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. 2021 Feb 2:6:21.
doi: 10.12688/wellcomeopenres.16507.1. eCollection 2021.

The international Perinatal Outcomes in the Pandemic (iPOP) study: protocol

Sarah J Stock #  1 , Helga Zoega #  2   3 , Meredith Brockway  4 , Rachel H Mulholland  1 , Jessica E Miller  5 , Jasper V Been  6   7   8 , Rachael Wood  9   10 , Ishaya I Abok  11 , Belal Alshaikh  12 , Adejumoke I Ayede  13   14 , Fabiana Bacchini  15 , Zulfiqar A Bhutta  16 , Bronwyn K Brew  17   18 , Jeffrey Brook  19   20 , Clara Calvert  21 , Marsha Campbell-Yeo  22 , Deborah Chan  4 , James Chirombo  23 , Kristin L Connor  24 , Mandy Daly  25   26 , Kristjana Einarsdóttir  3 , Ilaria Fantasia  27 , Meredith Franklin  28 , Abigail Fraser  29   30 , Siri Eldevik Håberg  31 , Lisa Hui  32 , Luis Huicho  33   34   35 , Maria C Magnus  31 , Andrew D Morris  36 , Livia Nagy-Bonnard  37 , Natasha Nassar  38 , Sylvester Dodzi Nyadanu  39   40 , Dedeke Iyabode Olabisi  41 , Kirsten R Palmer  42 , Lars Henning Pedersen  43   44 , Gavin Pereira  31   39   45 , Amy Racine-Poon  46 , Manon Ranger  47 , Tonia Rihs  48 , Christoph Saner  49 , Aziz Sheikh  1 , Emma M Swift  50 , Lloyd Tooke  51   52 , Marcelo L Urquia  53 , Clare Whitehead  54 , Christopher Yilgwan  11 , Natalie Rodriguez  4 , David Burgner  5   55 , Meghan B Azad  4   56 ; iPOP Study Team
Affiliations

The international Perinatal Outcomes in the Pandemic (iPOP) study: protocol

Sarah J Stock et al. Wellcome Open Res. .

Abstract

Preterm birth is the leading cause of infant death worldwide, but the causes of preterm birth are largely unknown. During the early COVID-19 lockdowns, dramatic reductions in preterm birth were reported; however, these trends may be offset by increases in stillbirth rates. It is important to study these trends globally as the pandemic continues, and to understand the underlying cause(s). Lockdowns have dramatically impacted maternal workload, access to healthcare, hygiene practices, and air pollution - all of which could impact perinatal outcomes and might affect pregnant women differently in different regions of the world. In the international Perinatal Outcomes in the Pandemic (iPOP) Study, we will seize the unique opportunity offered by the COVID-19 pandemic to answer urgent questions about perinatal health. In the first two study phases, we will use population-based aggregate data and standardized outcome definitions to: 1) Determine rates of preterm birth, low birth weight, and stillbirth and describe changes during lockdowns; and assess if these changes are consistent globally, or differ by region and income setting, 2) Determine if the magnitude of changes in adverse perinatal outcomes during lockdown are modified by regional differences in COVID-19 infection rates, lockdown stringency, adherence to lockdown measures, air quality, or other social and economic markers, obtained from publicly available datasets. We will undertake an interrupted time series analysis covering births from January 2015 through July 2020. The iPOP Study will involve at least 121 researchers in 37 countries, including obstetricians, neonatologists, epidemiologists, public health researchers, environmental scientists, and policymakers. We will leverage the most disruptive and widespread "natural experiment" of our lifetime to make rapid discoveries about preterm birth. Whether the COVID-19 pandemic is worsening or unexpectedly improving perinatal outcomes, our research will provide critical new information to shape prenatal care strategies throughout (and well beyond) the pandemic.

Keywords: COVID-19; global trends; low birth weight; pandemic lockdowns; perinatal outcomes; preterm birth; stillbirth.

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Conflict of interest statement

Competing interests: Helga Zoega is an employee of the Centre for Big Data Research in Health, UNSW Sydney which has received funding from AbbVie Australia to conduct research unrelated to the submitted work. Andrew Morris reports grants from the Bill & Melinda Gates Foundation during the conduct of this work. Kristin Palmer reports grants from GlaxoSmithKline, grants from Cerebral Palsy Alliance, grants from Equity Trustees, outside the submitted work. Clare Whitehead reports research funding from Bill & Melinda Gates Foundation Ferring International, unrelated to the submitted work. Aziz Sheikh reports grants from Health Data Research UK. He is a member of the ICODA Executive Leadership Team and Director of the Health Data Research UK BREATHE Hub.

Figures

Figure 1.
Figure 1.. iPOP Study Conceptual Framework.
OECD, Organisation for Economic Co-operation and Development.
Figure 2.
Figure 2.. Full directed acyclic graph (DAG) of lockdown to perinatal outcomes.
Figure 3.
Figure 3.. Directed acyclic graph (DAG) - Simple version (work package 1).
Figure 4.
Figure 4.. Map of iPOP collaborating countries as of Dec 1, 2020.
Figure 5.
Figure 5.. Data request flow diagram.
See this image and copyright information in PMC

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