Effect of the COVID-19 lockdown in Shanghai on maternal and neonatal outcomes

We aimed to evaluate the effects of COVID-19 social restrictions on maternal and newborn outcomes in Shanghai from April 1 to May 31 of 2022. We conducted a retrospective, cross-sectional analysis of all Live deliveries between April 1 and September 30 for the years 2021 and 2022 at our hospitals. Patients were assigned to three groups: “pre-lockdown” (April 1 to September 30, 2021), “during lockdown” (April 1 to May 31, 2022), and “post-lockdown” (June 1 to September 30, 2022). Cesarean delivery rate, pregnancy complications and neonatal outcomes were evaluated. Linear regression was used to model the continuous outcomes of birth weight and birth length, and logistic regression was implemented to model the binary outcomes of delivery mode, gestational diabetes mellitus (GDM), hypertension in pregnancy, neonatal asphyxia, fetal growth restriction (FGR), and preterm birth. A total of 2891 patients were enrolled in our study. Upon multivariate regression analysis and after adjustment for study epoch and patient characteristics, the lockdown period was associated with lower GDM (Exp(B) = 0.498; 95%CI, 0.379–0.655). The post-lockdown period was associated with a higher birth length (β = 0.040; 95%CI, 0.032–0.317) and more hypertension in pregnancy (Exp(B) = 1.683; 95%CI, 1.087–2.604) than the pre-lockdown period. The overall rates of cesarean delivery, preterm birth, neonatal asphyxia and FGR were not associated with the lockdown; however, maternal COVID-19 infection during lockdown was associated with a mean reduction of 150 g (95% CI, 11–288 g) in birth Weight at 37–39 weeks of gestation (p = 0.035). The lockdown period was associated with a diminution in GDM, and unlike the pre-lockdown period, the post-lockdown period was associated with an increase in birth weight and hypertension in pregnancy. Maternal COVID-19 infection during lockdown was also associated with lower neonatal birth Weight in deliveries at 37–39 weeks of gestation. Lockdown played a certain degree of impact on pregnancy complications and neonatal outcomes.