Changes in neonatal admissions, care processes and outcomes in England and Wales during the COVID-19 pandemic: a whole population cohort study

ObjectivesThe COVID-19 pandemic instigated multiple societal and healthcare interventions with potential to affect perinatal practice. We evaluated population-level changes in preterm and full-term admissions to neonatal units, care processes and outcomes.DesignObservational cohort study using the U...

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Bibliographic Details
Published in:BMJ open 2021-10, Vol.11 (10), p.e054410-e054410
Main Authors: Greenbury, Sam F, Longford, Nicholas, Ougham, Kayleigh, Angelini, Elsa D, Battersby, Cheryl, Uthaya, Sabita, Modi, Neena
Format: Article
Language:English
Subjects:
Babies
Cohort analysis
Cohort Studies
Communicable Disease Control
Coronaviruses
COVID-19
England - epidemiology
Epidemiology
Ethnicity
Female
Gestational age
Health services
Humans
Infant, Newborn
Infections
neonatal intensive & critical care
neonatology
Newborn babies
Paediatrics
Pandemics
Population
Pregnancy
Premature birth
public health
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
State Medicine
Stillbirth
Wales - epidemiology
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Summary:ObjectivesThe COVID-19 pandemic instigated multiple societal and healthcare interventions with potential to affect perinatal practice. We evaluated population-level changes in preterm and full-term admissions to neonatal units, care processes and outcomes.DesignObservational cohort study using the UK National Neonatal Research Database.SettingEngland and Wales.ParticipantsAdmissions to National Health Service neonatal units from 2012 to 2020.Main outcome measuresAdmissions by gestational age, ethnicity and Index of Multiple Deprivation, and key care processes and outcomes.MethodsWe calculated differences in numbers and rates between April and June 2020 (spring), the first 3 months of national lockdown (COVID-19 period), and December 2019–February 2020 (winter), prior to introduction of mitigation measures, and compared them with the corresponding differences in the previous 7 years. We considered the COVID-19 period highly unusual if the spring–winter difference was smaller or larger than all previous corresponding differences, and calculated the level of confidence in this conclusion.ResultsMarked fluctuations occurred in all measures over the 8 years with several highly unusual changes during the COVID-19 period. Total admissions fell, having risen over all previous years (COVID-19 difference: −1492; previous 7-year difference range: +100, +1617; p
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2021-054410