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Prevalence of Preterm Birth Rate During COVID-19 Lockdown in a Tertiary Care Hospital, Riyadh
Roya Huseynova1, Latifa Bin Mahmoud1, Adli Abdelrahim1
1Neonatal Intensive Care Unit, King Saud Medical City, Riyadh, SAU.
Insights
The COVID-19 lockdown significantly reduced premature births, particularly extremely preterm infants, by 23% overall. This study highlights the lockdown
Area of Science:
- Neonatalogy
- Public Health
- Epidemiology
Background:
- The first COVID-19 case in Saudi Arabia was reported on March 3, 2020, leading to government-imposed lockdown measures and travel restrictions from March to June 2020.
- The pandemic posed a significant public health risk, prompting investigations into its various impacts.
- A distinctive coronavirus was isolated from 190,823 patients by June 30, 2020.
Purpose of the Study:
- To evaluate the impact of the COVID-19 lockdown on the rate of premature births in Saudi Arabia.
- To compare preterm birth rates before and during the strict lockdown period.
Main Methods:
- A cross-sectional study was conducted observing premature births at a tertiary care Neonatal Intensive Care Unit (NICU).
- Birth rates of preterm infants during March 1–June 30, 2020 (lockdown period) were compared to the same calendar months from 2017–2019.
- Poisson regression models assessed temporal trends in preterm birth rates.
Main Results:
- A 23% overall reduction in preterm birth rate was observed during the lockdown period.
- Significant reductions were noted in extremely preterm births (<28 weeks) by 36% and moderate/late preterm births (32-36 weeks) by 26%.
- While preterm birth rates showed an increasing tendency among Saudi expatriates compared to Saudi nationals, this was not statistically significant during the lockdown.
Conclusions:
- The COVID-19 lockdown was associated with a significant decrease in the birth rates of extremely preterm and moderate/late preterm infants.
- Further research utilizing a national dataset is recommended to comprehensively assess the lockdown's full impact on preterm birth rates.
Abstract:
Background On March 3, 2020, the first case of coronavirus disease (COVID-19) was reported by the Ministry of Health, Kingdom of Saudi Arabia. Within days, the government confirmed more cases and adopted lockdown measures with travel restrictions from March to June 2020. A distinctive coronavirus was isolated from 190,823 patients by June 30. The pandemic resulted in a significant risk to public health. The study aimed to evaluate the impact of COVID-19 lockdown on the rate of premature births. Method In this cross-sectional study, we observed premature births at the Neonatal Intensive Care Unit (NICU). The study site is a 1,500-bed teaching hospital, with around 4,500 annual deliveries, 70 beds in level II and level III, and tertiary care NICU. We compared the birth rates among preterm infants between March 1 to June 30, 2017-2019, to the similar calendar months of 2020. Information on nationality, gestational age, and maternal conditions were collected from the medical records. We used the Poisson regression model to assess the preterm birth rate's temporal trends before lockdown versus during lockdown. Results Among 7,226 total live neonates, we recorded 1,320 preterm infants during the study period of 2017-2020. The preterm birth rate per 1,000 live births during lockdown showed a 23% drop in the overall preterm birth rate with Prevented Fraction of 36% in extremely preterm (<28 weeks gestational age) births and 26% in moderate/late premature (32 weeks to 36 weeks + 6 days gestational age) births. The estimated preterm birth rate among the Saudi expats (15.11/1,000 live births) showed an increased tendency compared to Saudi nationals (odds ratio [OR]=1.07; 95% CI: 0.75-1.52) and was statistically not significant during the strict lockdown. Conclusion There was a significant reduction in the birth rate of extremely preterm and moderate/late preterm infants during lockdown when compared to the preceding three years. A national dataset is required to evaluate the extent of lockdown's impact on the preterm birth rate.
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