<scp>COVID</scp>‐19 and stillbirth: direct <i>vs</i> indirect effect of the pandemic

Khalil, Asma; Blakeway, Helena; Samara, Athina; O’Brien, Pat

doi:10.1002/uog.24846

Cited by 11 publications

(6 citation statements)

References 73 publications

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“…19 In the present study, MNCWH services that were linked to clinical care provision were less disrupted than 22 Stillbirth numbers increased significantly during the first pandemic year, in line with international research done by Khalil and colleagues. 23 However, unlike many other indicators studied in this research, the noticeable spikes coincided with the first and second COVID-19 waves, rather than with lockdown periods. It is unclear whether this was due to maternal SARS-CoV-2 infection, or the additional strain on healthcare resources during times of increased infections and admissions.…”

Section: Discussioncontrasting

confidence: 56%

Effect of the COVID-19 pandemic on women’s, maternal and child health services in Tshwane District, South Africa

Kruger,

Letebele-Hartell,

Tshukudu

et al. 2023

South African Health Review

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Background The COVID-19 pandemic severely impacted healthcare service delivery globally. The aim of this study was to assess effects of the COVID-19 pandemic on the uptake of routine healthcare services related to maternal, newborn, child, and women’s health (MNCWH) in Tshwane District, an urban locality in Gauteng Province, South Africa. Methods As part of the observational Tshwane Maternal-Child COVID-19 study, routine data sources, including the District Health Information System and other district-based datasets, were studied from April 2019 to March 2022, to describe the impact of the first four COVID-19 waves in Tshwane District. The year pre-pandemic was used as a baseline. Data included MNCWH data elements/indicators, child health data elements/indicators, and COVID-19 surveillance data. Data analysis included descriptive statistics, together with visual analysis of trends over time. Statistical investigation included testing of differences between data from the pre-pandemic year (as baseline) and data from the following two pandemic years (2020/2021 and 2021/2022), as per the National Department of Health’s financial years (from April to March of the following year). Results Multiple MNCWH health elements/indicators showed major decreases during the COVID-19 pandemic period, with preventive services rendered at primary healthcare and community level more severely affected than facility-based clinical services. The most significant decreases were recorded during the first pandemic year, most notably during the first strict lockdown period, with partial or complete recovery in the second pandemic year, while selected indicators saw large impacts during the actual COVID-19 waves. Conclusions The COVID-19 pandemic severely impacted the ability of women and children to access healthcare services in this large urban district in South Africa. Health system strengthening measures and adequate planning for future emergency situations are crucial to mitigate the negative impact on maternal and child health, as South Africa strives to move towards reaching its Sustainable Development Goals.

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Section: Discussioncontrasting

confidence: 56%

Effect of the COVID-19 pandemic on women’s, maternal and child health services in Tshwane District, South Africa

Kruger,

Letebele-Hartell,

Tshukudu

et al. 2023

South African Health Review

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“…This may be due to referral bias; however, the proportional causes of stillbirth are still likely to reflect the national rate. Furthermore, the COVID-19 pandemic is likely to have increased these numbers and gaps in care, in keeping with data from other areas of the world 33–36…”

Section: Discussionmentioning

confidence: 57%

Incidence and causes of stillbirth in the only tertiary referral hospital in the Solomon Islands: a hospital-based retrospective cohort study

Silva

Panisi²,

Manubuasa³

et al. 2022

BMJ Open

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ObjectivesStillbirth is a major global health issue, which disproportionately affects families living in low-income and middle-income countries. The Solomon Islands is a Pacific nation with poor perinatal outcomes, however research investigating stillbirth is lacking. Thus, we aimed to investigate the incidence and cause of stillbirth occurring at the National Referral Hospital, Solomon Islands.DesignWe conducted a retrospective cohort study from January 2017 to December 2018.SettingAt the only tertiary referral hospital in the Solomon Islands, on the main island of Guadalcanal.ParticipantsAll births occurring in the hospital during the study period.Outcome measuresNumber of, causes and risk factors for stillbirths (fetal deaths before birth at ≥20 estimated gestational weeks, or ≥500 g in birth weight).ResultsOver 2 years 341 stillbirths and 11 056 total births were recorded, giving an institutional incidence of 31 stillbirths per 1000 births. Of the cases with a recorded cause of death, 72% were deemed preventable. Most stillbirths occurred antenatally and 62% at preterm gestations (<37 weeks). 59% had a birth weight below 2500 g and preventable maternal conditions were present in 42% of the cases. 46% of the cases were caused by an acute intrapartum event, and among these 92% did not receive intrapartum monitoring.ConclusionsStillbirth affects 31 in every 1000 births at the National Referral Hospital in the Solomon Islands and many cases are preventable. Our findings highlight the urgent need for increased focus on perinatal deaths in the Solomon Islands with universal classification and targeted training, improved quality of obstetrical care and community awareness.

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“…A more recent study (2018) reports an Odds Risk of 4.51 (95% CI 2.38 to 8.55) [ 105 ]. When comparing the rate of stillbirth in infected SARS-CoV-2 women to those uninfected, an adjusted relative risk of 1.90 was reported ([aRR] = 1.90; 95% CI = 1.69–2.15) [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Despite this, the correlation between the newborn’s infective status and in-utero infection was not studied. A more concerning aspect is the higher rate of intrauterine fetal demise (IUFD) in case of maternal infection; its causes are still not thoroughly studied [ 26 ]. Although still premature, some studies claim long-term neurodevelopmental and ophthalmologic sequelae in infants born from mothers infected with the coronavirus during pregnancy [ 27 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

Maternal Fever and Reduced Fetal Movement as Predictive Risk Factors for Adverse Neonatal Outcome in Cases of Congenital SARS-CoV-2 Infection: A Meta-Analysis of Individual Participant Data from Case Reports and Case Series

Bernad,

Duica,

Antoniadis

et al. 2023

Viruses

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Objectives: To determine risk factors for primary and secondary adverse neonatal outcomes in newborns with congenital SARS-CoV-2 infection.Data sources:PubMed/MEDLINE and Google Scholar from January 2020 to January 2022.Study eligibility criteria: newborns delivered after 24 weeks of gestation with confirmed/possible congenital SARS-CoV-2 infection, according to standard classification criteria.Methods: Execution of the IPD analyses followed the PRISMA-IPD statement. Univariate non-parametric tests compared numerical data distributions. Fisher’s exact or Chi-square test determined categorical variables’ statistical significance. Multivariate logistic regression revealed risk factors for adverse neonatal outcome.Results:Maternal fever was associated with symptomatic congenital infection (OR: 4.55, 95% CI:1.33–15.57). Two-thirds of women that reported decreased fetal movements were diagnosed with IUFD (p-value = 0.001). Reduced fetal movement increased the risk of intrauterine fetal death by 7.84 times (p-value = 0.016, 95% CI: 2.23–27.5). The risk of stillbirth decreased with gestational age at the time of maternal infection (p-value < 0.05, OR: 0.87, 95% CI: 0.79–0.97). Conclusions:Maternal fever and perception of reduced fetal movement may be predictive risk factors for adverse pregnancy outcome in cases with congenital SARS-CoV-2 infection.

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COVID‐19 and stillbirth: direct vs indirect effect of the pandemic

Cited by 11 publications

References 73 publications

Effect of the COVID-19 pandemic on women’s, maternal and child health services in Tshwane District, South Africa

Effect of the COVID-19 pandemic on women’s, maternal and child health services in Tshwane District, South Africa

Incidence and causes of stillbirth in the only tertiary referral hospital in the Solomon Islands: a hospital-based retrospective cohort study

Maternal Fever and Reduced Fetal Movement as Predictive Risk Factors for Adverse Neonatal Outcome in Cases of Congenital SARS-CoV-2 Infection: A Meta-Analysis of Individual Participant Data from Case Reports and Case Series

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