PDF(Pubmed)
Abstract：
UNASSIGNED: Neonatal mortality is a major public health concern that was potentially impacted by the COVID-19 pandemic. To prepare for future health crises, it is important to investigate whether COVID-19 pandemic-related interventions were associated with changes in neonatal mortality.
UNASSIGNED: To investigate whether social distancing during the pandemic was associated with a higher neonatal mortality rate.
UNASSIGNED: This cohort study examined maternal-linked birth and infant death records from the National Center for Health Statistics, a population-level US database, from 2016 through 2020. The mortality rates were correlated using machine learning-based autoregressive integrated moving average (ARIMA) models with the social distancing index (SDI). The reference period was January 2016 through February 2020, and the pandemic period was March through December 2020. Statistical analysis was performed from March 2023 to May 2024.
UNASSIGNED: SDI, computed from 6 mobility metrics.
UNASSIGNED: The primary outcome was neonatal mortality rate, defined as death at age less than 28 days.
UNASSIGNED: The study included 18 011 173 births, of which 15 136 596 were from the reference period (7 753 555 [51.22%] male; 11 643 094 [76.92%] with maternal age of 20 to 34 years) and 2 874 577 were from the pandemic period (1 472 539 [51.23%] male; 2 190 158 [76.19%] with maternal age of 20 to 34 years). Through ARIMA-adjusted analyses, accounting for the declining mortality trend in the reference period, the mortality rates during the pandemic period did not significantly differ from the expected rates. SDI did not exhibit significant correlations with neonatal mortality (unadjusted: correlation coefficient [CC], 0.14 [95% CI, -0.53 to 0.70]; ARIMA adjusted: CC, 0.29 [95% CI, -0.41 to 0.77]), early neonatal mortality (unadjusted: CC, 0.33 [95% CI, -0.37 to 0.79]; ARIMA adjusted: CC, 0.45 [95% CI, -0.24 to 0.84]), and infant mortality (unadjusted: CC, -0.09 [95% CI, -0.68 to 0.57]; ARIMA adjusted: CC, 0.35 [95% CI, -0.35 to 0.80]). However, lag analyses found that SDI was associated with higher neonatal and early neonatal mortality rates with a 2-month lag period, but not with infant mortality rate. SDI was also associated with increases in 22-to-27 weeks\' and 28-to-32 weeks\' preterm delivery with a 1-month lag period.
UNASSIGNED: In this population-level study of National Center for Health Statistics databases, neonatal, early neonatal, and infant mortality rates did not increase during the initial COVID-19 pandemic period. However, associations were observed between the pandemic period social distancing measures and higher rates of neonatal and early neonatal mortality, as well as preterm birth rate with a lag period, suggesting the importance of monitoring infant health outcomes following pandemic-related population behavior changes.
UNASSIGNED: To investigate whether social distancing during the pandemic was associated with a higher neonatal mortality rate.
UNASSIGNED: This cohort study examined maternal-linked birth and infant death records from the National Center for Health Statistics, a population-level US database, from 2016 through 2020. The mortality rates were correlated using machine learning-based autoregressive integrated moving average (ARIMA) models with the social distancing index (SDI). The reference period was January 2016 through February 2020, and the pandemic period was March through December 2020. Statistical analysis was performed from March 2023 to May 2024.
UNASSIGNED: SDI, computed from 6 mobility metrics.
UNASSIGNED: The primary outcome was neonatal mortality rate, defined as death at age less than 28 days.
UNASSIGNED: The study included 18 011 173 births, of which 15 136 596 were from the reference period (7 753 555 [51.22%] male; 11 643 094 [76.92%] with maternal age of 20 to 34 years) and 2 874 577 were from the pandemic period (1 472 539 [51.23%] male; 2 190 158 [76.19%] with maternal age of 20 to 34 years). Through ARIMA-adjusted analyses, accounting for the declining mortality trend in the reference period, the mortality rates during the pandemic period did not significantly differ from the expected rates. SDI did not exhibit significant correlations with neonatal mortality (unadjusted: correlation coefficient [CC], 0.14 [95% CI, -0.53 to 0.70]; ARIMA adjusted: CC, 0.29 [95% CI, -0.41 to 0.77]), early neonatal mortality (unadjusted: CC, 0.33 [95% CI, -0.37 to 0.79]; ARIMA adjusted: CC, 0.45 [95% CI, -0.24 to 0.84]), and infant mortality (unadjusted: CC, -0.09 [95% CI, -0.68 to 0.57]; ARIMA adjusted: CC, 0.35 [95% CI, -0.35 to 0.80]). However, lag analyses found that SDI was associated with higher neonatal and early neonatal mortality rates with a 2-month lag period, but not with infant mortality rate. SDI was also associated with increases in 22-to-27 weeks\' and 28-to-32 weeks\' preterm delivery with a 1-month lag period.
UNASSIGNED: In this population-level study of National Center for Health Statistics databases, neonatal, early neonatal, and infant mortality rates did not increase during the initial COVID-19 pandemic period. However, associations were observed between the pandemic period social distancing measures and higher rates of neonatal and early neonatal mortality, as well as preterm birth rate with a lag period, suggesting the importance of monitoring infant health outcomes following pandemic-related population behavior changes.
摘要：
新生儿死亡率是一个主要的公共卫生问题，可能受到COVID-19大流行的影响。为未来的健康危机做准备，重要的是要调查COVID-19大流行相关干预措施是否与新生儿死亡率的变化相关.
■调查大流行期间的社会距离是否与较高的新生儿死亡率有关。
■这项队列研究检查了来自国家卫生统计中心的与母亲相关的出生和婴儿死亡记录，美国人口水平的数据库，从2016年到2020年。使用基于机器学习的自回归综合移动平均（ARIMA）模型将死亡率与社会距离指数（SDI）相关联。参考期为2016年1月至2020年2月，大流行期为2020年3月至12月。从2023年3月至2024年5月进行统计分析。
■SDI,根据6个移动性度量计算。
■主要结局是新生儿死亡率，定义为年龄小于28天的死亡。
■该研究包括18011173名新生儿，其中15136596来自参考期(7753555[51.22%]男性;11643094[76.92%]产妇年龄为20~34岁)和2874577来自大流行期(1472539[51.23%]男性;2190158[76.19%]产妇年龄为20~34岁)。通过ARIMA调整分析，考虑到参考期内死亡率下降的趋势，大流行期间的死亡率与预期无显著差异.SDI与新生儿死亡率没有显著相关性(未调整：相关系数[CC]，0.14[95%CI，-0.53至0.70]；ARIMA调整后：CC，0.29[95%CI，-0.41至0.77])，早期新生儿死亡率（未调整：CC，0.33[95%CI，-0.37至0.79]；ARIMA调整后：CC，0.45[95%CI，-0.24至0.84])，和婴儿死亡率(未调整：CC，-0.09[95%CI，-0.68至0.57]；ARIMA调整后：CC，0.35[95%CI，-0.35至0.80]）。然而,滞后分析发现，SDI与较高的新生儿和早期新生儿死亡率相关，滞后2个月，但不是婴儿死亡率。SDI还与22至27周和28至32周的早产增加相关，滞后1个月。
■在国家卫生统计中心数据库的人口水平研究中，新生儿,早期新生儿，在最初的COVID-19大流行期间，婴儿死亡率没有增加。然而,大流行时期的社会距离措施与新生儿和早期新生儿死亡率较高之间存在关联，以及有滞后期的早产率，提示在大流行相关人群行为改变后监测婴儿健康结果的重要性。
■调查大流行期间的社会距离是否与较高的新生儿死亡率有关。
■这项队列研究检查了来自国家卫生统计中心的与母亲相关的出生和婴儿死亡记录，美国人口水平的数据库，从2016年到2020年。使用基于机器学习的自回归综合移动平均（ARIMA）模型将死亡率与社会距离指数（SDI）相关联。参考期为2016年1月至2020年2月，大流行期为2020年3月至12月。从2023年3月至2024年5月进行统计分析。
■SDI,根据6个移动性度量计算。
■主要结局是新生儿死亡率，定义为年龄小于28天的死亡。
■该研究包括18011173名新生儿，其中15136596来自参考期(7753555[51.22%]男性;11643094[76.92%]产妇年龄为20~34岁)和2874577来自大流行期(1472539[51.23%]男性;2190158[76.19%]产妇年龄为20~34岁)。通过ARIMA调整分析，考虑到参考期内死亡率下降的趋势，大流行期间的死亡率与预期无显著差异.SDI与新生儿死亡率没有显著相关性(未调整：相关系数[CC]，0.14[95%CI，-0.53至0.70]；ARIMA调整后：CC，0.29[95%CI，-0.41至0.77])，早期新生儿死亡率（未调整：CC，0.33[95%CI，-0.37至0.79]；ARIMA调整后：CC，0.45[95%CI，-0.24至0.84])，和婴儿死亡率(未调整：CC，-0.09[95%CI，-0.68至0.57]；ARIMA调整后：CC，0.35[95%CI，-0.35至0.80]）。然而,滞后分析发现，SDI与较高的新生儿和早期新生儿死亡率相关，滞后2个月，但不是婴儿死亡率。SDI还与22至27周和28至32周的早产增加相关，滞后1个月。
■在国家卫生统计中心数据库的人口水平研究中，新生儿,早期新生儿，在最初的COVID-19大流行期间，婴儿死亡率没有增加。然而,大流行时期的社会距离措施与新生儿和早期新生儿死亡率较高之间存在关联，以及有滞后期的早产率，提示在大流行相关人群行为改变后监测婴儿健康结果的重要性。
