{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T11:07:04Z","timestamp":1768820824420,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the impact of the COVID\u201019 pandemic on preterm birth (PB) and low birth weight (LBW), comparing public and private healthcare systems of the National Integrated Health System in Uruguay, where the mitigation measures for the COVID\u201019 pandemic generated an immediate socioeconomic and psychological crisis, which caused a sharp widening of existing socioeconomic inequalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A national observational study was conducted comparing perinatal outcomes in the first 6\u2009months of 2020 (period of the pandemic without pregnancy infections), which was the beginning of the pandemic, with the same period of the previous year 2019 (pre\u2010pandemic period with no mitigation measures) among pregnant women from the public and private health systems. Data were retrieved from the national database (Informatic Perinatal System) and analyzed by healthcare system category.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 36\u2009559 deliveries were assessed: 18\u2009563 in the 2019 study period and 17\u2009996 in the 2020 study period. In the public system, there was a significant increase in the risk of LBW (adjusted relative risk [aRR] 1.12, 95% confidence interval [CI] 1.05\u20131.36) and of the composite outcome (PB or LBW) (aRR 1.15, 95% CI 1.04\u20131.26). In the private system, by contrast, there was a non\u2010statistically significant decrease of LBW and there were no changes in the incidence of PB and the composite outcome in 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The different evolution of birth outcomes in the public and private systems suggests an unequal impact of mitigation measures on populations of different socioeconomic levels. Given that no COVID\u201019 infections were identified in pregnant women during the study period, this research offers an opportunity to differentiate the biologic effects of the virus from the psychological and social impacts derived from containment measures.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> Identifier<\/jats:title><jats:p>NCT05087160.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14778","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T11:59:19Z","timestamp":1681387159000},"page":"718-724","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["<scp>COVID<\/scp>\u201019 mitigation measures increase preterm birth and low birth weight in the public healthcare system in Uruguay"],"prefix":"10.1002","volume":"162","author":[{"given":"Leonel","family":"Briozzo","sequence":"first","affiliation":[{"name":"Gynecology Clinic, Faculty of Medicine University of the Republic  Montevideo Uruguay"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gisselle","family":"Tomasso","sequence":"additional","affiliation":[{"name":"Gynecology Clinic, Faculty of Medicine University of the Republic  Montevideo Uruguay"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet","family":"Trujillo","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social Medicine, Faculty of Medicine University of the Republic  Montevideo Uruguay"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9065-6692","authenticated-orcid":false,"given":"Stephanie","family":"Viroga","sequence":"additional","affiliation":[{"name":"Gynecology Clinic, Faculty of Medicine University of the Republic  Montevideo Uruguay"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Pintos","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social Medicine, Faculty of Medicine University of the Republic  Montevideo Uruguay"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda","family":"Nozar","sequence":"additional","affiliation":[{"name":"Gynecology Clinic, Faculty of Medicine University of the Republic  Montevideo Uruguay"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia","family":"Aleman","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social Medicine, Faculty of Medicine University of the Republic  Montevideo Uruguay"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Buekens","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Tulane School of Public Health and Tropical Medicine  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-021-01070-6"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2020.8472"},{"issue":"4","key":"e_1_2_9_4_1","first-page":"436","article-title":"An\u00e1lisis del impacto de la pandemia COVID\u201019 sobre la calidad de los servicios de salud sexual y reproductiva","volume":"36","author":"Briozzo L","year":"2021","journal-title":"Rev M\u00e9d Urug"},{"key":"e_1_2_9_5_1","unstructured":"Observatorio de Igualdad de G\u00e9nero de Am\u00e9rica Latina y el Caribe.Los riesgos de la pandemia de COVID \u201019 para el ejercicio de los derechos sexuales y Reproductivos de las mujeres. 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