PHIRI Perinatal health case study report : Use case A, deliverable 6.1, 24.06.2022

the Euro-Peristat Network, Aline Lecomte, Audrey Billy, Guy Weber

Research output: Book/ReportCommissioned reportpeer-review


Executive summary
The COVID-19 pandemic adversely affects pregnancy outcomes when pregnant women and their newborns are infected by the SARS-CoV-2 virus. Adverse perinatal outcomes may also be indirect and occur because of disrupted healthcare provision and increased stress, anxiety and economic hardship linked to COVID-19 disease or to lockdown and other mitigation measures. While clinical studies provide reliable evidence of the direct effects of COVID-19 on pregnancy outcomes, surveillance and analysis of maternal and newborn health indicators at the population level are essential for investigating the pandemic’s indirect effects. Having comparable data from different countries enhances the relevance and value of a population approach because outcomes can be contrasted by the level of circulation of the virus as well as varying societal mitigation policies. Data from different countries can also be combined to more rapidly detect signals of adverse effects for uncommon outcomes.
As part of the PHIRI (Population Health Information Research Infrastructure) project, we (1) assessed the availability of population data on maternal and newborn health in Europe for the evaluation of the impact of the COVID-19 pandemic; (2) developed a protocol to facilitate the exchange of data in Europe based on a federated analytical model and (3) implemented this protocol to assess changes in perinatal outcomes in 2020 in comparison to previous years.

Key points
This study illustrates the feasibility of a federated approach for the rapid production of data and subsequent analysis of key perinatal health indicators in a large number of European countries.
This model provides a roadmap for a health information system to monitor and evaluate the health of European pregnant women and their newborns. These results can also elucidate capacity building priorities in countries that could not provide data or did not have all items in the common data model.
Overall, the key perinatal health indicators in many European countries did not show major changes in 2020 despite the disruption to health care and normal daily life due to the COVID-19 pandemic. However, available data only allow reliable analyses of the period from March to September of 2020 and continued surveillance is required.
During this period, the preterm birth rates decreased by between 4 to 8% in some countries, which may reflect restricted health care provision and fewer medically indicated births or other potentially positive indirect effects of the pandemic (for example, more rest, less pollution). In contrast, several countries had significant increases in stillbirth rates and slight increases were observed in a larger number of countries. Pooling these effects on the European level and exploring the underlying reasons for the heterogeneity in observed trends in 2020 are planned in future analyses.
Original languageEnglish
PublisherINSERM and the Euro-Peristat Network
Number of pages114
Publication statusPublished - Dec 2023


  • public health report


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