COVID-19 lockdown and association with placental function - a quasi-experimental analysis

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Epidemiology

Background:

• The COVID-19 pandemic necessitated unprecedented public health interventions, including nationwide lockdowns.
• These measures may have impacted maternal health and pregnancy outcomes.
• Understanding these effects is crucial for managing future public health crises.

Purpose of the Study:

• To investigate the association between COVID-19 lockdown measures and pregnancy complications.
• Specifically evaluating the incidence of hypertensive disorders of pregnancy and fetal growth restriction.
• Assessing the impact based on gestational age during the lockdown period.

Main Methods:

• A national registry-based, quasi-experimental study design was employed.
• Included singleton births from nulliparous women between 2016-2020.
• Analyzed outcomes based on gestational age during the first nationwide lockdown (March 9th-June 1st, 2020).

Main Results:

• The study included 262,102 pregnancies.
• Lockdown exposure during the first trimester correlated with a +0.4% absolute risk increase in hypertensive disorders of pregnancy.
• A +0.2% increase in pre-eclampsia risk and a -0.5% risk reduction in small-for-gestational-age were observed.

Conclusions:

• COVID-19 lockdown exposure was linked to a modest rise in hypertensive disorders of pregnancy, including pre-eclampsia.
• A counterintuitive decrease in the risk of small-for-gestational-age was noted.
• The findings suggest a complex placental effect, particularly when lockdown exposure occurred in the first trimester.