Calvert, ClaraClaraCalvertBrockway, Meredith MerileeMeredith MerileeBrockwayZoega, HelgaHelgaZoegaMiller, Jessica EJessica EMillerBeen, Jasper VJasper VBeenAmegah, Adeladza KofiAdeladza KofiAmegahRacine-Poon, AmyAmyRacine-PoonOskoui, Solmaz EradatSolmaz EradatOskouiAbok, Ishaya IIshaya IAbokAghaeepour, NimaNimaAghaeepourAkwaowo, Christie DChristie DAkwaowoAlshaikh, Belal NBelal NAlshaikhAyede, Adejumoke IAdejumoke IAyedeBacchini, FabianaFabianaBacchiniBarekatain, BehzadBehzadBarekatainBarnes, RodrigoRodrigoBarnesBebak, KarolinaKarolinaBebakBerard, AnickAnickBerardBhutta, Zulfiqar AZulfiqar ABhuttaBrook, Jeffrey RJeffrey RBrookBryan, Lenroy RLenroy RBryanCajachagua-Torres, Kim NKim NCajachagua-TorresCampbell-Yeo, MarshaMarshaCampbell-YeoChu, Dinh-ToiDinh-ToiChuConnor, Kristin LKristin LConnorCornette, LucLucCornetteCortés, SandraSandraCortésDaly, MandyMandyDalyDebauche, ChristianChristianDebaucheDedeke, Iyabode Olabisi FIyabode Olabisi FDedekeEinarsdóttir, KristjanaKristjanaEinarsdóttirEngjom, HildeHildeEngjomEstrada-Gutierrez, GuadalupeGuadalupeEstrada-GutierrezFantasia, IlariaIlariaFantasiaFiorentino, Nicole MNicole MFiorentinoFranklin, MeredithMeredithFranklinFraser, AbigailAbigailFraserGachuno, Onesmus WOnesmus WGachunoGallo, Linda ALinda AGalloGissler, MikaMikaGisslerHåberg, Siri ESiri EHåbergHabibelahi, AbbasAbbasHabibelahiHäggström, JonasJonasHäggströmHookham, LaurenLaurenHookhamHui, LisaLisaHuiHuicho, LuisLuisHuichoHunter, Karen JKaren JHunterHuq, SayeedaSayeedaHuqKc, AshishAshishKcKadambari, SeileshSeileshKadambariKelishadi, RoyaRoyaKelishadiKhalili, NarjesNarjesKhaliliKippen, JoannaJoannaKippenLe Doare, KirstyKirstyLe DoareLlorca, JavierJavierLlorcaMagee, Laura ALaura AMageeMagnus, Maria CMaria CMagnusMan, Kenneth K CKenneth K CManMburugu, Patrick MPatrick MMburuguMediratta, Rishi PRishi PMedirattaMorris, Andrew DAndrew DMorrisMuhajarine, NazeemNazeemMuhajarineMulholland, Rachel HRachel HMulhollandBonnard, Livia NagyLivia NagyBonnardNakibuuka, VictoriaVictoriaNakibuukaNassar, NatashaNatashaNassarNyadanu, Sylvester DSylvester DNyadanuOakley, LauraLauraOakleyOladokun, AdesinaAdesinaOladokunOlayemi, Oladapo OOladapo OOlayemiOlutekunbi, Olanike AOlanike AOlutekunbiOluwafemi, Rosena ORosena OOluwafemiOgunkunle, Taofik OTaofik OOgunkunleOrton, ChrisChrisOrtonÖrtqvist, Anne KAnne KÖrtqvistOuma, JosephJosephOumaOyapero, OyejokeOyejokeOyaperoPalmer, Kirsten RKirsten RPalmerPedersen, Lars HLars HPedersenPereira, GavinGavinPereiraPereyra, IsabelIsabelPereyraPhilip, Roy KRoy KPhilipPruski, DominikDominikPruskiPrzybylski, MarcinMarcinPrzybylskiQuezada-Pinedo, Hugo GHugo GQuezada-PinedoRegan, Annette KAnnette KReganRhoda, Natasha RNatasha RRhodaRihs, Tonia ATonia ARihsRiley, TaylorTaylorRileyRocha, Thiago Augusto HernandesThiago Augusto HernandesRochaRolnik, Daniel LDaniel LRolnikSaner, ChristophChristophSanerSchneuer, Francisco JFrancisco JSchneuerSouter, Vivienne LVivienne LSouterStephansson, OlofOlofStephanssonSun, ShengzhiShengzhiSunSwift, Emma MEmma MSwiftSzabó, MiklósMiklósSzabóTemmerman, MarleenMarleenTemmermanTooke, LloydLloydTookeUrquia, Marcelo LMarcelo LUrquiavon Dadelszen, PeterPetervon DadelszenWellenius, Gregory AGregory AWelleniusWhitehead, ClareClareWhiteheadWong, Ian C KIan C KWongWood, RachaelRachaelWoodWróblewska-Seniuk, KatarzynaKatarzynaWróblewska-SeniukYeboah-Antwi, KojoKojoYeboah-AntwiYilgwan, Christopher SChristopher SYilgwanZawiejska, AgnieszkaAgnieszkaZawiejskaSheikh, AzizAzizSheikhRodriguez, NatalieNatalieRodriguezBurgner, DavidDavidBurgnerStock, Sarah JSarah JStockAzad, Meghan BMeghan BAzad2024-10-252024-10-252023-04https://boris-portal.unibe.ch/handle/20.500.12422/164556Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from -90% to +30%, were reported in many countries following early COVID-19 pandemic response measures ('lockdowns'). It is unclear whether this variation reflects real differences in lockdown impacts, or perhaps differences in stillbirth rates and/or study designs. Here we present interrupted time series and meta-analyses using harmonized data from 52 million births in 26 countries, 18 of which had representative population-based data, with overall PTB rates ranging from 6% to 12% and stillbirth ranging from 2.5 to 10.5 per 1,000 births. We show small reductions in PTB in the first (odds ratio 0.96, 95% confidence interval 0.95-0.98, P value <0.0001), second (0.96, 0.92-0.99, 0.03) and third (0.97, 0.94-1.00, 0.09) months of lockdown, but not in the fourth month of lockdown (0.99, 0.96-1.01, 0.34), although there were some between-country differences after the first month. For high-income countries in this study, we did not observe an association between lockdown and stillbirths in the second (1.00, 0.88-1.14, 0.98), third (0.99, 0.88-1.12, 0.89) and fourth (1.01, 0.87-1.18, 0.86) months of lockdown, although we have imprecise estimates due to stillbirths being a relatively rare event. We did, however, find evidence of increased risk of stillbirth in the first month of lockdown in high-income countries (1.14, 1.02-1.29, 0.02) and, in Brazil, we found evidence for an association between lockdown and stillbirth in the second (1.09, 1.03-1.15, 0.002), third (1.10, 1.03-1.17, 0.003) and fourth (1.12, 1.05-1.19, <0.001) months of lockdown. With an estimated 14.8 million PTB annually worldwide, the modest reductions observed during early pandemic lockdowns translate into large numbers of PTB averted globally and warrant further research into causal pathways.en600 - Technology::610 - Medicine & healtharticle10.48350/1793263684959010.1038/s41562-023-01522-y