What may happen if you are pregnant during Covid-19 lockdown? A retrospective study about peripartum outcomes

Background: One of the provisions implemented to contain the spread of Covid-19 infections in Italy was the lockdown. Effects of the lockdown on childbirth outcomes and on the well-being of both the mother and the child have not yet been defined. An inadequate diet during pregnancy and a reduced physical activity can predispose women to become overweight or obese and trigger the development of various complications and maternal-fetal adverse outcomes. Methods: This is a retrospective study including all consecutive patients who delivered at University Hospital Maggiore della Carità in Novara, Italy, in April-May 2017 (group 1, n=294), a period prior to the pandemic, and during the same months in 2020 (group 2, n=256) during and immediately after lockdown. Clinical data were extracted from The Report "Childbirth Assistance Certificate (CedAP) - Birth Event Analysis". Results: Demographic characteristics were similar between the two study groups, except for a decreased number of married couples in group 2 (p-value 0.018) and an increased percentage of patients with clinical checkups at Family Planning facilities in 2020 (p-value 0.04). The number of hospitalizations during pregnancy was 26 (8.9%) vs 10 (3.9%) with a significative reduction during 2020 (p-value 0.004). Regarding obstetric outcomes, we observed a significant increase in induction of labour in 2020 (23.9% vs 35.9%; p-value 0. 002), a reduction of amniorrhexis (11.3% vs 5.5% p-value 0.015), a reduction of supine positions with an increase of vertical and all fours positions in 2020 (49.3% vs 61.9% and 9.5% vs 12.4% respectively, p 0.023), and a reduction of left occipito-anterior presented part (63.2% vs 55.4%) in favor of right occipito-anterior (34.7% vs 41.2%, p-value 0.019). Conclusions: There were no significant differences either for antepartum or intrapartum complications. Long-term studies are needed to evaluate psychological, behavioral, and epigenetic effects of maternal physical inactivity on obstetric outcomes.