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Pregnancy outcomes in Italy during COVID-19 pandemic: a population-based cohort study.
  • +20
  • Franca Rusconi,
  • Monia Puglia,
  • Martina Pacifici,
  • Sonia Brescianini,
  • Luigi Gagliardi,
  • Anna Maria Nannavecchia,
  • Pietro Buono,
  • Sara Cantoira,
  • Sara Farchi,
  • Michele Gobbato,
  • Edda Pellegrini,
  • Enrica Perrone,
  • Riccardo Pertile,
  • Elisa Eleonora Tavormina,
  • Laura Visonà Dalla Pozza,
  • Francesca Zambri,
  • Edoardo Corsi ,
  • Debora Formisano,
  • Olivia Leoni,
  • Monica Mazzuccato,
  • Arianna Polo,
  • Raffaella Rusciani,
  • Alessandro Scoppa
Franca Rusconi
Azienda USL Toscana nord ovest Sede Pisa

Corresponding Author:franca.rusconi@uslnordovest.toscana.it

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Monia Puglia
Regione Toscana
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Martina Pacifici
Regione Toscana
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Sonia Brescianini
Istituto Superiore di Sanita
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Luigi Gagliardi
Azienda USL Toscana nord ovest
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Anna Maria Nannavecchia
Puglia Health System
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Pietro Buono
Campania Region
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Sara Cantoira
University of Turin
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Sara Farchi
Regione Lazio
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Michele Gobbato
Azienda Regionale di Coordinamento della Salute
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Edda Pellegrini
Lombardy Regional Health Welfare General Management
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Enrica Perrone
Regione Emilia-Romagna
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Riccardo Pertile
Trento Provincial Authority for Health Services
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Elisa Eleonora Tavormina
Istituto per la Ricerca e l'Innovazione Biomedica Consiglio Nazionale delle Ricerche
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Laura Visonà Dalla Pozza
Veneto Region
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Francesca Zambri
Istituto Superiore di Sanita
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Edoardo Corsi
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Debora Formisano
Azienda USL - IRCCS di Reggio Emilia
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Olivia Leoni
Lombardy Regional Health Welfare General Management
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Monica Mazzuccato
Veneto Region
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Arianna Polo
Regione Lazio
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Raffaella Rusciani
Servizio Sovrazonale di Epidemiologia
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Alessandro Scoppa
Regione Campania
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Abstract

Objective. To compare the estimates of preterm birth (PTB; 22-36 weeks gestational age, GA) and stillbirth rates during COVID-19 pandemic in Italy with those recorded in the three previous years. Design. A population-based cohort study of liveborn and stillborn infants was conducted using data from Regional Health Systems and comparing the pandemic period (March 1st, 2020-March 31st, 2021, N= 362,129) to an historical period (January 2017- February 2020, N=1,117,172). The cohort covered 84.3% of the births in Italy. Methods. Logistic regressions were run in each Region and meta-analyses were performed centrally. We used an interrupted time series regression analysis to study the trend of preterm births from 2017 to 2021. Main Outcome Measures. The primary outcomes were PTB and stillbirths. Secondary outcomes were late PTB (32-36 weeks’ GA), very PTB (<32 weeks’ GA), and extreme PTB (<28 weeks’ GA), overall and stratified into singleton and multiples. Results. The pandemic period compared with the historical one was associated with a reduced risk for PTB (Odds Ratio: 0.90; 95% Confidence Interval, CI: 0.87, 0.93), late PTB (0.91; 0.87, 0.94), very PTB (0.87; 0.84, 0.91), and extreme PTB (0.88; 0.82, 0.94). In multiples, point estimates were not very different, but had wider CIs. No association was found for stillbirths (1.01; 0.90, 1.13). A linear decreasing trend in PTB rate was present in the historical period, with a further reduction after the lockdown. Conclusions We demonstrated a decrease in PTB rate after the introduction of COVID-19 restriction measures, without an increase in stillbirths.
13 Apr 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
17 Apr 2022Submission Checks Completed
17 Apr 2022Assigned to Editor
17 Apr 2022Reviewer(s) Assigned
20 Jun 2022Review(s) Completed, Editorial Evaluation Pending
07 Jul 2022Editorial Decision: Revise Major
27 Jul 20221st Revision Received
29 Jul 2022Submission Checks Completed
29 Jul 2022Assigned to Editor
29 Jul 2022Review(s) Completed, Editorial Evaluation Pending
08 Aug 2022Editorial Decision: Accept
24 Oct 2022Published in BJOG: An International Journal of Obstetrics & Gynaecology. 10.1111/1471-0528.17315