Preterm Birth and Perinatal Mortality During the COVID-19 Pandemic Period: A Systematic Review and Meta-Analysis.

BACKGROUND: Preterm birth rates may have been affected during the COVID-19 pandemic but the impact of this on perinatal morbidity is unknown. AIM: To review the impact of the COVID-19 pandemic on rates of preterm birth and perinatal mortality. METHODS: Medline, Embase, and online pre-prints were searched from Jan 2020 to Oct 2022. Case-control, cohort studies and reports comparing rates of preterm birth, stillbirth and neonatal death before and during the COVID-19 pandemic period were included. The pooled odds ratio (OR) for preterm birth, stillbirth and neonatal death was calculated using a random effects model. The primary outcome was the rate of preterm birth, stillbirth and neonatal death in the pre-pandemic and pandemic periods. CONCLUSION: The COVID-19 pandemic was associated with a reduction in preterm births and neonatal deaths. Further research is needed to investigate the mechanisms underlying these findings. Stillbirth rates increased in low- and middle-income countries where access to healthcare may have been restricted and strategies to address this in future pandemics are warranted.