UCLA

Objectives

To assess the relationship between COVID-19 mitigation measures and stillbirth, low birth weight (LBW), and preterm birth (PTB) in sub-Saharan Africa.

Study design

Systematic review/meta-analysis.

Methods

We searched six databases for literature indexed from January 2020 to December 2022 for studies examining COVID-19 policies and neonatal outcomes in sub-Saharan Africa. These studies were assessed for their risk of bias and described via narrative synthesis. Meta-analysis with random effects was performed to generate risk ratios (RRs) that were stratified by study scope to explore heterogeneity.

Results

Our search identified 515 unique studies, sixteen of which were included. Most studies were multi-/single-center examinations (n = 7) and national/regional investigations (n = 6). The stillbirth RR suggested a marginal increase during mitigation measures (RR: 1.13; 95 % CI: 0.97, 1.31); however, among national/regional studies, there was no increase (RR: 0.96; 95 % CI: 0.82, 1.14). Similarly, the LBW RR suggested an increase during mitigation measures (RR: 1.18; 95 % CI: 0.90, 1.56), but the RR among national/regional investigations indicated no increase (RR: 0.97; 95 % CI: 0.91, 1.04). For PTB, the RR indicated no increase during mitigation measures (RR: 1.00; 95 % CI: 0.94, 1.07); there were no differences between multi-/single-center examinations and national/regional investigations.

Conclusions

Our results suggest that outcome risk did not change after mitigation measures were imposed when focusing on national/regional investigations and provide insights for both African health officials and researchers.