Impact of COVID-19 mandatory lockdown on maternal gestational weight gain and neonatal macrosomia rate at an academic medical center in Israel

Figures & data

Figure 1. Flow diagram describing all deliveries during the two periods in 2020 (Covid-19) and 2019 (unexposed), and number of deliveries included in the final analysis.

Table 1. Women demographic and obstetric variables during the COVID-19 lockdown period in 2020 compared to the control period in 2019.

Variable	Study period in 2020 (N = 2442)	Control period in 2019 (N = 2323)	p-value
Maternal age, mean ± SD, [median; IQR], years	29.9 ± 5.2^a [29.6; 25.9–33.4]	30.0 ± 5.4 [29.8; 25.9–34.0]	.38
Maternal age >35, No. (%), years	434 (17.8)^a	447 (19.2)	.19
Pre-gestational weight, mean ± SD, [median; IQR], Kg	65.0 ± 14.3 [63; 55–72]	64.3 ± 13.7 [62; 54–72]	.13
Pre-gestational body mass index, mean ± SD, [median; IQR], kg/m^2	24.6 ± 5.2 [23.7; 20.8–27.3]	24.37 ± 4.97 [23.3; 20.8–27.0]	.12
Pre-gestational body mass index >30, No. (%), kg/m^2	341 (14.0)	298 (12.8)	.27
Macrosomia in prior pregnancies, No. (%)	127 (5.2)	115 (5.0)	.70
Gravidity, mean ± SD, [median; IQR]	2.9 ± 1.8 [3; 1-4]	2.9 ± 1.8 [2; 1–4]	.78
Parity, mean ± SD, [median; IQR]	2.4 ± 1.4 [2; 1–3]	2.4 ± 1.4 [2; 1–3]	.96
Pre-gestational diabetes, No. (%)	24 (1.0)^a	19 (0.8)^a	.53

^aData on one observation is missing.

SD: standard deviation; IQR: interquartile range.

Table 2. Neonatal outcomes during the two study periods.

Outcome	Study period in 2020 (N = 2442)	Control period in 2019 (N = 2323)	p-value	OR [95%CI]
Macrosomia, No. (%)	152 (6.2)	114 (4.9)	.0480	1.29 [1.002–1.65]
Birthweight, mean ± SD, [median; IQR], gr	3330 ± 495 [3310; 3030-3610]	3245 ± 513 [3270; 2980-3580]	.001	N/A
Birthweight ≥ 95^th percentile, No. (%)	140 (5.7)	123 (5.3)	.54	1.09 [0.85–1.40]
Birthweight <2500 gr, No. (%)	113 (4.6)	136 (5.9)	.06	0.78 [0.60–1.01]
Male neonates, No. (%)	1263 (51.8)	1225 (52.7)	.51	1.04 [0.93–1.16]
Shoulder dystocia, No. (%)	7 (0.3)	9 (0.4)	.55	0.79 [0.28–1.99]
Apgar score < 7 at 1 min, No. (%)	53/2434 (2.2)	52/2319 (2.2)	.89	0.97 [0.66–1.43]
Apgar score < 7 at 5 min, No. (%)	19/2436 (0.8)	14/2318 (0.6)	.37	1.29 [0.65–2.59]
Cord artery ph < 7.1, No. (%)	54/2370 (2.3)	62/2199 (2.8)	.24	0.80 [0.56–1.16]

OR: odds ratio; CI: confidence interval; SD: standard deviation; IQR: interquartile range.

Table 3. Maternal outcomes during the two study periods.

Outcome	Study period in 2020 (N = 2442)	Control period in 2019 (N = 2323)	p-value	OR [95%CI]
Maternal weight at delivery,	76.8 ± 14.0	75.8 ± 13.8	.01	N/A
mean ± SD, [median; IQR], kg	[75; 67.0-85.0]	[74; 66.0-83.4]
Antepartum weight gain,	11.9 ± 6.6	11.5 ± 5.8	.008	N/A
mean ± SD, [median; IQR], kg	[12; 8-16]	[11; 8-15]
Body mass index at delivery,	29.1 ± 4.9	28.7 ± 4.9	.005	N/A
mean ± SD, [median; IQR], kg/m^2	[28.6; 25.6-32.0]	[28.1; 25.2–31.6]
Smoked during pregnancy, No. (%)	125 (5.1)	86 (3.7)	.02	1.40 [1.06–1.86]
Gestational diabetes, No. (%)	231 (9.5)	198 (8.5)	.26	1.12 [0.92–1.37]
GDMA1	148 (6.1)	130 (5.6)	.50	1.09 [0.85–1.40]
GDMA2	83 (3.4)	68 (2.9)	.35	1.17 [0.84–1.62]
Did not perform the test	241 (9.9)	173 (7.5)	.003	1.36 [1.11–1.67]
Gestational hypertension or preeclampsia, No. (%)	141 (5.8)	103 (4.4)	.042	1.32 [1.02–1.71]
Gestational age at delivery, mean ± SD, [median; IQR], weeks	39.3 ± 1.7 [39.6; 38.6–40.3]	39.2 ± 1.8 [39.4; 38.4–40.3]	.02	N/A
Delivery < 37, No. (%), weeks	147 (6.0)	141 (6.1)	.94	0.99 [0.78–1.26]
Delivery ≥ 41, No. (%), weeks	272 (11.1)	257 (11.1)	.93	1.01 [0.84–1.21]
Delivery mode			.56
Spontaneous vaginal, No. (%)	1937 (79.3)	1817 (78.2)		1.00 [reference]
Vacuum extraction, No. (%)	113 (4.6)	106 (4.6)		1.00 [0.76–1.31]
Cesarean, No. (%)	392 (16.1)	400 (17.2)		0.92 [0.79–1.07]
Cesarean delivery, No. (%)	392 (16.1)	400 (17.2)	.28	0.92 [0.79–1.07]
Postpartum hemorrhage, No. (%)	136 (5.6)	80 (3.4)	.001	1.65 [1.25–2.19]

OR: odds ratio; CI: confidence interval; SD: standard deviation. IQR: interquartile range; GDM: gestational diabetes mellitus.