{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T09:49:00Z","timestamp":1774691340963,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T00:00:00Z","timestamp":1627430400000},"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":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Previous evidence has been conflicting regarding the effect of coronavirus disease 2019 (COVID\u201019) pandemic lockdowns on obstetric intervention and preterm birth rates. The literature to date suggests potentially differential underlying mechanisms based on country economic setting. We aimed to study these outcomes in an Icelandic population where uniform lockdown measures were implemented across the country.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>The study included all singleton births (<jats:italic>n<\/jats:italic>\u00a0=\u00a020\u00a0680) during 2016\u20132020 identified from the population\u2010based Icelandic Medical Birth Register. We defined two lockdown periods during March\u2013May and October\u2013December in 2020 according to government implemented nationwide lockdown. We compared monthly rates of cesarean section, induction of labor and preterm birth during lockdown with the same time periods in the 4 previous years (2016\u20132019) using logit binomial regression adjusted for confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our results indicated a reduction in the overall cesarean section rate, which was mainly evident for elective cesarean section, both during the first (adjusted odd ratio [aOR] 0.71, 95% CI 0.51\u20130.99) and second (aOR 0.72, 95% CI 0.52\u20130.99) lockdown periods, and not for emergency cesarean section. No change during lockdown was observed in induction of labor. Our results also suggested a reduction in the overall preterm birth rate during the first lockdown (aOR 0.69, 95% CI 0.49\u20130.97) and in the months immediately following the lockdown (June\u2013September) (aOR 0.67, 95% CI 0.49\u20130.89). The reduction during the first lockdown was mainly evident for medically indicated preterm birth (although not statistically significant) and the reduction during June\u2013September was mainly evident for spontaneous preterm birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study suggested a reduction in elective cesarean section during COVID\u201019 lockdown, possibly reflecting changes in prioritization of non\u2010urgent health care during lockdown. We also found a reduction in overall preterm birth during the first lockdown and spontaneous preterm birth following the first lockdown, but further research is needed to shed light on the underlying mechanisms for these findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14231","type":"journal-article","created":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T19:01:51Z","timestamp":1626202911000},"page":"1924-1930","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Changes in obstetric interventions and preterm birth during COVID\u201019: A nationwide study from Iceland"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4931-7650","authenticated-orcid":false,"given":"Kristjana","family":"Einarsd\u00f3ttir","sequence":"first","affiliation":[{"name":"Center of Public Health Sciences Faculty of Medicine University of Iceland Reykjavik Iceland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma Marie","family":"Swift","sequence":"additional","affiliation":[{"name":"Faculty of Nursing\/Department of Midwifery University of Iceland Reykjav\u00edk Iceland"},{"name":"Women\u2019s Clinic Landspitali National University Hospital of Iceland Reykjavik Iceland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helga","family":"Zoega","sequence":"additional","affiliation":[{"name":"Center of Public Health Sciences Faculty of Medicine University of Iceland Reykjavik Iceland"},{"name":"Centre for Big Data Research in Health Faculty of Medicine University of New South Wales Sydney Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,7,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1106"},{"key":"e_1_2_10_3_1","first-page":"2975089","article-title":"Impact of the COVID\u201019 pandemic on acute general surgical admissions in a district general hospital in the United Kingdom: a Retrospective Cohort study","volume":"2020","author":"Callan R","year":"2020","journal-title":"Surg Res Pract"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0237420"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15313"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2020-319990"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2021.100330"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004236"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-003075"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-021-03984-6"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-047900"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004237"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(21)00079-6"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.12688\/wellcomeopenres.16507.1"},{"key":"e_1_2_10_15_1","unstructured":"The Icelandic Directorate of Health\u2010Covid\u201019 information.2020. Available from:https:\/\/www.covid.is\/tolulegar\u2010upplysingar."},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.16336"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2019.1684467"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jes.2020.07.029"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.buildenv.2021.107718"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14231","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.14231","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14231","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T03:35:27Z","timestamp":1693280127000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,28]]},"references-count":18,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1111\/aogs.14231"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14231","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,28]]},"assertion":[{"value":"2021-04-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}