Tessier Benoit, Annesi-Maesano Isabella, Cambonie Gilles, Molinari Nicolas, Kalfa Nicolas
Department of Pediatric Surgery and Urology, Lapeyronie Hospital, CHU Montpellier-University of Montpellier, Montpellier, France.
Debrest Institute of Epidemiology and Public Health IDESP, UMR INSERM-University of Montpellier, Montpellier, France.
Front Pediatr. 2023 Sep 7;11:1223692. doi: 10.3389/fped.2023.1223692. eCollection 2023.
The worldwide rate of preterm birth (PTB) has been increasing over the last two decades. COVID-19 lockdowns provide a unique opportunity to assess the effects of socioenvironmental and lifestyle factors on premature birth and birth weight. We explored the effects of COVID-19 lockdowns on the PTB rate and birth weight at a nationwide scale in France until one year after their occurrence.
This national retrospective observational study evaluated the rate of PTB and birth weight in France from January 2016 to December 2020. Data were obtained from the national database. The rates of global and sub-categories of PTB were tested. The birth weight was studied before and after lockdown for all live births, for term and premature neonates, and for each category of low birth weight (LBW) by a stratified analysis.
Data from 2,949,372 births from January 2016 to December 2019, including 228,857 PTB, were compared to those of 699,344 births and 51,886 PTB from January to December 2020. The national rate of PTB decreased significantly from 7.7% to 7.3%, when compared with the 2016-2019 period. This decrease was persistent up to 9 months later. It was observed only for moderate PTB, whereas very PTB and extremely PTB remained stable. The national mean birth weight for full-term babies increased after the lockdown and was still observable up to 8 months later (+0.16%, < 0.0001). The proportion of children with LBW also decreased 2 months after lockdown (-0.15%; = 0.02). For VLBW, the difference only appeared over the 6-month post-lockdown period (-0.06%; = 0.006).
This nationwide study shows a significant reduction in prematurity and a significant increase in birth weight in France after the lockdown for a period of time not limited to the lockdown itself. A more in-depth study of the factors determining these variations may help to drive PTB prevention policies.
在过去二十年中,全球早产率一直在上升。新冠疫情封锁提供了一个独特的机会,来评估社会环境和生活方式因素对早产和出生体重的影响。我们在法国全国范围内探讨了新冠疫情封锁对早产率和出生体重的影响,直至封锁发生后一年。
这项全国性回顾性观察研究评估了2016年1月至2020年12月法国的早产率和出生体重。数据来自国家数据库。对全球早产率和子类别早产率进行了检测。通过分层分析,研究了所有活产、足月和早产新生儿以及每个低出生体重类别在封锁前后的出生体重。
将2016年1月至2019年的2949372例出生数据(包括228857例早产)与2020年1月至12月的699344例出生数据和51886例早产数据进行了比较。与2016 - 2019年期间相比,全国早产率从7.7%显著降至7.3%。这种下降持续到9个月后。仅中度早产出现下降,而极早产和极度早产保持稳定。封锁后足月婴儿的全国平均出生体重增加,并且在8个月后仍可观察到(+0.16%,<0.0001)。低出生体重儿童的比例在封锁后2个月也有所下降(-0.15%;=0.02)。对于极低出生体重儿,差异仅在封锁后6个月期间出现(-0.06%;=0.006)。
这项全国性研究表明,在法国封锁后,早产率显著降低,出生体重显著增加,且这种情况在不限于封锁本身的一段时间内持续存在。对决定这些变化的因素进行更深入的研究可能有助于推动早产预防政策。