TY - JOUR
T1 - Health care in pregnancy during the COVID-19 pandemic and pregnancy outcomes in six low- and-middle-income countries
T2 - Evidence from a prospective, observational registry of the Global Network for Women’s and Children’s Health
AU - Naqvi, Seemab
AU - Naqvi, Farnaz
AU - Saleem, Sarah
AU - Thorsten, Vanessa R.
AU - Figueroa, Lester
AU - Mazariegos, Manolo
AU - Garces, Ana
AU - Patel, Archana
AU - Das, Prabir
AU - Kavi, Avinash
AU - Goudar, Shivaprasad S.
AU - Esamai, Fabian
AU - Mwenchanya, Musaku
AU - Chomba, Elwyn
AU - Lokangaka, Adrien
AU - Tshefu, Antoinette
AU - Yousuf, Sana
AU - Bauserman, Melissa
AU - Bose, Carl L.
AU - Liechty, Edward A.
AU - Krebs, Nancy F
AU - Derman, Richard J.
AU - Carlo, Waldemar A.
AU - Hibberd, Patricia L.
AU - Billah, Sk Masum
AU - Peres-da-Silva, Nalini
AU - Haque, Rashidul
AU - Petri, William A.
AU - Koso-Thomas, Marion
AU - Nolen, Tracy
AU - McClure, Elizabeth M.
AU - Goldenberg, Robert L.
N1 - Publisher Copyright:
© 2022 John Wiley & Sons Ltd.
PY - 2022/7
Y1 - 2022/7
N2 - Objective: To assess, on a population basis, the medical care for pregnant women in specific geographic regions of six countries before and during the first year of the coronavirus disease 2019 (COVID-19) pandemic in relationship to pregnancy outcomes. Design: Prospective, population-based study. Setting: Communities in Kenya, Zambia, the Democratic Republic of the Congo, Pakistan, India and Guatemala. Population: Pregnant women enrolled in the Global Network for Women's and Children's Health's Maternal and Newborn Health Registry. Methods: Pregnancy/delivery care services and pregnancy outcomes in the pre-COVID-19 time-period (March 2019–February 2020) were compared with the COVID-19 time-period (March 2020–February 2021). Main outcome measures: Stillbirth, neonatal mortality, preterm birth, low birthweight and maternal mortality. Results: Across all sites, a small but statistically significant increase in home births occurred between the pre-COVID-19 and COVID-19 periods (18.9% versus 20.3%, adjusted relative risk [aRR] 1.12, 95% CI 1.05–1.19). A small but significant decrease in the mean number of antenatal care visits (from 4.1 to 4.0, p = <0.0001) was seen during the COVID-19 period. Of outcomes evaluated, overall, a small but significant decrease in low-birthweight infants in the COVID-19 period occurred (15.7% versus 14.6%, aRR 0.94, 95% CI 0.89–0.99), but we did not observe any significant differences in other outcomes. There was no change observed in maternal mortality or antenatal haemorrhage overall or at any of the sites. Conclusions: Small but significant increases in home births and decreases in the antenatal care services were observed during the initial COVID-19 period; however, there was not an increase in the stillbirth, neonatal mortality, maternal mortality, low birthweight, or preterm birth rates during the COVID-19 period compared with the previous year. Further research should help to elucidate the relationship between access to and use of pregnancy-related medical services and birth outcomes over an extended period.
AB - Objective: To assess, on a population basis, the medical care for pregnant women in specific geographic regions of six countries before and during the first year of the coronavirus disease 2019 (COVID-19) pandemic in relationship to pregnancy outcomes. Design: Prospective, population-based study. Setting: Communities in Kenya, Zambia, the Democratic Republic of the Congo, Pakistan, India and Guatemala. Population: Pregnant women enrolled in the Global Network for Women's and Children's Health's Maternal and Newborn Health Registry. Methods: Pregnancy/delivery care services and pregnancy outcomes in the pre-COVID-19 time-period (March 2019–February 2020) were compared with the COVID-19 time-period (March 2020–February 2021). Main outcome measures: Stillbirth, neonatal mortality, preterm birth, low birthweight and maternal mortality. Results: Across all sites, a small but statistically significant increase in home births occurred between the pre-COVID-19 and COVID-19 periods (18.9% versus 20.3%, adjusted relative risk [aRR] 1.12, 95% CI 1.05–1.19). A small but significant decrease in the mean number of antenatal care visits (from 4.1 to 4.0, p = <0.0001) was seen during the COVID-19 period. Of outcomes evaluated, overall, a small but significant decrease in low-birthweight infants in the COVID-19 period occurred (15.7% versus 14.6%, aRR 0.94, 95% CI 0.89–0.99), but we did not observe any significant differences in other outcomes. There was no change observed in maternal mortality or antenatal haemorrhage overall or at any of the sites. Conclusions: Small but significant increases in home births and decreases in the antenatal care services were observed during the initial COVID-19 period; however, there was not an increase in the stillbirth, neonatal mortality, maternal mortality, low birthweight, or preterm birth rates during the COVID-19 period compared with the previous year. Further research should help to elucidate the relationship between access to and use of pregnancy-related medical services and birth outcomes over an extended period.
KW - COVID-19
KW - Global Network
KW - health care
KW - low and middle-income countries
KW - pregnancy
UR - http://www.scopus.com/inward/record.url?scp=85132207367&partnerID=8YFLogxK
U2 - 10.1111/1471-0528.17175
DO - 10.1111/1471-0528.17175
M3 - Article
C2 - 35377514
AN - SCOPUS:85132207367
SN - 1470-0328
VL - 129
SP - 1298
EP - 1307
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
IS - 8
ER -
