Evidence map›Paper›PMID 38728292›Full record

ArticlePloS one2024

Mode of delivery and birth outcomes before and during COVID-19 -A population-based study in Ontario, Canada.

Teresa To, Jingqin Zhu, Emilie Terebessy, Cornelia M Borkhoff, Andrea S Gershon, Tetyana Kendzerska, Smita S Pakhale, Nicholas T Vozoris, Kimball Zhang, Christopher Licskai

Abstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

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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

10 authors.

Teresa ToDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0001-7463-3423
Jingqin ZhuChild Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
Emilie TerebessyChild Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
Cornelia M BorkhoffDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0003-3420-1866
Andrea S GershonDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Tetyana KendzerskaICES, Ontario, Canada.
Smita S PakhaleDepartment of Medicine, The Ottawa Hospital and Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
Nicholas T VozorisLi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Kimball ZhangChild Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
Christopher LicskaiSchulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

There is lack of clarity on whether pregnancies during COVID-19 resulted in poorer mode of delivery and birth outcomes in Ontario, Canada. We aimed to compare mode of delivery (C-section), birth (low birthweight, preterm birth, NICU admission), and health services use (HSU, hospitalizations, ED visits, physician visits) outcomes in pregnant Ontario women before and during COVID-19 (pandemic periods). We further stratified for pre-existing chronic diseases (asthma, eczema, allergic rhinitis, diabetes, hypertension). Deliveries before (Jun 2018-Feb 2020) and during (Jul 2020-Mar 2022) pandemic were from health administrative data. We used multivariable logistic regression analyses to estimate adjusted odds ratios (aOR) of delivery and birth outcomes, and negative binomial regression for adjusted rate ratios (aRR) of HSU. We compared outcomes between pre-pandemic and pandemic periods. Possible interactions between study periods and covariates were also examined. 323,359 deliveries were included (50% during pandemic). One in 5 (18.3%) women who delivered during the pandemic had not received any COVID-19 vaccine, while one in 20 women (5.2%) lab-tested positive for COVID-19. The odds of C-section delivery during the pandemic was 9% higher (aOR = 1.09, 95% CI: 1.08-1.11) than pre-pandemic. The odds of preterm birth and NICU admission were 15% (aOR = 0.85, 95% CI: 0.82-0.87) and 10% lower (aOR = 0.90, 95% CI: 0.88-0.92), respectively, during COVID-19. There was a 17% reduction in ED visits but a 16% increase in physician visits during the pandemic (aRR = 0.83, 95% CI: 0.81-0.84 and aRR = 1.16, 95% CI: 1.16-1.17, respectively). These aORs and aRRs were significantly higher in women with pre-existing chronic conditions. During the pandemic, healthcare utilization, especially ED visits (aRR = 0.83), in pregnant women was lower compared to before. Ensuring ongoing prenatal care during the pandemic may reduce risks of adverse mode of delivery and the need for acute care during pregnancy.

Indexed as

COVID-19Delivery, ObstetricPregnancy OutcomeAdultCesarean SectionFemaleHospitalizationHumansInfant, NewbornOntarioPandemicsPregnancyPremature BirthSARS-CoV-2Young Adult

Identifiers

PMID38728292
PMCPMC11086824

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Registered trials

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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.