Increased adverse pregnancy outcomes among decreased assisted reproductions during the COVID-19 pandemic: insights from a birth cohort study in Southwest China
Abstract Objectives We elucidate the impact of the coronavirus disease 2019 (COVID-19) pandemic on assisted reproductive technology (ART) services and birth outcomes and establish an evidence-based framework to maintain the high quality of ART healthcare services and ensure continuous improvement of...
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BMC
2024-11-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-024-06935-9 |
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| author | Jinnuo Hu Jiaxin Liu Qin Zeng Jiuzhi Zeng Min Luo Dan He Yan Zhang Piao Zhang Juan Ming Weixin Liu |
| author_facet | Jinnuo Hu Jiaxin Liu Qin Zeng Jiuzhi Zeng Min Luo Dan He Yan Zhang Piao Zhang Juan Ming Weixin Liu |
| author_sort | Jinnuo Hu |
| collection | DOAJ |
| description | Abstract Objectives We elucidate the impact of the coronavirus disease 2019 (COVID-19) pandemic on assisted reproductive technology (ART) services and birth outcomes and establish an evidence-based framework to maintain the high quality of ART healthcare services and ensure continuous improvement of birth outcomes. Methods A total of 19,170 pregnant women from Sichuan, Guizhou and Chongqing in Southwest China between 2018 and 2021 were included in this study. The log-binomial regression model was employed to analyse the changes in the probability of adverse birth outcomes, such as low birth weight (LBW), preterm birth (PTB), Apgar score < 7 at 1 min and congenital anomalies (CAs) and their relationship with ART before and after the pandemic. In this analysis, confounding factors such as family annual income, maternal ethnicity, delivery age, subjective prenatal health status, vitamin or mineral supplementation during pregnancy and level of prenatal care provided by the hospital were controlled. Results ART mothers had the highest probability of giving birth to LBW babies (relative risk (RR): 2.82, 95% confidence interval (CI): 2.32–3.41), experiencing PTB (RR: 2.72, 95% CI: 2.78–3.22) and delivering babies with an Apgar score < 7 at 1 min (RR: 1.73, 95% CI: 1.05–2.69). Before the pandemic, the ART rate increased from 4.42% in 2018 to 6.71% in 2019 (rate difference of 2.29%, P < 0.001). After the pandemic, the ART rate decreased from 6.71% in 2019 to 6.55% in 2020 (rate difference of − 0.16%, P = 0.752). Compared with the pre-pandemic period, the rate difference for LBW decreased from − 0.21% (P = 0.646) in 2018–2019 to an increase of + 0.89% (P = 0.030) in 2019–2020. Similarly, PTB showed an increase in rate difference from + 0.20% (P = 0.623) before the pandemic to + 0.53% (P = 0.256) afterwards. Apgar score < 7 at 1 min had a negative rate difference of − 0.50% (P = 0.012), which changed to a positive value of + 0.20% (P = 0.340). For CAs, the rate difference increased from + 0.34% (P = 0.089) prior to the outbreak to + 0.59% (P = 0.102) at post-outbreak. In 2018 (pre-pandemic), ART was the most significant predictor of LBW, exhibiting an RR of 3.45 (95% CI: 2.57–4.53). Furthermore, in 2020, its RR was 2.49 (95% CI: 1.78–3.42). Prior to the onset of the pandemic (2018), ART (RR: 3.17, 95% CI: 2.42–4.08) was the most robust predictor of PTB. In 2020, its RR was 2.23 (95% CI: 1.65–2.97). Conclusion ART services have been significantly impacted by the COVID-19 pandemic, and the resulting delays in ART services have had notable implications for maternal birth outcomes. |
| format | Article |
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| language | English |
| publishDate | 2024-11-01 |
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| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-47c4077458e246a09b819cabe43053fb2025-08-20T02:33:08ZengBMCBMC Pregnancy and Childbirth1471-23932024-11-0124111110.1186/s12884-024-06935-9Increased adverse pregnancy outcomes among decreased assisted reproductions during the COVID-19 pandemic: insights from a birth cohort study in Southwest ChinaJinnuo Hu0Jiaxin Liu1Qin Zeng2Jiuzhi Zeng3Min Luo4Dan He5Yan Zhang6Piao Zhang7Juan Ming8Weixin Liu9Gynaecology and Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College)Gynaecology and Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College)Gynaecology and Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College)Gynaecology and Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College)Gynaecology and Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College)Gynaecology and Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College)Gynaecology and Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College)Gynaecology and Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College)Gynaecology and Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College)Gynaecology and Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College)Abstract Objectives We elucidate the impact of the coronavirus disease 2019 (COVID-19) pandemic on assisted reproductive technology (ART) services and birth outcomes and establish an evidence-based framework to maintain the high quality of ART healthcare services and ensure continuous improvement of birth outcomes. Methods A total of 19,170 pregnant women from Sichuan, Guizhou and Chongqing in Southwest China between 2018 and 2021 were included in this study. The log-binomial regression model was employed to analyse the changes in the probability of adverse birth outcomes, such as low birth weight (LBW), preterm birth (PTB), Apgar score < 7 at 1 min and congenital anomalies (CAs) and their relationship with ART before and after the pandemic. In this analysis, confounding factors such as family annual income, maternal ethnicity, delivery age, subjective prenatal health status, vitamin or mineral supplementation during pregnancy and level of prenatal care provided by the hospital were controlled. Results ART mothers had the highest probability of giving birth to LBW babies (relative risk (RR): 2.82, 95% confidence interval (CI): 2.32–3.41), experiencing PTB (RR: 2.72, 95% CI: 2.78–3.22) and delivering babies with an Apgar score < 7 at 1 min (RR: 1.73, 95% CI: 1.05–2.69). Before the pandemic, the ART rate increased from 4.42% in 2018 to 6.71% in 2019 (rate difference of 2.29%, P < 0.001). After the pandemic, the ART rate decreased from 6.71% in 2019 to 6.55% in 2020 (rate difference of − 0.16%, P = 0.752). Compared with the pre-pandemic period, the rate difference for LBW decreased from − 0.21% (P = 0.646) in 2018–2019 to an increase of + 0.89% (P = 0.030) in 2019–2020. Similarly, PTB showed an increase in rate difference from + 0.20% (P = 0.623) before the pandemic to + 0.53% (P = 0.256) afterwards. Apgar score < 7 at 1 min had a negative rate difference of − 0.50% (P = 0.012), which changed to a positive value of + 0.20% (P = 0.340). For CAs, the rate difference increased from + 0.34% (P = 0.089) prior to the outbreak to + 0.59% (P = 0.102) at post-outbreak. In 2018 (pre-pandemic), ART was the most significant predictor of LBW, exhibiting an RR of 3.45 (95% CI: 2.57–4.53). Furthermore, in 2020, its RR was 2.49 (95% CI: 1.78–3.42). Prior to the onset of the pandemic (2018), ART (RR: 3.17, 95% CI: 2.42–4.08) was the most robust predictor of PTB. In 2020, its RR was 2.23 (95% CI: 1.65–2.97). Conclusion ART services have been significantly impacted by the COVID-19 pandemic, and the resulting delays in ART services have had notable implications for maternal birth outcomes.https://doi.org/10.1186/s12884-024-06935-9COVID-19PTBLBWCAApgar |
| spellingShingle | Jinnuo Hu Jiaxin Liu Qin Zeng Jiuzhi Zeng Min Luo Dan He Yan Zhang Piao Zhang Juan Ming Weixin Liu Increased adverse pregnancy outcomes among decreased assisted reproductions during the COVID-19 pandemic: insights from a birth cohort study in Southwest China BMC Pregnancy and Childbirth COVID-19 PTB LBW CA Apgar |
| title | Increased adverse pregnancy outcomes among decreased assisted reproductions during the COVID-19 pandemic: insights from a birth cohort study in Southwest China |
| title_full | Increased adverse pregnancy outcomes among decreased assisted reproductions during the COVID-19 pandemic: insights from a birth cohort study in Southwest China |
| title_fullStr | Increased adverse pregnancy outcomes among decreased assisted reproductions during the COVID-19 pandemic: insights from a birth cohort study in Southwest China |
| title_full_unstemmed | Increased adverse pregnancy outcomes among decreased assisted reproductions during the COVID-19 pandemic: insights from a birth cohort study in Southwest China |
| title_short | Increased adverse pregnancy outcomes among decreased assisted reproductions during the COVID-19 pandemic: insights from a birth cohort study in Southwest China |
| title_sort | increased adverse pregnancy outcomes among decreased assisted reproductions during the covid 19 pandemic insights from a birth cohort study in southwest china |
| topic | COVID-19 PTB LBW CA Apgar |
| url | https://doi.org/10.1186/s12884-024-06935-9 |
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