Association between earthquakes and perinatal outcomes: A systematic review and meta-analysis

BackgroundEvidence for the association between earthquakes and adverse perinatal outcomes is limited.ObjectivesTo evaluate the association between earthquakes and perinatal outcomes including preterm birth and low birth weight.Search StrategyWe searched studies using MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, World Health Organization International Clinical Trials Platform Search Portal, and on February 9, 2023.Selection CriteriaWe included before-and-after studies that evaluated the associations between earthquakes and perinatal outcomes in women living in affected areas.Data Collection and AnalysisTwo independent reviewers extracted data. We calculated the pooled odds ratio (OR) with the random-effects model. We analyzed outcomes in subgroups of Asians and others. We evaluated the certainty of evidence with the Grading of Recommendations Assessment, Development and Evaluation system.Main ResultsWe included 2 607 405 women in 13 studies. Earthquakes may not increase preterm birth (nine studies, 1 761 760 participants: OR 1.10, 95% confidence interval [CI] 0.98-1.24, low certainty of evidence) or low birth weight (seven studies, 1 753 891 participants: OR 1.10, 95% CI 0.94-1.28, low certainty of evidence). Subgroup analyses showed that earthquakes may be associated with an increase of preterm birth among populations in Asia (OR 1.44, 95% CI 1.07-1.95), but this was not evident in others (OR 0.93, 95% CI 0.83-1.05).ConclusionsPerinatal outcomes might not change after earthquakes. Further research on the association between earthquakes and perinatal outcomes, combined with an assessment of the characteristics of the region, is needed. Preterm birth and low birth weight might not change after earthquakes. However, earthquakes may be associated with an increase of preterm birth in Asia.