Andrea Trombetta|Laura Travan|Pierandrea Elefante|Melania Canton|Francesco Rispoli|Gianpaolo Maso|Egidio Barbi|Francesco Maria Risso
The first Italian COVID?19 lockdown reduced births and voluntary terminations by just under a fifth
University of Trieste|IRCCS Materno Infantile Burlo Garofolo|University of Trieste|University of Trieste|University of Trieste|IRCCS Materno Infantile Burlo Garofolo|University of Trieste|IRCCS Materno Infantile Burlo Garofolo|IRCCS Materno Infantile Burlo Garofolo
acta paediatricavolume 110 issue 8 p 23872388 brief reportopen access first italian covid19 lockdown reduced births voluntary terminations fifth andrea trombetta andrea trombetta orcidorg0000000320923067 university trieste trieste italysearch papers authorlaura travan laura travan neonatology unit institute maternal child health irccs burlo garofolo trieste italysearch papers authorpierandrea elefante pierandrea elefante university trieste trieste italysearch papers authormelania canton corresponding author melania canton email protected university trieste trieste italy correspondence melania canton university trieste via dellistria 651 34137 trieste italy email email protectedsearch papers authorfrancesco rispoli francesco rispoli university trieste trieste italysearch papers authorgianpaolo maso gianpaolo maso obstetrics gynecology unit institute maternal child health irccs burlo garofolo trieste trieste italysearch papers authoregidio barbi egidio barbi orcidorg000000026343846x university trieste trieste italy neonatology unit institute maternal child health irccs burlo garofolo trieste italysearch papers authorfrancesco maria risso francesco maria risso neonatology unit institute maternal child health irccs burlo garofolo trieste italysearch papers author andrea trombetta andrea trombetta orcidorg0000000320923067 university trieste trieste italysearch papers authorlaura travan laura travan neonatology unit institute maternal child health irccs burlo garofolo trieste italysearch papers authorpierandrea elefante pierandrea elefante university trieste trieste italysearch papers authormelania canton corresponding author melania canton email protected university trieste trieste italy correspondence melania canton university trieste via dellistria 651 34137 trieste italy email email protectedsearch papers authorfrancesco rispoli francesco rispoli university trieste trieste italysearch papers authorgianpaolo maso gianpaolo maso obstetrics gynecology unit institute maternal child health irccs burlo garofolo trieste trieste italysearch papers authoregidio barbi egidio barbi orcidorg000000026343846x university trieste trieste italy neonatology unit institute maternal child health irccs burlo garofolo trieste italysearch papers authorfrancesco maria risso francesco maria risso neonatology unit institute maternal child health irccs burlo garofolo trieste italysearch papers author first published 29 march 2021 httpsdoiorg101111apa15862aboutsectionspdf toolsrequest permissionexport citationadd favoritestrack citation shareshare give accessshare full text accessshare fulltext accessplease review terms conditions use check box share fulltext version articlei read accept wiley online library terms conditions useshareable linkuse link share fulltext version article friends colleagues learn morecopy url share linkshare onfacebooktwitterlinkedinredditwechat italian covid19 lockdown 11 march 16 may 2020 led economic crisis social uncertainty stress also limited access health services including pregnancy followup visits possible rise poor outcomes women newborn infants however limited data available number births perinatal outcomes pregnancies began lockdown period1 hypothesised lockdown would reduced number pregnancies crosssectional observational study conducted institute maternal child health trieste italy compared live births 7 august 2020 20 february 2021 2442 weeks start lockdown period previous year also compared voluntary terminations lockdown period 2019 secondary outcome association covid19 restrictions perinatal outcomes compared previous year performed retrospective chart review births using data registered national administrative form routinely completed deliveries children conceived march 11 may 16 years excluded late terminations foetal abnormalities dates nonviable infants born gestational age 23 weeks categorised stillbirths birth rates pandemic period previous year compared using chisquare test analyses took account natural decreasing trend 4 2018 2019 region friuli venezia giulia2 also factored 57 reduction italy nine months chernobyl disaster due fear possible unknown consequences nuclear fallout pregnancies across europe3 based trend felt 10 reduction deliveries voluntary terminations two periods would significant study approved institutional review board hospital rc 0321 used students test mannwhitney u test evaluate differences continuous perinatal outcomes two time periods evaluated differences categorical outcomes chisquare test fishers exact test p value 005 considered significant statistical analyses carried spss version 21 ibm corp reviewed 2529 clinical records found 308 247 infants conceived 11 march16 may 2019 2020 respectively born 2442 weeks lockdown table 1 number factors could explain reduction 20 including impact economic recession poverty total fertility rate4 psychological issues fear getting infected worries complications pregnancy shortage healthcare workers may also impact addition assisted reproductive services closed 1 march 2020 lockdown could also reduced paternal discrepancy child fathered someone man thinks father reported vary 08 30 table 1 live deliveries 2442 weeks first italian lockdown voluntary terminations lockdown data compared periods previous year gestational age weeks days born 7 august 201920 february 2020a born 7 august 202020 february 2021a difference term 37416 284 922 229 927 194 late preterm 32366 16 52 13 53 188 preterm 28316 6 19 4 16 333 extremely preterm 24276 2 06 1 04 50 total live births 308 247 198 home delivery 1 03 4 16 400 stillbirth 2 3 150 intensive care unit admission 40 129 23 93 425 small gestational age 28 9 20 81 386 caesarean section 58 187 34 138 414 assisted conception 8 26 0 0 na 11 marchmay 16 2019 11 march16 may 2020 voluntary terminations 74 60 189 note statistical significance p 005 conceived 11 march16 may 2019 2020 study observe statistical differences p 005 preterm delivery rate caesarean section rate intensive care admissions unlike previous reports5 could partially explained different timing mitigation measures countries physical distancing increased hygiene awareness substantial reductions preterm births could also related fewer infections lower stress due less physically demanding work better sleep duration reduced air pollution reduction voluntary terminations almost 19 74 60 could explained reduced sexual activity better family planning study limitations retrospective comprised limited number pregnancies moreover accurately identifying conception difficult significant variations menstrual cycles however aim compare differences birth rate already assumed decreasing developed countries1 finally could assess cause variations measure maternal stress pandemic widely reported literature italy one first countries europe heavily affected covid19 report analyses impact lockdown childbirth comparing data one year earlier reduction birth rate 20 approximately four times higher 45 reduction region saw 2018 2019 country unique characteristics comes literacy family planning prevalence disease mortality morbidity different trajectories fertility birth rates however data suggest effective policies needed support italian birth rate covid19 pandemic studies also needed larger cohorts extended periods address parents fears concerns assess overall impact birth rate possible causes variations time conflict interest none references 1luppi f arpino b rosina impact covid19 fertility plans italy germany france spain united kingdom demographic res 2020 4347 1399 1412 2 birth fertility resident population available httpdatiistatitindexaspxdatasetcodedcisfecondita1langen 3bertollini r di lallo mastroiacovo p et al reduction births italy chernobyl accident scand j work environ health 1990 162 96 101 4anser mk yousaf z khan et al impacts covid19 measures global environment fertility rate double coincidence air qual atmos heal 2020 13 1083 1092 5de curtis villani l polo increase stillbirth decrease late preterm infants covid19 pandemic lockdown arch dis child fetal neonatal ed 2020 httpsdoiorg101136archdischild2020320682 volume110 issue8august 2021pages 23872388 article also appears incovid19 children referencesrelatedinformation