Evidence map›Paper›PMID 34973435›Full record

ArticleJournal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC2022

Maternal-Newborn Health System Changes and Outcomes in Ontario, Canada, During Wave 1 of the COVID-19 Pandemic-A Retrospective Study.

Nicole F Roberts, Ann E Sprague, Monica Taljaard, Deshayne B Fell, Joel G Ray, Modupe Tunde-Byass, Anne Biringer, Jon F R Barrett, Faiza Khurshid, Sanober Diaz and 6 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 2 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 7 institutions in 3 countries.

Nicole F RobertsBetter Outcomes Registry & Network (BORN) Ontario, Ottawa, ON. Electronic address: niroberts@bornontario.ca.
Ann E SpragueBetter Outcomes Registry & Network (BORN) Ontario, Ottawa, ON; Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON.
Monica TaljaardClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON.
Deshayne B FellChildren's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON.
Joel G RayDepartment of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, ON.
Modupe Tunde-ByassTemerty Faculty of Medicine, University of Toronto, Toronto, ON; Department of Obstetrics and Gynaecology, North York General Hospital, North York, ON.
Anne BiringerRay D. Wolfe Department of Family Medicine, Sinai Health System, University of Toronto, Toronto, ON.
Jon F R BarrettDepartment of Obstetrics and Gynecology, McMaster University, Hamilton, ON.
Faiza KhurshidDepartment of Pediatrics, School of Medicine, Queen's University, Kingston, ON.
Sanober DiazProvincial Council for Maternal and Child Health, Toronto, ON.
Kara Bellai-DussaultBetter Outcomes Registry & Network (BORN) Ontario, Ottawa, ON; Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON.
Dana-Marie RadkeBetter Outcomes Registry & Network (BORN) Ontario, Ottawa, ON.
Lise M BisnaireBetter Outcomes Registry & Network (BORN) Ontario, Ottawa, ON; Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON.
Christine M ArmourBetter Outcomes Registry & Network (BORN) Ontario, Ottawa, ON; Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON; Department of Pediatrics, University of Ottawa, Ottawa, ON.
Ian C JoinerBetter Outcomes Registry & Network (BORN) Ontario, Ottawa, ON.
Mark C WalkerBetter Outcomes Registry & Network (BORN) Ontario, Ottawa, ON; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON; International and Global Health, Faculty of Medicine, University of Ottawa, Ottawa, ON; Champlain Maternal Newborn Regional Program, Ottawa, ON; Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, Ottawa, ON.
University of Ottawa · CAChildren's Hospital of Eastern Ontario · CAUniversity of Toronto · CABorneo Orangutan Survival Foundation · IDMcMaster University · CAQueen's University · CASt. Michael's Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the population-level impact of COVID-19 pandemic-related obstetric practice changes on maternal and newborn outcomes.

methodsSegmented regression analysis examined changes that occurred 240 weeks pre-pandemic through the first 32 weeks of the pandemic using data from Ontario's Better Outcomes Registry & Network. Outcomes included birth location, length of stay, labour analgesia, mode of delivery, preterm birth, and stillbirth. Immediate and gradual effects were modelled with terms representing changes in intercepts and slopes, corresponding to the start of the pandemic.

resultsThere were 799 893 eligible pregnant individuals included in the analysis; 705 767 delivered in the pre-pandemic period and 94 126 during the pandemic wave 1 period. Significant immediate decreases were observed for hospital births (relative risk [RR] 0.99; 95% CI 0.98-0.99), length of stay (median change -3.29 h; 95% CI -3.81 to -2.77), use of nitrous oxide (RR 0.11; 95% CI 0.09-0.13) and general anesthesia (RR 0.69; 95% CI 0.58- 0.81), and trial of labour after cesarean (RR 0.89; 95% CI 0.83-0.96). Conversely, there were significant immediate increases in home births (RR 1.35; 95% CI 1.21-1.51), and use of epidural (RR 1.02; 95% CI 1.01-1.04) and regional anesthesia (RR 1.01; 95% CI 1.01-1.02). There were no significant immediate changes for any other outcomes, including preterm birth (RR 0.99; 95% CI 0.93-1.05) and stillbirth (RR 1.11; 95% CI 0.87-1.42).

conclusionProvincial health system changes implemented at the start of the pandemic resulted in immediate clinical practice changes but not insignificant increases in adverse outcomes.

Indexed as

COVID-19Premature BirthCesarean SectionFemaleHumansInfant HealthInfant, NewbornOntarioPandemicsPregnancyRetrospective StudiesStillbirthCOVID-19 pandemicdelivery of health carematernal childobstetricspregnancy outcometime series

Identifiers

PMID34973435
PMCPMC8716144
OpenAlexW4200147143

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.