Impact of COVID-19 mitigation measures on perinatal outcomes in the Netherlands

Lizbeth Burgos-Ochoa; Loes CM Bertens; Nienke W. Boderie; Benjamin Y. Gravesteijn; Sylvia Obermann-Borst; Ageeth Rosman; Jeroen Struijs; Jeremy Labrecque; Christianne J. de Groot; Jasper V. Been; Elena Ambrosino; Kim Van den Auweele; Jasper Been; Roseriet Beijers; Loes Bertens; Kitty Bloemenkamp; Nienke W. Boderie; Lex Burdorf; Ank de Jonge; Caroline de Weerth; Arie Franx; Sam Harper; Brenda M. Kazemier; Peter Paul Klein; Daniëlle Kretz; Ben Willem Mol; Jean Muris; Marianne Nieuwenhuijze; Sylvia Obermann; Martijn Oudijk; Lilian Peters; Lotte Ramerman; Anita Ravelli; Ageeth Schonewille- Rosman; Sam Schoenmakers; Hanneke Torij; Monique Van Beukering; Thomas van den Akker; Marion van den Heuvel; Jeroen van Dillen; Frank van Lenthe; Tom Van Ourti; Arnoud Verhoeff; Marijn Vermeulen; Nettie Visser; Saskia Willers

doi:10.1016/j.puhe.2024.09.002

Impact of COVID-19 mitigation measures on perinatal outcomes in the Netherlands

Lizbeth Burgos-Ochoa^*, Loes CM Bertens, Nienke W. Boderie, Benjamin Y. Gravesteijn, Sylvia Obermann-Borst, Ageeth Rosman, Jeroen Struijs, Jeremy Labrecque, Christianne J. de Groot, Jasper V. Been, Elena Ambrosino, Kim Van den Auweele, Jasper Been, Roseriet Beijers, Loes Bertens, Kitty Bloemenkamp, Nienke W. Boderie, Lex Burdorf, Ank de Jonge, Caroline de WeerthArie Franx, Sam Harper, Brenda M. Kazemier, Peter Paul Klein, Daniëlle Kretz, Ben Willem Mol, Jean Muris, Marianne Nieuwenhuijze, Sylvia Obermann, Martijn Oudijk, Lilian Peters, Lotte Ramerman, Anita Ravelli, Ageeth Schonewille- Rosman, Sam Schoenmakers, Hanneke Torij, Monique Van Beukering, Thomas van den Akker, Marion van den Heuvel, Jeroen van Dillen, Frank van Lenthe, Tom Van Ourti, Arnoud Verhoeff, Marijn Vermeulen, Nettie Visser, Saskia Willers,

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective: Investigate the acute impact of COVID-19 mitigation measures implemented in March 2020 on a comprehensive range of perinatal outcomes. Study design: National registry-based quasi-experimental study. Methods: We obtained data from the Dutch Perinatal Registry (2010–2020) which was linked to multiple population registries containing sociodemographic variables. A difference-in-discontinuity approach was used to examine the impact of COVID-19 mitigation measures on various perinatal outcomes. We investigated preterm birth incidence across onset types, alongside other perinatal outcomes including low birth weight, small-for-gestational-age, NICU admission, low-APGAR-score, perinatal mortality, neonatal death, and stillbirths. Results: The analysis of the national-level dataset revealed a consistent pattern of reduced preterm births after the enactment of COVID-19 mitigation measures on March 9, 2020 (OR = 0.80, 95% CI 0.68–0.96). A drop in spontaneous preterm births post-implementation was observed (OR = 0.80, 95% CI 0.62–0.98), whereas no change was observed for iatrogenic births. Regarding stillbirths (OR = 0.95, 95% CI 0.46–1.95) our analysis did not find compelling evidence of substantial changes. For the remaining outcomes, no discernible shifts were observed. Conclusions: Our findings confirm the reduction in preterm births following COVID-19 mitigation measures in the Netherlands. No discernible changes were observed for other outcomes, including stillbirths. Our results challenge previous concerns of a potential increase in stillbirths contributing to the drop in preterm births, suggesting alternative mechanisms.

Original language	English
Pages (from-to)	322-327
Number of pages	6
Journal	Public Health
Volume	236
DOIs	https://doi.org/10.1016/j.puhe.2024.09.002
Publication status	Published - 1 Nov 2024

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Burgos-Ochoa, L., Bertens, L. CM., Boderie, N. W., Gravesteijn, B. Y., Obermann-Borst, S., Rosman, A., Struijs, J., Labrecque, J., de Groot, C. J., Been, J. V., Ambrosino, E., Van den Auweele, K., Been, J., Beijers, R., Bertens, L., Bloemenkamp, K., Boderie, N. W., Burdorf, L., de Jonge, A. (2024). Impact of COVID-19 mitigation measures on perinatal outcomes in the Netherlands. Public Health, 236, 322-327. https://doi.org/10.1016/j.puhe.2024.09.002

@article{8286ae61a4b54a6eabd7f64326d77956,

title = "Impact of COVID-19 mitigation measures on perinatal outcomes in the Netherlands",

abstract = "Objective: Investigate the acute impact of COVID-19 mitigation measures implemented in March 2020 on a comprehensive range of perinatal outcomes. Study design: National registry-based quasi-experimental study. Methods: We obtained data from the Dutch Perinatal Registry (2010–2020) which was linked to multiple population registries containing sociodemographic variables. A difference-in-discontinuity approach was used to examine the impact of COVID-19 mitigation measures on various perinatal outcomes. We investigated preterm birth incidence across onset types, alongside other perinatal outcomes including low birth weight, small-for-gestational-age, NICU admission, low-APGAR-score, perinatal mortality, neonatal death, and stillbirths. Results: The analysis of the national-level dataset revealed a consistent pattern of reduced preterm births after the enactment of COVID-19 mitigation measures on March 9, 2020 (OR = 0.80, 95% CI 0.68–0.96). A drop in spontaneous preterm births post-implementation was observed (OR = 0.80, 95% CI 0.62–0.98), whereas no change was observed for iatrogenic births. Regarding stillbirths (OR = 0.95, 95% CI 0.46–1.95) our analysis did not find compelling evidence of substantial changes. For the remaining outcomes, no discernible shifts were observed. Conclusions: Our findings confirm the reduction in preterm births following COVID-19 mitigation measures in the Netherlands. No discernible changes were observed for other outcomes, including stillbirths. Our results challenge previous concerns of a potential increase in stillbirths contributing to the drop in preterm births, suggesting alternative mechanisms.",

author = "Lizbeth Burgos-Ochoa and Bertens, {Loes CM} and Boderie, {Nienke W.} and Gravesteijn, {Benjamin Y.} and Sylvia Obermann-Borst and Ageeth Rosman and Jeroen Struijs and Jeremy Labrecque and {de Groot}, {Christianne J.} and Been, {Jasper V.} and Elena Ambrosino and {Van den Auweele}, Kim and Jasper Been and Roseriet Beijers and Loes Bertens and Kitty Bloemenkamp and Boderie, {Nienke W.} and Lex Burdorf and {de Jonge}, Ank and {de Weerth}, Caroline and Arie Franx and Sam Harper and Kazemier, {Brenda M.} and Klein, {Peter Paul} and Dani{\"e}lle Kretz and Mol, {Ben Willem} and Jean Muris and Marianne Nieuwenhuijze and Sylvia Obermann and Martijn Oudijk and Lilian Peters and Lotte Ramerman and Anita Ravelli and {Schonewille- Rosman}, Ageeth and Sam Schoenmakers and Hanneke Torij and {Van Beukering}, Monique and {van den Akker}, Thomas and {van den Heuvel}, Marion and {van Dillen}, Jeroen and {van Lenthe}, Frank and {Van Ourti}, Tom and Arnoud Verhoeff and Marijn Vermeulen and Nettie Visser and Saskia Willers",

note = "Funding Information: This project was funded by ZonMW, Chiesi Pharmaceuticals, de Snoo-van \u2018t Hoogerhuijs Foundation, and Strong Babies. The funders of the study were not involved in the study design, data collection, data analysis, interpretation, or the writing of the manuscript. Publisher Copyright: {\textcopyright} 2024 The Authors",

year = "2024",

month = nov,

day = "1",

doi = "10.1016/j.puhe.2024.09.002",

language = "English",

volume = "236",

pages = "322--327",

journal = "Public Health",

issn = "0033-3506",

publisher = "Elsevier Saunders",

}

Burgos-Ochoa, L, Bertens, LCM, Boderie, NW, Gravesteijn, BY, Obermann-Borst, S, Rosman, A, Struijs, J, Labrecque, J, de Groot, CJ, Been, JV, Ambrosino, E, Van den Auweele, K, Been, J, Beijers, R, Bertens, L, Bloemenkamp, K, Boderie, NW, Burdorf, L, de Jonge, A, de Weerth, C, Franx, A, Harper, S, Kazemier, BM, Klein, PP, Kretz, D, Mol, BW, Muris, J, Nieuwenhuijze, M, Obermann, S, Oudijk, M, Peters, L, Ramerman, L, Ravelli, A, Schonewille- Rosman, A, Schoenmakers, S, Torij, H, Van Beukering, M, van den Akker, T, van den Heuvel, M, van Dillen, J, van Lenthe, F, Van Ourti, T, Verhoeff, A, Vermeulen, M, Visser, N, Willers, S 2024, 'Impact of COVID-19 mitigation measures on perinatal outcomes in the Netherlands', Public Health, vol. 236, pp. 322-327. https://doi.org/10.1016/j.puhe.2024.09.002

TY - JOUR

T1 - Impact of COVID-19 mitigation measures on perinatal outcomes in the Netherlands

AU - Burgos-Ochoa, Lizbeth

AU - Bertens, Loes CM

AU - Boderie, Nienke W.

AU - Gravesteijn, Benjamin Y.

AU - Obermann-Borst, Sylvia

AU - Rosman, Ageeth

AU - Struijs, Jeroen

AU - Labrecque, Jeremy

AU - de Groot, Christianne J.

AU - Been, Jasper V.

AU - Ambrosino, Elena

AU - Van den Auweele, Kim

AU - Been, Jasper

AU - Beijers, Roseriet

AU - Bertens, Loes

AU - Bloemenkamp, Kitty

AU - Boderie, Nienke W.

AU - Burdorf, Lex

AU - de Jonge, Ank

AU - de Weerth, Caroline

AU - Franx, Arie

AU - Harper, Sam

AU - Kazemier, Brenda M.

AU - Klein, Peter Paul

AU - Kretz, Daniëlle

AU - Mol, Ben Willem

AU - Muris, Jean

AU - Nieuwenhuijze, Marianne

AU - Obermann, Sylvia

AU - Oudijk, Martijn

AU - Peters, Lilian

AU - Ramerman, Lotte

AU - Ravelli, Anita

AU - Schonewille- Rosman, Ageeth

AU - Schoenmakers, Sam

AU - Torij, Hanneke

AU - Van Beukering, Monique

AU - van den Akker, Thomas

AU - van den Heuvel, Marion

AU - van Dillen, Jeroen

AU - van Lenthe, Frank

AU - Van Ourti, Tom

AU - Verhoeff, Arnoud

AU - Vermeulen, Marijn

AU - Visser, Nettie

AU - Willers, Saskia

N1 - Funding Information: This project was funded by ZonMW, Chiesi Pharmaceuticals, de Snoo-van \u2018t Hoogerhuijs Foundation, and Strong Babies. The funders of the study were not involved in the study design, data collection, data analysis, interpretation, or the writing of the manuscript. Publisher Copyright: © 2024 The Authors

PY - 2024/11/1

Y1 - 2024/11/1

N2 - Objective: Investigate the acute impact of COVID-19 mitigation measures implemented in March 2020 on a comprehensive range of perinatal outcomes. Study design: National registry-based quasi-experimental study. Methods: We obtained data from the Dutch Perinatal Registry (2010–2020) which was linked to multiple population registries containing sociodemographic variables. A difference-in-discontinuity approach was used to examine the impact of COVID-19 mitigation measures on various perinatal outcomes. We investigated preterm birth incidence across onset types, alongside other perinatal outcomes including low birth weight, small-for-gestational-age, NICU admission, low-APGAR-score, perinatal mortality, neonatal death, and stillbirths. Results: The analysis of the national-level dataset revealed a consistent pattern of reduced preterm births after the enactment of COVID-19 mitigation measures on March 9, 2020 (OR = 0.80, 95% CI 0.68–0.96). A drop in spontaneous preterm births post-implementation was observed (OR = 0.80, 95% CI 0.62–0.98), whereas no change was observed for iatrogenic births. Regarding stillbirths (OR = 0.95, 95% CI 0.46–1.95) our analysis did not find compelling evidence of substantial changes. For the remaining outcomes, no discernible shifts were observed. Conclusions: Our findings confirm the reduction in preterm births following COVID-19 mitigation measures in the Netherlands. No discernible changes were observed for other outcomes, including stillbirths. Our results challenge previous concerns of a potential increase in stillbirths contributing to the drop in preterm births, suggesting alternative mechanisms.

AB - Objective: Investigate the acute impact of COVID-19 mitigation measures implemented in March 2020 on a comprehensive range of perinatal outcomes. Study design: National registry-based quasi-experimental study. Methods: We obtained data from the Dutch Perinatal Registry (2010–2020) which was linked to multiple population registries containing sociodemographic variables. A difference-in-discontinuity approach was used to examine the impact of COVID-19 mitigation measures on various perinatal outcomes. We investigated preterm birth incidence across onset types, alongside other perinatal outcomes including low birth weight, small-for-gestational-age, NICU admission, low-APGAR-score, perinatal mortality, neonatal death, and stillbirths. Results: The analysis of the national-level dataset revealed a consistent pattern of reduced preterm births after the enactment of COVID-19 mitigation measures on March 9, 2020 (OR = 0.80, 95% CI 0.68–0.96). A drop in spontaneous preterm births post-implementation was observed (OR = 0.80, 95% CI 0.62–0.98), whereas no change was observed for iatrogenic births. Regarding stillbirths (OR = 0.95, 95% CI 0.46–1.95) our analysis did not find compelling evidence of substantial changes. For the remaining outcomes, no discernible shifts were observed. Conclusions: Our findings confirm the reduction in preterm births following COVID-19 mitigation measures in the Netherlands. No discernible changes were observed for other outcomes, including stillbirths. Our results challenge previous concerns of a potential increase in stillbirths contributing to the drop in preterm births, suggesting alternative mechanisms.

U2 - 10.1016/j.puhe.2024.09.002

DO - 10.1016/j.puhe.2024.09.002

M3 - Article

SN - 0033-3506

VL - 236

SP - 322

EP - 327

JO - Public Health

JF - Public Health

ER -

Impact of COVID-19 mitigation measures on perinatal outcomes in the Netherlands

Abstract

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