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Nearly 50,000 preterm births may have been prevented in an organization in higher-income countries in a single month.
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by Elizabeth Preston
Elizabeth Decker had a stressful time during pregnancy, plagued by daily vomiting and fears that this bath, like the first, could dangerously increase her blood pressure and have to give birth early. Oddly enough, the most relaxing component of its last quarter, which extended on both sides of the world’s descent into lockdown Covid in spring 2020.
Ms. Decker, who is 36 years old and lives in North Reading, Massachusetts, made the decision to leave her job as a lawyer under great pressure and stay home. Her husband, a teacher, started running away from home at that time, training online. She took care of her baby and took care of food while Mrs. Decker rested and slept. “I couldn’t do anything for the last 3 months of my pregnancy,” she said. The rise in blood pressure her doctor expected didn’t come until after June, a week after Decker’s due date, when she gave birth to a healthy baby boy.
An ambitious global birth study suggests that Ms. Decker was not the only expectant to avoid the experience of preterm birth in the first months of confinement. The study, published Monday in the journal Nature Human Behavior, showed that in a top-of-the-peak organization commonly high-income countries, such as the United States, Belgium, Canada, Chile, Denmark and Switzerland, in the spring of 2020, there were about 4 percent fewer preterm births than expected. Globally, the study authors estimated, replacement was maximum maximum, probably in addition to nearly 50,000 preterm births avoided in the first month of lockdown alone.
This discovery may allow researchers to better perceive the reasons for premature birth, which remain frustrating and elusive for medical science.
“This is a once-in-a-lifetime herbal experiment, where everyone has experienced this pretty drastic blockage at the same time,” said Meghan Azad, associate professor of pediatrics and child fitness at the University of Manitoba and one of the “So, it’s a wonderful opportunity to take a look at what this can mean for maternal and infant fitness. “
When Decker was worried about their full-term delivery, doctors in countries were also seeing fewer premature toddlers than they had anticipated. Some of their observations, shared before the peer review but officially published since then, were surprising: in Denmark, for example, the number of younger preterm infants had been reduced by 90%. In one hospital in Ireland, very preterm births were reduced by three-quarters or more.
The Irish authors hypothesized that pregnant women cooped up at home delight in less stress, less air pollution, or fewer viral or bacterial infections, which may reduce their chances of giving birth early.
In response to the Irish study on Twitter, Dr. Azad wondered aloud (morbidly, she admitted) if doctors were seeing decreases in premature births that spring because some of the young children had died from stillbirths or miscarriages.
Within two days, Dr. Azad teamed up with other scientists to examine this question. “It was that kind of crazy moment,” he said. They were on the loose to dive into a large-scale-looking project.
The collaboration eventually grew to more than a hundred scientists worldwide and 52 million births. Using knowledge from 2015 to 2020, the scientists modeled the expected number of preterm births and stillbirths in the first few months of each country’s strict lockdown period. .
They learned that data from smaller samples, such as a single hospital, might not tell a complete story. For example, Dr. Azad said, what if this hospital had become a compromised Covid treatment site and simply diverted its pregnant patients elsewhere?
For this reason, the researchers focused their main research on high-quality datasets that covered an entire country or a giant region of a country. This included 18 high- and upper-middle-income countries, the World Bank explained. From one place to another, the researchers concluded that preterm births were reduced by an average of 4% during the first and second months of confinement.
In the third month, the statistical sign is weaker. By the fourth month of lockdown, when countries were maxed out, probably diverging in their rules and how rigorously other people followed them, Dr. Azad said, the decline in preterm births was gone.
The authors found a slight accumulation of stillbirths in Brazil in the current and third month, and in Canada in the first month. .
The authors noted that covid itself increases a person’s threat of premature birth and stillbirth. But since virus infection was less prevalent in the spring of 2020 than in later periods, this most likely did not affect the study results.
“The causes of premature birth have been so elusive, despite great effort,” said Dr. Brown. Denise Jamieson, an obstetrician at Emory University School of Medicine in Atlanta, was not involved in the new study. Although the global study found a drop of only about four percent, “I think any relief in preterm birth is remarkable and significant,” he said.
“The next step is to take a look at why,” Dr. Jamieson added.
Dr Azad and Dr Roy Philip, a co-author of the new paper and also an Irish neonatologist at the University of Limerick’s Maternity Hospital, who in 2020 discovered a surprising drop in very premature births at their hospital, said it was conceivable that the closures had very different other effects. effects on other teams of people. A pregnant user like Ms. Becker who was able to stay home in a low-stress environment, with intelligent support, could have benefited. A frontline employee without health insurance might have had another experience.
In this way, the effects highlighted everything that is still unknown about the reasons for premature births. “Although there are 52 million births in the study, it may not promptly answer all the questions,” Dr. Philip said. But at least it deserves to encourage other people to take a closer look at what the ideal pregnancy is. “
The review also highlighted asymmetric preterm birth rates between countries. During the five years of data, the U. S. The U. S. had the highest preterm birth rate of all high-income countries included: just under 10%. Finland’s rate, on the other hand, less than 6%
The disparity is not surprising, Dr. Jamieson said. Unfortunately, the U. S. UU. es an outlier in many maternal and infant fitness outcomes when compared to other high-income countries. “
Future studies may use this global dataset to investigate those diversifications in maternal fitness. Dr Azad said she first hoped to delve deeper into the drivers of blocking preterm birth, not just their frequency: did adjustments in air pollutants correlate with adjustments in preterm births?What about hygiene, source of income, or access to physical care?But it lacked the investment to do more in-depth research, Dr. Azad said, and now the other projects that were postponed until the beginning of the pandemic have stuck with it. and his colleagues.
Dr. Azad doubts that one of his tweets today can simply launch a massive foreign studies effort. In the spring of 2020, other people had “this burning preference to do anything, whether it’s to help the pandemic or do something with it,” she said. Some scholars even worked on the task without receiving payment. “I’m a scientist; I don’t like to use the word ‘magic,'” he said. “But it’s a bit magical. “
Now, the mysteries of premature birth will have to wait for other researchers, Dr. Azad said, adding, “We don’t all have that extra time anymore. “
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