Impact of COVID-19 Lockdowns on Maternal and Perinatal Health

The global COVID-19 crisis and associated lockdowns have had an unprecedented impact on virtually any aspect of society and provided a unique natural experiment. Amidst this worldwide tragedy, initial observations of substantial reductions in preterm birth incidence across a number of settings provided a possible silver lining. Could the pandemic in this way offer an opening to identify novel pathways for prevention of preterm birth, currently affecting 15 million babies and causing 1 million child deaths annually? Two years into the pandemic, the overall assessment of research on the topic paints a more nuanced picture, as we describe in this chapter. Taken together, lockdown measures across the globe do seem to have been followed by a modest reduction in preterm births. While initially these appeared to be partially offset by an increase in stillbirths, this was not confirmed in recent meta-analyses. Maternal health was also affected by the pandemic in various ways. Findings from several studies assessing the perinatal and maternal health impacts of the COVID-19 crisis are in keeping with the general recognition of existing socioeconomic inequalities being aggravated. Interpretation of the overall evidence base assessing the impact of the pandemic and lockdowns on maternal and perinatal health is complicated by methodological challenges, which we also highlight. Key recommendations for future research are formulated, so that we may draw lessons from these experiences to enable a healthier and more equal start for future generations.