{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:18:30Z","timestamp":1788344310957,"version":"build-2803163510"},"reference-count":130,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001232","name":"Royal Australasian College of Physicians","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001232","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Foreseeing how policy impacts pregnant women and infants is limited by ethical challenges of experimental research within these groups. The COVID\u201019 pandemic generated natural experiments, offering rare opportunities to explore associations between specific policy responses and maternal\u2010infant health outcomes. These insights are useful for informing policy design aligned with the 2030 Sustainable Development Goals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To systematically review evidence of associations between COVID\u201019 policies, OxCGRT Stringency Index (a University of Oxford tool for comparing the stringency of policies) and maternal\u2010infant health outcomes during pregnancy, birth, and the first 12 months postpartum from 2020\u20102022 in high\u2010income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA guidelines, Embase, MEDLINE, PubMed, and Web of Science were searched (January 1 2020\u2010July 9 2022) using subject headings, keywords, and variants for \u201cCOVID\u201019\u201d, \u201cpolicies\u201d, \u201cperinatal\u201d, and \u201crandomized\u201d, and \u201cnon\u2010randomized\u201d study designs. Eligible studies were from high\u2010income countries, published in English, and used comparison groups. Two reviewers independently extracted and analyzed data. Heterogeneity and risk of bias made meta\u2010analysis inappropriate. Outcomes were instead reported using tables and visuals of effect sizes, ratio estimates, and 95% confidence intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 3143 citations, 35 studies met inclusion criteria. All reported high OxCGRT Stringency Index during exposure, validating the fidelity of adhering to defined policy exposure periods. Lockdown was associated with reductions in preterm and low birthweight births, infant emergency admissions, and breast feeding women, and increases in hypertensive disorders of pregnancy and gestational diabetes mellitus. Telehealth was associated with earlier gestational age at antenatal visits and less breast feeding women. Maternal mental health and stillbirth results were mixed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>High stringency policies, including lockdowns and telehealth, were associated with both favorable and adverse maternal\u2010infant outcomes. Findings inform avenues for future causal inference research and areas for mitigation planning should high stringency policies be reintroduced, supporting progress towards the 2030 Sustainable Development Goals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71523","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T07:41:37Z","timestamp":1778830897000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Policy Responses to the COVID\u201019 Pandemic in High\u2010Income Countries and the Associated Maternal\u2010Infant Health Outcomes: A Systematic Literature and Policy Review"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3750-833X","authenticated-orcid":false,"given":"Ashleigh","family":"Shipton","sequence":"first","affiliation":[{"name":"Department of Paediatrics University of Melbourne Melbourne Australia"},{"name":"Generation Victoria, Murdoch Children's Research Institute Melbourne Australia"},{"name":"Centre for Community Child Health, Royal Children's Hospital Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6135-7412","authenticated-orcid":false,"given":"Katie","family":"Mcbain","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Melbourne Melbourne Australia"},{"name":"Generation Victoria, Murdoch Children's Research Institute Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7501-9257","authenticated-orcid":false,"given":"Melissa","family":"Wake","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Melbourne Melbourne Australia"},{"name":"Generation Victoria, Murdoch Children's Research Institute Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6520-7094","authenticated-orcid":false,"given":"Sharon","family":"Goldfeld","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Melbourne Melbourne Australia"},{"name":"Centre for Community Child Health, Royal Children's Hospital Melbourne Australia"},{"name":"Population Health, Murdoch Children's Research, Institute Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6951-9949","authenticated-orcid":false,"given":"Fiona","family":"Mensah","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Melbourne Melbourne Australia"},{"name":"Intergenerational Health Group, Murdoch Children's Research Institute Melbourne Australia"},{"name":"Women and Kids, South Australian Health and Medical Research Institute Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.47389\/37.1.72"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2020.102821"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.paed.2018.01.001"},{"key":"e_1_2_14_5_1","unstructured":"WHO Director\u2010General's Opening Remarks at the Media Briefing on COVID\u201019World Health Organization 2020 https:\/\/www.who.int\/director\u2010general\/speeches\/detail\/who\u2010director\u2010general\u2010s\u2010opening\u2010remarks\u2010at\u2010the\u2010media\u2010briefing\u2010on\u2010covid\u201019\u201011\u2010march\u20102020."},{"key":"e_1_2_14_6_1","unstructured":"Covid\u201019 Government Response Tracker:Blavatnik School of Government University of Oxford; 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