ArticleNature human behaviour2023
Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries.
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Article in Nature human behaviour, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 6 of them syntheses that pooled it.
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68citing papers in PubMed, 6 pooled it
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Who cites it
68 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Lessons for the Next Global Health Crisis: A Qualitative Systematic Review of Women's Experiences of the Perinatal Period During the COVID-19 Pandemic in Australia.The Australian & New Zealand journal of obstetrics & gynaecology · 2026Pooled it
- Effectiveness of music therapy intervention on parent-infant attachment and parental anxiety in premature infants care: a systematic review and meta-analysis.Pediatric research · 2026Pooled it
- The association of COVID-19 lockdowns with adverse birth and pregnancy outcomes in 28 high-income countries: a systematic review and meta-analysis.Nature human behaviour · 2025Pooled it
- The impact of COVID-19 mitigation measures on neonatal health outcomes in sub-Saharan Africa: A systematic review and meta-analysis.Public health · 2025Pooled it
- Early suppression policies protected pregnant women from COVID-19 in 2020: A population-based surveillance from the Nordic countries.Acta obstetricia et gynecologica Scandinavica · 2024Pooled it
- Changes in the global hospitalisation burden of respiratory syncytial virus in young children during the COVID-19 pandemic: a systematic analysis.The Lancet. Infectious diseases · 2024Pooled it
- Right-sizing Incentives.Journal of development economics · 2026Article
- Preparedness for maternal and offspring health surveillance in pandemics: Lessons learned from studies on COVID-19 using Scandinavian registry data.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Temporal Trends in Preterm Birth Associated With Hypertensive Disorders of Pregnancy in Victoria, Australia: A Population-Based Interrupted Time-Series Study.The Medical journal of Australia · 2026Article
- COVID-19 and Global Perinatal Health: Lessons Learned on Maternal-Neonatal Outcomes, Infant Feeding Practices, and Health Care Economics across Income Settings.American journal of perinatology · 2026Article
- Disruptions in perinatal outcomes across Manitoba, Canada: before and over 2 years of the COVID-19 pandemic.BMJ paediatrics open · 2026Article
- [Disease burden and trends of preterm birth in China from 1990 to 2023].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2026Article
- SARS-CoV-2 seroprevalence among pregnant women during the first three waves of the COVID-19 pandemic in southern Mozambique.BMC pregnancy and childbirth · 2026Observational
- Policy Responses to the COVID-19 Pandemic in High-Income Countries and the Associated Maternal-Infant Health Outcomes: A Systematic Literature and Policy Review.Health science reports · 2026Review
- Stillbirths in Colombia before and during the COVID-19 pandemic: analysis by geographic location and health insurance.BMC public health · 2026Article
- Stillbirths in a large Shanghai maternity centre (2014-2024): trends, sex distribution, and gestational age-specific risk.BMC pregnancy and childbirth · 2026Article
- Finding treasure in the journey: a single center quality improvement bundle to reduce bronchopulmonary dysplasia.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- The Pandemic Effect: Secondary Impact on the Diagnosis of Clinically Significant Congenital Heart Disease and Role of Deprivation Index.Pediatric cardiology · 2026Article
- Late gestation stillbirth epidemiology: findings from a nationally representative mortality survey of one million population sample in India.BMC pregnancy and childbirth · 2026Article
- Association of COVID-19 mitigation measures with preterm birth and cervical length: A cohort study.Pregnancy (Hoboken, N.J.) · 2026Article
8 more citing papers are in PubMed but not listed here.
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Authors and funding
115 authors.
Clara Calvert *Usher Institute, University of Edinburgh, Edinburgh, UK.ORCID http://orcid.org/0000-0003-3272-1040
Meredith Merilee Brockway *Children's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
Helga Zoega *School of Population Health, Faculty of Medicine & Health, University of New South Wales Sydney, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0003-0761-9028
Jessica E Miller *Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.ORCID http://orcid.org/0000-0002-1806-1894
Jasper V BeenDivision of Neonatology, Department of Paediatrics; Department of Obstetrics and Gynaecology; Department of Public Health; Erasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, the Netherlands.ORCID http://orcid.org/0000-0002-4907-6466
Adeladza Kofi AmegahPublic Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana.ORCID http://orcid.org/0000-0001-5868-6402
Amy Racine-PoonNovartis, Basel, Switzerland.
Solmaz Eradat OskouiUsher Institute, University of Edinburgh, Edinburgh, UK.
Ishaya I AbokDepartment of Pediatrics, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.ORCID http://orcid.org/0000-0003-0488-5072
Nima AghaeepourDepartment of Anesthesiology, Pain, and Perioperative Medicine, Stanford University School of Medicine, Stanford, CA, USA.ORCID http://orcid.org/0000-0002-6117-8764
Christie D AkwaowoInstitute of Health Research and Development, University of Uyo Teaching Hospital, Uyo, Nigeria.ORCID http://orcid.org/0000-0001-5265-8267
Belal N AlshaikhDepartment of Pediatrics, University of Calgary, Calgary, Alberta, Canada.ORCID http://orcid.org/0000-0002-6080-6888
Adejumoke I AyedeDepartment of Pediatrics, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria.ORCID http://orcid.org/0000-0003-1772-1798
Fabiana BacchiniCanadian Premature Babies Foundation, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0003-4343-774X
Behzad BarekatainDepartment of Pediatrics, Division of Neonatology, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.ORCID http://orcid.org/0000-0002-7370-5525
Rodrigo BarnesAridhia Informatics, Glasgow, UK.ORCID http://orcid.org/0000-0001-9204-5756
Karolina BebakObstetrics and Gynaecology Ward, District Public Hospital in Poznań, Poznań, Poland.
Anick BerardFaculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.
Zulfiqar A BhuttaCenter of Excellence in Women Child Health, The Aga Khan University, Karachi, Pakistan.
Jeffrey R BrookDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Lenroy R BryanDepartment of Obstetrics & Gynaecology and Child Health, University of The West MonaIndies, Mona, Jamaica.ORCID http://orcid.org/0000-0002-6312-3716
Kim N Cajachagua-TorresThe Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.ORCID http://orcid.org/0000-0002-0213-6935
Marsha Campbell-YeoSchool of Nursing, Dalhousie University and IWK Health, Halifax, Nova Scotia, Canada.
Dinh-Toi ChuCenter for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Vietnam.
Kristin L ConnorDepartment of Health Sciences, Carleton University, Ottawa, Ontario, Canada.ORCID http://orcid.org/0000-0003-1494-3221
Luc CornetteAZ St-Jan Bruges-Ostend AV Hospital, Bruges, Belgium.
Sandra CortésDepartment of Public Health, School of Medicine, Advanced Center for Chronic Diseases Diagonal (ACCDIS), Santiago, Chile.ORCID http://orcid.org/0000-0003-3293-1419
Mandy DalyIrish Neonatal Health Alliance, Wicklow, Ireland.
Christian DebaucheDepartment of Neonatology, Cliniques Universitaires Saint-Luc, IREC, UCLouvain, Brussels, Belgium.
Iyabode Olabisi F DedekeDepartment of Paediatrics, Federal Medical Centre, Abeokuta, Nigeria.
Kristjana EinarsdóttirCentre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.ORCID http://orcid.org/0000-0003-4931-7650
Hilde EngjomDepartment of Health Registry Research and Development, Norwegian Institute of Public Health, Oslo, Norway.ORCID http://orcid.org/0000-0003-1582-4283
Guadalupe Estrada-GutierrezNational Institute of Perinatology, Mexico City, Mexico.ORCID http://orcid.org/0000-0001-9551-9021
Ilaria FantasiaInstitute for Maternal and Child Health, IRCCS Burlo Garofolo Children's Hospital, Trieste, Italy.ORCID http://orcid.org/0000-0003-4340-7225
Nicole M FiorentinoChildren's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
Meredith FranklinDepartment of Statistical Sciences and School of the Environment, University of Toronto, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0003-3802-8829
Abigail FraserPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Onesmus W GachunoObstetrics and Gynecology, Medicine, University of Nairobi, Nairobi, Kenya.
Linda A GalloSchool of Biomedical Sciences, The University of Queensland, St. Lucia, Queensland, Australia.
Mika GisslerDepartment of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland.
Siri E HåbergCentre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
Abbas HabibelahiNeonatology, Neonatal Health Office, Ministry of Health and Medical Education, Tehran, Iran.
Jonas HäggströmCytel, Waltham, MA, USA.
Lauren HookhamSt. George's University, Makerere University - Johns Hopkins University Research Collaboration, London, UK.ORCID http://orcid.org/0000-0001-9703-655X
Lisa HuiDepartment of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia.
Luis HuichoCentro de Investigación en Salud Materna e Infantil, Centro de Investigación para el Desarrollo Integral y Sostenible and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.ORCID http://orcid.org/0000-0002-5272-5885
Karen J HunterUsher Institute, University of Edinburgh, Edinburgh, UK.ORCID http://orcid.org/0000-0003-2679-8471
Sayeeda HuqNutrition and Clinical Services Division, ICDDR,B (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh.
Ashish KcUppsala University, Uppsala, Sweden.ORCID http://orcid.org/0000-0002-0541-4486
Seilesh KadambariOxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK.
Roya KelishadiChild Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Narjes KhaliliPreventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Joanna KippenObstetrics and Gynaecology Ward, District Public Hospital in Poznań, Poznań, Poland.
Kirsty Le DoareInternational Centre for Neonatal and Paediatric Infection, St. George's, University of London, London, UK.
Javier LlorcaUniversidad de Cantabria, Santander, Spain.
Laura A MageeInstitute of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK.ORCID http://orcid.org/0000-0002-1355-610X
Maria C MagnusCentre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
Kenneth K C ManResearch Department of Practice and Policy, University College London School of Pharmacy, London, UK.ORCID http://orcid.org/0000-0001-8645-1942
Patrick M MburuguDepartment of Child Health and Paediatrics, School of Medicine, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.ORCID http://orcid.org/0000-0001-7635-5236
Rishi P MedirattaDivision of Pediatric Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.ORCID http://orcid.org/0000-0001-6322-9329
Andrew D MorrisHealth Data Research UK, London, UK.
Nazeem MuhajarineCommunity Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Rachel H MulhollandUsher Institute, University of Edinburgh, Edinburgh, UK.
Livia Nagy BonnardMelletted a helyem Egyesület, Right(s) Beside You Association, Budapest, Hungary.
Victoria NakibuukaDepartment of Paediatrics, St. Francis Nsambya Hospital, Kampala, Uganda.
Natasha NassarChild Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Sylvester D NyadanuCurtin School of Population Health, Curtin University, Perth, Western Australia, Australia.ORCID http://orcid.org/0000-0002-6233-0262
Laura OakleyCentre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.ORCID http://orcid.org/0000-0002-4697-4316
Adesina OladokunDepartment of Obstetrics and Gynaecology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria.ORCID http://orcid.org/0000-0002-5489-8333
Oladapo O OlayemiDepartment of Obstetrics and Gynaecology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria.
Olanike A OlutekunbiLagos Island Maternity Hospital, Lagos, Nigeria.ORCID http://orcid.org/0000-0002-5822-7043
Rosena O OluwafemiDepartment of Paediatrics and Child Health, Mother and Child Hospital, Akure, Nigeria.ORCID http://orcid.org/0000-0001-5122-6577
Taofik O OgunkunleDepartment of Paediatrics, Dalhatu Araf Specialist Hospital, Lafia, Nigeria.ORCID http://orcid.org/0000-0002-7243-7741
Chris OrtonSwansea University, Swansea, UK.
Anne K ÖrtqvistClinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
Joseph OumaMakerere University - Johns Hopkins University Research Collaboration, Kampala, Uganda.ORCID http://orcid.org/0000-0001-5249-7440
Oyejoke OyaperoPaediatrics Department, Ikorodu General Hospital, Ikorodu, Nigeria.
Kirsten R PalmerDepartment of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia.ORCID http://orcid.org/0000-0001-7421-6291
Lars H PedersenDepartment of Obstetrics and Gynecology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.ORCID http://orcid.org/0000-0001-6726-1991
Gavin PereiraCentre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.ORCID http://orcid.org/0000-0003-3740-8117
Isabel PereyraSchool of Nutrition, Catholic University del Maule, Region del Maule, Chile.ORCID http://orcid.org/0000-0002-4696-8063
Roy K PhilipDivision of Neonatology, Department of Paediatrics, University Maternity Hospital Limerick and University of Limerick School of Medicine, Limerick, Ireland.ORCID http://orcid.org/0000-0002-6097-9869
Dominik PruskiObstetrics and Gynaecology Ward, District Public Hospital in Poznań, Poznań, Poland.
Marcin PrzybylskiObstetrics and Gynaecology Ward, District Public Hospital in Poznań, Poznań, Poland.
Hugo G Quezada-PinedoThe Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Annette K ReganSchool of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA.
Natasha R RhodaPaediatric Department, School of Adolescent and Child Health, University of Cape Town, Cape Town, South Africa.
Tonia A RihsFederal Statistical Office (FSO), Neuchâtel, Switzerland.
Taylor RileyDepartment of Epidemiology, University of Washington, Seattle, WA, USA.
Thiago Augusto Hernandes RochaEvidence and Intelligence for Action in Health Department, Pan-American Health Organization - World Health Organization, Washington, DC, USA.
Daniel L RolnikDepartment of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia.ORCID http://orcid.org/0000-0002-2263-3592
Christoph SanerMurdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.ORCID http://orcid.org/0000-0003-1380-0341
Francisco J SchneuerThe Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0002-6245-7159
Vivienne L SouterFoundation for Health Care Quality, Seattle, WA, USA.
Olof StephanssonClinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.ORCID http://orcid.org/0000-0003-1528-4563
Shengzhi SunDepartment of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
Emma M SwiftFaculty of Nursing, Department of Midwifery, University of Iceland, Reykjavík, Iceland.
Miklós SzabóDivision of Neonatology, 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
Marleen TemmermanCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya.ORCID http://orcid.org/0000-0003-2069-8752
Lloyd TookeDepartment of Paediatrics, University of Cape Town, Cape Town, South Africa.ORCID http://orcid.org/0000-0001-5905-9996
Marcelo L UrquiaManitoba Centre for Health Policy, Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Peter von DadelszenInstitute of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK.ORCID http://orcid.org/0000-0003-4136-3070
Gregory A WelleniusDepartment of Environmental Health, Boston University School of Public Health, Boston, MA, USA.ORCID http://orcid.org/0000-0003-0427-7376
Clare WhiteheadThe Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia.
Ian C K WongResearch Department of Practice and Policy, University College London School of Pharmacy, London, UK.ORCID http://orcid.org/0000-0001-8242-0014
Rachael WoodUsher Institute, University of Edinburgh, Edinburgh, UK.ORCID http://orcid.org/0000-0003-4453-623X
Katarzyna Wróblewska-SeniukII Department of Neonatology, Poznań University of Medical Sciences, Poznań, Poland.ORCID http://orcid.org/0000-0003-3908-6617
Kojo Yeboah-AntwiPublic Health Unit, Father Thomas Alan Rooney Memorial Hospital, Asankrangwa, Western Region, Ghana.ORCID http://orcid.org/0000-0002-3516-9266
Christopher S YilgwanDepartment of Paediatrics, University of Jos, Jos, Nigeria.
Agnieszka ZawiejskaDepartment of Medical Simulation, Chair of Medical Education, Poznań University of Medical Sciences, Poznań, Poland.ORCID http://orcid.org/0000-0002-3616-6550
Aziz SheikhUsher Institute, University of Edinburgh, Edinburgh, UK.ORCID http://orcid.org/0000-0001-7022-3056
Natalie RodriguezChildren's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
David BurgnerMurdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia. david.burgner@mcri.edu.au.ORCID http://orcid.org/0000-0002-8304-4302
Sarah J StockUsher Institute, University of Edinburgh, Edinburgh, UK. sarah.stock@ed.ac.uk.ORCID http://orcid.org/0000-0003-4308-856X
Meghan B AzadChildren's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada. meghan.azad@umanitoba.ca.ORCID http://orcid.org/0000-0002-5942-4444
Funding
Machine Learning for Integrative Modeling of the Immune System in Clinical SettingsR35GM138353 · NIGMS · STANFORD UNIVERSITY · PI AGHAEEPOUR, NIMA · 2020 to 2024
$2.2MNIGMS NIH HHS R35 GM138353Wellcome Trust 209560/Z/17/ZWorld Health Organization 001
Abstract
Preterm 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.
Indexed as
COVID-19Premature BirthStillbirthCommunicable Disease ControlFemaleHumansInfantInfant, NewbornPandemicsPregnancy
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