COVID-19 Lockdown Increased the Risk of Preterm Birth

Ting Ting Lin, Chen Zhang, Lei Chen, Li Jin, Xian Hua Lin, Jie Xue Pan, Cindy Lee Dennis, Ben W. Mol, He Feng Huang*, Yan Ting Wu

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Purpose: To estimate whether the city-specific lockdown in Shanghai induced by the COVID-19 pandemic affected preterm birth rates among uninfected pregnant women in different trimesters. Methods: The population-based retrospective cohort study was conducted in the International Peace Maternity and Child Health Hospital (IPMCH) in Shanghai, China. Pregnant women without COVID-19 received perinatal healthcare during lockdown (from January 24, 2020 to March 24, 2020) and non-lockdown (from January 24, 2019 to March 24, 2019) period and giving birth to a live infant at IPMCH were enrolled. 1:1 propensity score matching and Inverse probability of treatment weighting were used to evaluate preterm birth (<37 weeks), very preterm birth (<34 weeks), preterm birth with premature rupture of membranes (PROM-PTB), spontaneous preterm birth with intact membranes (S-PTB), and medically induced preterm birth (MI-PTB) between two groups. Results: 8,270 pregnant women were in the lockdown group, and 9,815 were in the non-lockdown group. Pregnant women in second trimester during lockdown had a higher risk of PTB than those during the non-lockdown period [OR: 1.43 (CI 1.01–2.02), ARD: 1.7% (CI 0.04–3.4%), p = 0.045]. Furthermore, pregnant women in third trimester during lockdown had a higher risk of PROM-PTB than those during the non-lockdown period [OR: 1.64 (CI 1.09–2.47), ARD: 0.9% (CI 0.2–1.6%), p = 0.02]; no group differences were found related to rates of VPTB, S-PTB or MI-PTB. Conclusion: In this cohort study in China, we found that there was an increased risk in preterm birth for non-infected women in COVID-19 lockdown who were in their second trimester.

Original languageEnglish
Article number705943
Number of pages9
JournalFrontiers in Medicine
Publication statusPublished - 27 Sept 2021

Bibliographical note

Funding Information:
This research was supported by the National Key Research and Development Program of China (2018YFC1002804), National Natural Science Foundation of China (82001571 and 81671412), Program of Shanghai Academic Research Leader (20XD1424100), Outstanding Youth Medical Talents of Shanghai Rising Stars of Medical Talent Youth Development Program, Science and Technology Innovation Fund of Shanghai

Data Availability Statement

The Supplementary Material for this article can be found online at:


  • COVID-19
  • lockdown
  • premature rupture of membranes
  • preterm birth
  • very preterm birth


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