The effect of the COVID‐19 pandemic on maternal health due to delay in seeking health care: Experience from a tertiary center

Goyal, Manu; Singh, Pratibha; Singh, Kuldeep; Shekhar, Shashank; Agrawal, Neha; Misra, Sanjeev

doi:10.1002/ijgo.13457

Cited by 210 publications

(289 citation statements)

References 10 publications

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“…Of 3592 abstracts screened, 192 were relevant for full-text review and 40 met the inclusion criteria for systematic review ( figure 1 ). 4 , 5 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 A list of excluded studies with reasons for exclusion is provided in the appendix (p 6) . Reporting on resource use or service reconfiguration outcomes is summarised in the appendix (p 27) .…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies 16 , 17 , 20 , 28 , 30 , 31 , 32 , 35 , 47 had a comparison group of annually matched periods from several preceding years ( table 1 ). 18 studies 4 , 5 , 13 , 14 , 18 , 21 , 22 , 25 , 26 , 27 , 29 , 36 , 37 , 41 , 43 , 44 , 46 , 48 had a comparison group from immediately before the lockdown period in the respective country. Exposed sample sizes varied from nine to 56 720 pregnancies ( table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Three studies 13 , 25 , 27 included data on maternal death, all of which reported an increase during the pandemic compared with before the pandemic, although this increase was statistically significant in only one study. 25 Two studies in which statistical analysis was done, from India and Mexico, were included in the meta-analysis (1 237 018 pregnancies during and 2 224 859 before the pandemic), which showed a significant increase in maternal death during the pandemic (OR 1·37 [95% CI 1·22–1·53]; I 2 =0%; table 3 , figure 2A ), with findings dominated by a single study.…”

Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Chmielewska

Barratt

Townsend

et al. 2021

The Lancet Global Health

802

820

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Background The COVID-19 pandemic has had a profound impact on health-care systems and potentially on pregnancy outcomes, but no systematic synthesis of evidence of this effect has been undertaken. We aimed to assess the collective evidence on the effects on maternal, fetal, and neonatal outcomes of the pandemic. Methods We did a systematic review and meta-analysis of studies on the effects of the pandemic on maternal, fetal, and neonatal outcomes. We searched MEDLINE and Embase in accordance with PRISMA guidelines, from Jan 1, 2020, to Jan 8, 2021, for case-control studies, cohort studies, and brief reports comparing maternal and perinatal mortality, maternal morbidity, pregnancy complications, and intrapartum and neonatal outcomes before and during the pandemic. We also planned to record any additional maternal and offspring outcomes identified. Studies of solely SARS-CoV-2-infected pregnant individuals, as well as case reports, studies without comparison groups, narrative or systematic literature reviews, preprints, and studies reporting on overlapping populations were excluded. Quantitative meta-analysis was done for an outcome when more than one study presented relevant data. Random-effects estimate of the pooled odds ratio (OR) of each outcome were generated with use of the Mantel-Haenszel method. This review was registered with PROSPERO (CRD42020211753). Findings The search identified 3592 citations, of which 40 studies were included. We identified significant increases in stillbirth (pooled OR 1·28 [95% CI 1·07–1·54]; I 2 =63%; 12 studies, 168 295 pregnancies during and 198 993 before the pandemic) and maternal death (1·37 [1·22–1·53; I 2 =0%, two studies [both from low-income and middle-income countries], 1 237 018 and 2 224 859 pregnancies) during versus before the pandemic. Preterm births before 37 weeks' gestation were not significantly changed overall (0·94 [0·87–1·02]; I 2 =75%; 15 studies, 170 640 and 656 423 pregnancies) but were decreased in high-income countries (0·91 [0·84–0·99]; I 2 =63%; 12 studies, 159 987 and 635 118 pregnancies), where spontaneous preterm birth was also decreased (0·81 [0·67–0·97]; two studies, 4204 and 6818 pregnancies). Mean Edinburgh Postnatal Depression Scale scores were higher, indicating poorer mental health, during versus before the pandemic (pooled mean difference 0·42 [95% CI 0·02–0·81; three studies, 2330 and 6517 pregnancies). Surgically managed ectopic pregnancies were increased during the pandemic (OR 5·81 [2·16–15·6]; I 2 =26%; three studies, 37 and 272 pregnancies). No overall significant effects were identified for other outcomes included in the quantitative analysis: maternal gestational diabetes; hypertensive disorders of pregnancy; preterm birth before 34 weeks', 32 weeks',...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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

Chmielewska

Barratt

Townsend

et al. 2021

The Lancet Global Health

802

820

View full text Add to dashboard Cite

show abstract

“…Efforts to prevent the spread of COVID-19, such as strict lockdowns, have affected the health-seeking behaviors of expecting mothers, for example, by reducing attendance at antenatal appointments (15,16).…”

Section: Introductionmentioning

confidence: 99%

Frequency and Source of Worries in An International Sample of Pregnant and Postpartum Women During the COVID-19 Pandemic

Wyszynski

Hernández–Dı́az

Gordon-Dseagu

et al. 2020

Preprint

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BackgroundPregnant and postpartum women face unique challenges and concerns during the COVID-19 pandemic. Thus far, no studies have explored the factors associated with increased levels of worry in this population globally. The current study sought to assess the frequency and sources of worry during the COVID-19 pandemic in an international sample of pregnant and postpartum women.MethodsWe conducted an anonymous, online, cross-sectional survey in 64 countries between May and June 2020. The survey was available in 12 languages and hosted on the Pregistry platform for COVID-19 studies. Participants were sought mainly on social media platforms and online parenting forums. The survey included questions related to demographics, level of worry, support, stress, COVID-19 exposure, frequency of media usage, and mental health indicators.ResultsThe study included 7,561 participants. Eighty-three percent of all participants indicated that they were either ‘somewhat’ or ‘very’ worried. Women 13-28 weeks pregnant were significantly more likely to indicate that they were ‘very worried’ compared to those who were postpartum or at other stages of pregnancy. When compared with women living in Europe, those in Africa, Asia and Pacific, North America and South/Latin America were more likely to have increased levels of worry, as were those who more frequently interacted with social media. Different forms of support and stress also had an impact upon level of worry, while indicators of stress and anxiety were positively associated with worry level.ConclusionPregnant and postpartum women are vulnerable to the changes in societal norms brought about by the COVID-19 pandemic. Understanding the factors associated with levels of worry within this population will enable society to address potential unmet needs and improve the current and future mental health of parents and children.

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Social Distancing During the COVID-19 Pandemic and Neonatal Mortality in the US

Shukla,

Weaver,

Singh

et al. 2024

JAMA Netw Open

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ImportanceNeonatal mortality is a major public health concern that was potentially impacted by the COVID-19 pandemic. To prepare for future health crises, it is important to investigate whether COVID-19 pandemic–related interventions were associated with changes in neonatal mortality.ObjectiveTo investigate whether social distancing during the pandemic was associated with a higher neonatal mortality rate.Design, Setting, and ParticipantsThis cohort study examined maternal-linked birth and infant death records from the National Center for Health Statistics, a population-level US database, from 2016 through 2020. The mortality rates were correlated using machine learning–based autoregressive integrated moving average (ARIMA) models with the social distancing index (SDI). The reference period was January 2016 through February 2020, and the pandemic period was March through December 2020. Statistical analysis was performed from March 2023 to May 2024.ExposuresSDI, computed from 6 mobility metrics.Main Outcomes and MeasuresThe primary outcome was neonatal mortality rate, defined as death at age less than 28 days.ResultsThe study included 18 011 173 births, of which 15 136 596 were from the reference period (7 753 555 [51.22%] male; 11 643 094 [76.92%] with maternal age of 20 to 34 years) and 2 874 577 were from the pandemic period (1 472 539 [51.23%] male; 2 190 158 [76.19%] with maternal age of 20 to 34 years). Through ARIMA-adjusted analyses, accounting for the declining mortality trend in the reference period, the mortality rates during the pandemic period did not significantly differ from the expected rates. SDI did not exhibit significant correlations with neonatal mortality (unadjusted: correlation coefficient [CC], 0.14 [95% CI, −0.53 to 0.70]; ARIMA adjusted: CC, 0.29 [95% CI, −0.41 to 0.77]), early neonatal mortality (unadjusted: CC, 0.33 [95% CI, −0.37 to 0.79]; ARIMA adjusted: CC, 0.45 [95% CI, −0.24 to 0.84]), and infant mortality (unadjusted: CC, −0.09 [95% CI, −0.68 to 0.57]; ARIMA adjusted: CC, 0.35 [95% CI, −0.35 to 0.80]). However, lag analyses found that SDI was associated with higher neonatal and early neonatal mortality rates with a 2-month lag period, but not with infant mortality rate. SDI was also associated with increases in 22-to-27 weeks’ and 28-to-32 weeks’ preterm delivery with a 1-month lag period.Conclusions and RelevanceIn this population-level study of National Center for Health Statistics databases, neonatal, early neonatal, and infant mortality rates did not increase during the initial COVID-19 pandemic period. However, associations were observed between the pandemic period social distancing measures and higher rates of neonatal and early neonatal mortality, as well as preterm birth rate with a lag period, suggesting the importance of monitoring infant health outcomes following pandemic-related population behavior changes.

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The effect of the COVID‐19 pandemic on maternal health due to delay in seeking health care: Experience from a tertiary center

Abstract: There are indirect adverse effects of COVID-19 on maternal health as the rate of complications increases.

Cited by 210 publications

References 10 publications

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

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

Frequency and Source of Worries in An International Sample of Pregnant and Postpartum Women During the COVID-19 Pandemic

Social Distancing During the COVID-19 Pandemic and Neonatal Mortality in the US

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