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Perinatal Outcomes During the COVID-19 Pandemic in Ontario, Canada

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Public health measures to control the COVID-19 pandemic may be associated with reduced risk of preterm birth (PTB).1,2 Conversely, avoidance of health care may be associated with increased risk of stillbirth.3 We evaluated rates of PTB and stillbirth during the first 6 months of the pandemic because previous studies conducted early in the pandemic have had inconsistent results.

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Article Information

Accepted for Publication: March 19, 2021.

Published: May 12, 2021. doi:10.1001/jamanetworkopen.2021.10104

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Simpson AN et al. JAMA Network Open.

Corresponding Author: Andrea N. Simpson, MD, MSc, Department of Obstetrics and Gynaecology, St Michael’s Hospital, Unity Health Toronto, 61 Queen St E, 5th Flr, Toronto, ON M5C 2T2, Canada (andrea.simpon@unityhealth.to).

Author Contributions: Dr Simpson had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Simpson, Snelgrove, Sutradhar.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Simpson, Sutradhar.

Critical revision of the manuscript for important intellectual content: Snelgrove, Sutradhar, Everett, Liu, Baxter.

Statistical analysis: All authors.

Obtained funding: Simpson, Baxter.

Administrative, technical, or material support: Simpson, Baxter.

Supervision: Sutradhar, Baxter.

Conflict of Interest Disclosures: None reported.

Funding/Support: This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). This study was conducted with grant funding from the John R. McArthur Endowment Research Grant, Department of Obstetrics and Gynaecology, University of Toronto, and from the Department of Obstetrics and Gynaecology, St Michael’s Hospital (start-up grant to Dr Simpson).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimers: The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement by ICES or the MOHLTC is intended or should be inferred. Parts of this material are based on data and information compiled and provided by the Canadian Institute for Health Information and Ministry of Health & Long-Term Care. However, the conclusions, opinions, and statements expressed herein are solely those of the authors, and not of those bodies listed. No endorsement by these bodies is intended or should be inferred.

Additional Information: The data set from this study is held securely in coded form at ICES. Although data sharing agreements prohibit ICES from making the data set publicly available, access may be granted to those who meet prespecified criteria for confidential access (http://www.ices.on.ca/DAS).

References
1.
Hedermann  G , Hedley  PL , Baekvad-Hansen  M ,  et al.  Danish premature birth rates during the COVID-19 lockdown.   Arch Dis Child Fetal Neonatal Ed 2021;106(1):93-95. doi:10.1136/archdischild-2020-319990PubMedGoogle ScholarCrossref
2.
Philip  RK , Purtill  H , Reidy  E ,  et al.  Unprecedented reduction in births of very low birthweight (VLBW) and extremely low birthweight (ELBW) infants during the COVID-19 lockdown in Ireland: a ‘natural experiment’ allowing analysis of data from the prior two decades.   BMJ Glob Health. 2020;5(9):e003075. doi:10.1136/bmjgh-2020-003075PubMedGoogle Scholar
3.
Khalil  A , von Dadelszen  P , Draycott  T , Ugwumadu  A , O’Brien  P , Magee  L .  Change in the incidence of stillbirth and preterm delivery during the COVID-19 pandemic.   JAMA. 2020;324(7):705-706. doi:10.1001/jama.2020.12746PubMedGoogle ScholarCrossref
4.
Joseph  KS , Fahey  J ; Canadian Perinatal Surveillance System.  Validation of perinatal data in the Discharge Abstract Database of the Canadian Institute for Health Information.   Chronic Dis Can. 2009;29(3):96-100. doi:10.24095/hpcdp.29.3.01PubMedGoogle ScholarCrossref
5.
Knottnerus  A , Tugwell  P .  STROBE—a checklist to Strengthen the Reporting of Observational Studies in Epidemiology.   J Clin Epidemiol. 2008;61(4):323. doi:10.1016/j.jclinepi.2007.11.006PubMedGoogle ScholarCrossref
6.
Pasternak  B , Neovius  M , Söderling  J ,  et al.  Preterm birth and stillbirth during the COVID-19 pandemic in Sweden: a nationwide cohort study.   Ann Intern Med. Published online January 12, 2021. doi:10.7326/M20-6367PubMedGoogle Scholar
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