COV_PERINAT

Pregnant women and children constitute vulnerable populations during a pandemic. This is because of the specificity of their immune systems and the possibility of mother to child transmission, their non-deferrable needs for health services and the effects of environmental factors on adverse pregnancy outcomes, notably the strong association of social disadvantage with risks of perinatal morbidity and mortality. Furthermore, adverse perinatal events can have lifelong consequences. Mortality and morbidity resulting from infection are directly related to the pandemic, while indirect effects can stem from reductions in the accessibility or quality of health services or from mitigation policies and economic hardship. Because pregnant women and newborns are generally in good health and because many of these health consequences may depend on health care organization and the socioeconomic context, studies of these effects require large population-based samples. The COV-PERINAT study’s aim is to investigate the indirect effects of the pandemic on the health of pregnant woman and newborns using routine hospital and administrative databases in the French National Health Data System (SNDS). It complements an on-going population-based study on the direct effects of the infection on the health of pregnant women and their newborns in France (COROPREG). Specifically, this project will (1) evaluate changes in population measures of health and healthcare use among pregnant women and newborns associated with the pandemic and strategies to contain the pandemic, (2) investigate whether these consequences differ by healthcare organization, socioeconomic context and other environmental factors, (3) assess the strengths and the weaknesses of using these routine sources to evaluate the impact of the pandemic and generate knowledge to reinforce monitoring capacity for future outbreaks, and (4) contribute to other on-going and future studies that rely on these data sources, including the COROPREG study and a European study (PHIRI) to facilitate exchange of population data between European countries. Requested funding for the 12 month study period will cover the costs of an experienced statistician to work with perinatal health researchers to (1) establish a validated cohort of pregnant women and their newborns (births from January 2016 to December 2020) linked to contextual data about the pandemic, pandemic policies and area-based organizational, social and environmental factors, (2) describe and analyze changes in population measures of maternal and newborn health, taking into consideration seasonality using time series models, and (3) assess the influence of context on these changes. The team has extensive experience analyzing population data on perinatal health. A scientific committee will involve experts from professional societies and public health agencies in the interpretation and dissemination of the results. Complementarity with on-going projects and possibilities for new follow-up projects ensure that the results produced within the 12 month period will reinforce the foundation for further research on COVID-19 among pregnant women and newborns.