Hindes Iona, Sarwar Hawa Nuralhuda, Gravesteijn Benjamin Y, Jardine Jennifer, Burgos-Ochoa Lizbeth, Been Jasper V, Zenner Dominik, Iliodromiti Stamatina
Women's Health Research Unit, Centre for Public Health and Policy, Wolfson Institute of Population Health, Queen Mary University London, London, UK.
Amsterdam Reproduction and Development, Amsterdam University Medical Centre, Amsterdam, the Netherlands.
Nat Hum Behav. 2025 Apr 30. doi: 10.1038/s41562-025-02139-z.
We conducted a systematic review and meta-analysis to review the association of lockdowns with adverse birth and pregnancy outcomes (ABPOs) and related inequalities, in high-income countries (HICs). Databases (EMBASE, MEDLINE/PubMed and Web of Science) were searched from 1 January 2019 to 22 June 2023 for original observational studies based in HICs that compared the rates of ABPOs, before and during lockdowns. The risk of bias was assessed using the Newcastle-Ottawa tool for cohort studies. We ran random-effects meta-analyses and subgroup analyses per region, lockdown period, ethnicity group and deprivation level and adjusted for underlying temporal trends. A total of 132 studies were meta-analysed from 28 HICs. Reduced rates of preterm birth (reported by 26 studies) were associated with the first lockdown (relative risk 0.96, 95% confidence interval 0.93-0.99), 11 studies adjusted for long-term trends and the association remained (0.97, 0.95-0.99), and subgroup analysis found that this association varied by continental region. Ten studies reported positive screening rates for possible depression antenatally, and lockdown was associated with increases in positive screening rates (1.37, 1.06-1.78). No other ABPOs were associated with lockdowns. Investigation of inequalities was limited due to data availability and heterogeneity; further research is warranted on the effect of lockdowns on health inequalities. This study was funded by the National Institute of Health Research, School of Primary Care Research and registered on PROSPERO (CRD42022327448).
我们进行了一项系统综述和荟萃分析，以研究在高收入国家（HICs）中，封锁措施与不良出生和妊娠结局（ABPOs）以及相关不平等现象之间的关联。检索了数据库（EMBASE、MEDLINE/PubMed和Web of Science），时间范围为2019年1月1日至2023年6月22日，以查找基于HICs的原始观察性研究，这些研究比较了封锁前和封锁期间ABPOs的发生率。使用纽卡斯尔-渥太华工具对队列研究进行偏倚风险评估。我们针对每个地区、封锁期、种族群体和贫困水平进行了随机效应荟萃分析和亚组分析，并对潜在的时间趋势进行了调整。共对来自28个HICs的132项研究进行了荟萃分析。首次封锁与早产率降低相关（26项研究报告）（相对风险0.96，95%置信区间0.93 - 0.99），11项研究对长期趋势进行了调整，该关联仍然存在（0.97，0.95 - 0.99），亚组分析发现这种关联因大陆地区而异。10项研究报告了产前可能抑郁症的阳性筛查率，封锁与阳性筛查率增加相关（1.37，1.06 - 1.78）。没有其他ABPOs与封锁相关。由于数据可用性和异质性，对不平等现象的调查有限；关于封锁对健康不平等影响的进一步研究是必要的。本研究由国家卫生研究院初级保健研究学院资助，并在PROSPERO上注册（CRD42022327448）。
