Health of singleton neonates in Switzerland through time and crises: a cross-sectional study at the population level, 2007-2022.

Birth weight COVID-19 Crises Neonatal health Pandemics

Journal

BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799

Informations de publication

Date de publication:
25 Mar 2024
Historique:
received: 21 12 2023
accepted: 12 03 2024
medline: 26 3 2024
pubmed: 26 3 2024
entrez: 26 3 2024
Statut: epublish

Résumé

Being exposed to crises during pregnancy can affect maternal health through stress exposure, which can in return impact neonatal health. We investigated temporal trends in neonatal outcomes in Switzerland between 2007 and 2022 and their variations depending on exposure to the economic crisis of 2008, the flu pandemic of 2009, heatwaves (2015 and 2018) and the COVID-19 pandemic. Using individual cross-sectional data encompassing all births occurring in Switzerland at the monthly level (2007-2022), we analysed changes in birth weight and in the rates of preterm birth (PTB) and stillbirth through time with generalized additive models. We assessed whether the intensity or length of crisis exposure was associated with variations in these outcomes. Furthermore, we explored effects of exposure depending on trimesters of pregnancy. Over 1.2 million singleton births were included in our analyses. While birth weight and the rate of stillbirth have remained stable since 2007, the rate of PTB has declined by one percentage point. Exposure to the crises led to different results, but effect sizes were overall small. Exposure to COVID-19, irrespective of the pregnancy trimester, was associated with a higher birth weight (+12 grams [95% confidence interval (CI) 5.5 to 17.9 grams]). Being exposed to COVID-19 during the last trimester was associated with an increased risk of stillbirth (odds ratio 1.24 [95%CI 1.02 to 1.50]). Exposure to the 2008 economic crisis during pregnancy was not associated with any changes in neonatal health outcomes, while heatwave effect was difficult to interpret. Overall, maternal and neonatal health demonstrated resilience to the economic crisis and to the COVID-19 pandemic in a high-income country like Switzerland. However, the effect of exposure to the COVID-19 pandemic is dual, and the negative impact of maternal infection on pregnancy is well-documented. Stress exposure and economic constraint may also have had adverse effects among the most vulnerable subgroups of Switzerland. To investigate better the impact of heatwave exposure on neonatal health, weekly or daily-level data is needed, instead of monthly-level data.

Sections du résumé

BACKGROUND BACKGROUND
Being exposed to crises during pregnancy can affect maternal health through stress exposure, which can in return impact neonatal health. We investigated temporal trends in neonatal outcomes in Switzerland between 2007 and 2022 and their variations depending on exposure to the economic crisis of 2008, the flu pandemic of 2009, heatwaves (2015 and 2018) and the COVID-19 pandemic.
METHODS METHODS
Using individual cross-sectional data encompassing all births occurring in Switzerland at the monthly level (2007-2022), we analysed changes in birth weight and in the rates of preterm birth (PTB) and stillbirth through time with generalized additive models. We assessed whether the intensity or length of crisis exposure was associated with variations in these outcomes. Furthermore, we explored effects of exposure depending on trimesters of pregnancy.
RESULTS RESULTS
Over 1.2 million singleton births were included in our analyses. While birth weight and the rate of stillbirth have remained stable since 2007, the rate of PTB has declined by one percentage point. Exposure to the crises led to different results, but effect sizes were overall small. Exposure to COVID-19, irrespective of the pregnancy trimester, was associated with a higher birth weight (+12 grams [95% confidence interval (CI) 5.5 to 17.9 grams]). Being exposed to COVID-19 during the last trimester was associated with an increased risk of stillbirth (odds ratio 1.24 [95%CI 1.02 to 1.50]). Exposure to the 2008 economic crisis during pregnancy was not associated with any changes in neonatal health outcomes, while heatwave effect was difficult to interpret.
CONCLUSION CONCLUSIONS
Overall, maternal and neonatal health demonstrated resilience to the economic crisis and to the COVID-19 pandemic in a high-income country like Switzerland. However, the effect of exposure to the COVID-19 pandemic is dual, and the negative impact of maternal infection on pregnancy is well-documented. Stress exposure and economic constraint may also have had adverse effects among the most vulnerable subgroups of Switzerland. To investigate better the impact of heatwave exposure on neonatal health, weekly or daily-level data is needed, instead of monthly-level data.

Identifiants

pubmed: 38528502
doi: 10.1186/s12884-024-06414-1
pii: 10.1186/s12884-024-06414-1
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

218

Subventions

Organisme : Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
ID : 197305
Organisme : Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
ID : 197305
Organisme : Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
ID : 197305

Informations de copyright

© 2024. The Author(s).

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Auteurs

Mathilde Le Vu (M)

Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland.

Katarina L Matthes (KL)

Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland.

Marek Brabec (M)

Institute of Computer Science of the Czech Academy of Sciences, Prague, Czech Republic.

Julien Riou (J)

Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.

Veronika W Skrivankova (VW)

Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.

Irene Hösli (I)

Department of Obstetrics and Gynaecology, University Hospital of Basel, Basel, Switzerland.

Sabine Rohrmann (S)

Epidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland.

Kaspar Staub (K)

Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland. kaspar.staub@iem.uzh.ch.
Swiss School of Public Health (SSPH+), Zurich, Switzerland. kaspar.staub@iem.uzh.ch.

Classifications MeSH