Socioeconomic Inequalities Exacerbated by Mitigation Measures to COVID-19 and Differences in Prematurity Prevalence

Socioeconomic Inequalities Exacerbates by Mitigation Measures Against COVID-19 in the Differential Prevalence of Prematurity and Low Weight in Uruguay

Objective: to assess the perinatal results in Uruguay during the semester of successful control of the COVID 19 pandemic to evaluate the impact of the crises in the public and private sub sectors of the Health System.

Methodology: An analytical observational study was carried out, comparing the semesters from March 15 to September 30, 2019 (year prior to the COVID 19 pandemic) with the same period 2020 (year of the COVID 19 pandemic), in the 2 sub sectors of public and private health care.

Study Overview

• Status: Completed
• Conditions: COVID-19 Pandemic; Preterm; Low Birth-weight
• Intervention / Treatment: Other: mitigation measures against COVID 19

Detailed Description

An analytical observational study was carried out, comparing the semesters from March 15 to September 30, 2019 with the same period 2020, in the 2 sub sectors of public health care of the private sub sector throughout the country, taking all births in that period of time.

The semester selected is based on the fact that the first months of the pandemic were the ones with the greatest mitigation measures with drastic socio-economic consequences, but it was also a period of almost zero COVID infection in pregnancy, this being an opportune moment not to have as confounding factor to the maternal and fetal biological complications of this infection.

The situation will be analyzed in the 2 sub sectors of public health care, made up of the State Health Services Administration (ASSE), police health and military health, and the UDELAR Clinic Hospital, on the one hand, and the private sub-sector. made up of the Institutions of Collectivized Medical Assistance (IAMC) of Montevideo and the Interior (FEPREMI) and the private health care insurance.

The primary variable to be analyzed in both periods and in both subsectors of the national integrated system health was the incidence of preterm births (less than 37 weeks gestational age), low birth weight (newborns with a birth weight less than 2,500 grams) and intrauterine growth restriction (marked by doctor attending the birth, as a clinical diagnosis of the current pregnancy)

For the analysis of the national data, of the study periods, the database was requested from the Ministry of Public Health. This database is provided to researchers anonymously

• Study Type: Observational
• Enrollment (Actual): 37323

Contacts and Locations

Study Locations

• Uruguay
  • Montevideo, Uruguay, 11300
    • Stephanie Viroga

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: Female

• Sampling Method: Non-Probability Sample

Study Population

all live births in the 2 sub sectors of public health care of the private sub sector in the selected period of time

Description

Inclusion Criteria:

• all live birth

Exclusion Criteria:

• stillbirth

Study Plan

How is the study designed?

Number of groups / cohorts

4

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
semester pre pandemia in sub sectors of public health care in Uruguay; all birth in sub sectors of public health care between march 15 and September 30 of 2019, pre pandemia
semester pre pandemia in sub sectors of private health care in Uruguay; all birth in sub sectors of private health care between march 15 and September 30 of 2019, pre pandemia
semester with mitigation measures against COVID 19 in sub sectors of public health care in Uruguay; all birth in sub sectors of public health care between march 15 and September 30 of 2020, with mitigation measures against COVID- 19	Other: mitigation measures against COVID 19; no intervention
semester with mitigation measures against COVID 19 in sub sectors of private health care in Uruguay; all birth in sub sectors of private health care between march 15 and September 30 of 2020, with mitigation measures against COVID- 19	Other: mitigation measures against COVID 19; no intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
incidence of incidence of preterm births, low birth weight and intrauterine growth restriction	number of birth in total birth with these conditions en two periods time in the two subsectors of health care	March 15 to September 30, 2019 and March 15 to September 30, 2020

Collaborators and Investigators

• Sponsor: Universidad de la Republica

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2021
• Primary Completion (Actual): August 30, 2021
• Study Completion (Actual): September 30, 2021

Study Registration Dates

• First Submitted: October 6, 2021
• First Submitted That Met QC Criteria: October 20, 2021
• First Posted (Actual): October 21, 2021

Study Record Updates

• Last Update Posted (Actual): October 21, 2021
• Last Update Submitted That Met QC Criteria: October 20, 2021
• Last Verified: October 1, 2021

More Information

Terms related to this study

• Keywords: COVID-19; preterm; low birth weight
• Additional Relevant MeSH Terms: Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Virus Diseases; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Pneumonia, Viral; Pneumonia; Lung Diseases; Body Weight; COVID-19; Birth Weight
• Other Study ID Numbers: COVID-19 and perinatal results

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No