Gynaecology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
Public Health. 2023 Jul;220:10-17. doi: 10.1016/j.puhe.2023.04.009. Epub 2023 Apr 21.
Lockdown was implemented in many countries during the pandemic, which led to myriad changes in pregnant women's lives. However, the potential impacts of the COVID-19 pandemic on neonatal outcomes remain unclear. We aimed to evaluate the association between the pandemic and neonatal birth weight.
This was a systematic review and meta-analysis of the previous literature.
We searched the MEDLINE and Embase databases up to May 2022 and extracted 36 eligible studies that compared neonatal birth weight between the pandemic and the prepandemic period. The following outcomes were included: mean birth weight, low birth weight (LBW), very low birth weight (VLBW), macrosomia, small for gestational age (SGA), very small for gestational age (VSGA), and large for gestational age (LGA). Statistical heterogeneity among studies was assessed to determine whether a random effects model or fixed effects model was conducted.
Of the 4514 studies identified, 36 articles were eligible for inclusion. A total of 1,883,936 neonates during the pandemic and 4,667,133 neonates during the prepandemic were reported. We identified a significant increase in mean birth weight (pooled mean difference [95% confidence interval (CI)] = 15.06 [10.36, 19.76], I = 0.0%, 12 studies) and a reduction in VLBW (pooled OR [95% CI] = 0.86 [0.77, 0.97], I = 55.4%, 12 studies). No overall effect was identified for other outcomes: LBW, macrosomia, SGA, VSGA, and LGA. There was publication bias for mean birth weight with a borderline significance (Egger's P = 0.050).
Pooled results showed the pandemic was significantly associated with an increase in mean birth weight and a reduction in VLBW, but not for other outcomes. This review provided clues about the indirect effects of the pandemic on neonatal birth weight and more healthcare measures needed to improve neonatal long-term health.
大流行期间许多国家都实施了封锁措施，这导致孕妇的生活发生了诸多变化。然而，COVID-19 大流行对新生儿结局的潜在影响尚不清楚。我们旨在评估大流行与新生儿出生体重之间的关联。
这是对既往文献的系统评价和荟萃分析。
我们检索了 MEDLINE 和 Embase 数据库，截至 2022 年 5 月，共提取了 36 项比较大流行期间和大流行前期间新生儿出生体重的研究。纳入的结局包括：平均出生体重、低出生体重（LBW）、极低出生体重（VLBW）、巨大儿、小于胎龄儿（SGA）、极小于胎龄儿（VSGA）和大于胎龄儿（LGA）。评估研究间的统计学异质性，以确定是否采用随机效应模型或固定效应模型。
在 4514 项研究中，有 36 篇文章符合纳入标准。共报告了大流行期间的 1883936 名新生儿和大流行前的 4667133 名新生儿。我们发现平均出生体重显著增加（合并均数差[95%置信区间（CI）]为 15.06[10.36，19.76]，I²=0.0%，12 项研究），VLBW 减少（合并比值比[95%CI]为 0.86[0.77，0.97]，I²=55.4%，12 项研究）。其他结局：LBW、巨大儿、SGA、VSGA 和 LGA 均无总体效应。平均出生体重存在发表偏倚，具有边缘显著性（Egger's P=0.050）。
汇总结果显示，大流行与平均出生体重增加和 VLBW 减少显著相关，但与其他结局无关。本综述提供了有关大流行对新生儿出生体重间接影响的线索，并需要采取更多的医疗保健措施来改善新生儿的长期健康。
