Change in obstetric attendance and activities during the COVID-19 pandemic

Abstract

care-seeking observed in the general UK population during the COVID-19 pandemic. 5,6 However, the absence of data from years before 2019 limits the model's capability to capture seasonality. We cannot rule out that the observed trend was present before the beginning of the pandemic.We believe there is an urgent need to evaluate maternity service delivery, care-seeking, and pregnancy outcomes nationally, so as to plan for both immediate post-pandemic care and future health system shocks.We declare no competing interests.

Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis

“…On the basis of 11 studies, 14 , 15 , 18 , 21 , 26 , 30 , 31 , 32 , 33 , 38 , 46 there was no significant change in the rate of spontaneous vaginal delivery (OR 0·98 [95% CI 0·93–1·02]; I 2 =25%; appendix p 51 ) during versus before the pandemic. 17 studies, 6 , 14 , 15 , 18 , 19 , 21 , 25 , 26 , 30 , 31 , 32 , 33 , 38 , 42 , 45 , 46 , 49 including 48 550 pregnancies during and 67 442 before the pandemic, showed no significant change in caesarean section rate (1·03 [0·99–1·07]; I 2 =46%; table 3 , appendix p 52 ), with consistent findings when subdivided into HICs and LMICs. Additionally, on the basis of seven studies, 14 , 18 , 19 , 21 , 30 , 31 , 32 rates of instrumental delivery did not differ during versus before the pandemic (1·06 [0·97–1·15]; I 2 =0%; table 3 , appendix p 53 ).…”

“…Although maternal anxiety was consistently shown to be increased during the pandemic, health-care providers around the world have reported reduced attendance for routine 6 , 13 , 15 , 52 , 53 , 54 , 55 and unscheduled pregnancy care. 6 , 12 , 13 , 15 , 19 , 56 This reduction could be driven by concern about the risk of acquiring COVID-19 in health-care settings, governmental advice to stay at home, or reduced public transport and childcare access during lockdowns. 13 , 52 In HICs, much of routine care was rapidly restructured and delivered remotely using diverse models, including telephone or video-based appointments.…”

“… 4 , 5 A reduction in health-care-seeking behaviour, as well as reduced provision of maternity services, has been suggested as a possible cause. 6 Robust estimates of the indirect maternal health effects of the pandemic can be derived from historical cohorts by examining the change in outcomes and calculating the excess event rate. 7 This before–after approach applied to key pregnancy outcomes can be used to estimate the indirect effects of the COVID-19 pandemic.…”

Global changes in maternity care provision during the COVID-19 pandemic: A systematic review and meta-analysis

“…2b). 23,24,31,36,39,68,71 In the two studies that reported the outcome, from Israel and Italy, the associated risk of hospital admission amongst 1042 pregnant women who presented at the emergency department significantly increased, by 214% (pooled RR 1214, 95% CI: 1118À1319, I 2 =0%, P<0.0001) (Table 4, Fig. 2c) [68,71].…”

Obstetric anaesthesia as a career

“…COVID-19 pandemic did not significantly affect the delivery rate. [ 23 ] Challenges to the obstetric anaesthetists in the current COVID-19 pandemic include the high incidence of asymptomatic carriers among the pregnant women and those in the incubation period. [ 24 ] Though the rate of cross-transmission of COVID-19 to healthcare workers with neuraxial anaesthesia is less, the health care workers can get exposed during labour epidural services, which require exposure to the patient multiple times.…”