The impact of the Covid-19 pandemic on maternity services: A review of maternal and neonatal outcomes before, during and after the pandemic

Abstract

Highlights No negative impact on maternal or neonatal outcomes during the course of pandemic A decrease in preterm birth rate was found during the Covid-19 pandemic During the peak of the pandemic, there were less disclosures of domestic violence

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

“…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) .…”

“…Of the 40 included studies, 31 for which comparable outcomes were also reported in at least one other study were included in the meta-analysis. 4 , 12 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 24 , 25 , 26 , 27 , 28 , 30 , 31 , 32 , 33 , 34 , 37 , 38 , 40 , 42 , 45 , 46 , 47 , 48 , 49 Table 1 shows the characteristics of the 40 included studies, all of which used a historical cohort design. 17 countries were represented, with substantial variation in pandemic mitigation measures among countries.…”

“…17 countries were represented, with substantial variation in pandemic mitigation measures among countries. No study reported data from countries in the lowest WHO Healthcare Efficiency Index quartile, and the majority (28 studies) 4 , 5 , 12 , 14 , 16 , 17 , 19 , 20 , 22 , 23 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 39 , 40 , 42 , 44 , 45 , 46 , 48 , 49 reported data from countries in the highest quartile ( table 2 ). 21 of the 31 studies included in the quantitative analysis were from high-income countries (HICs) according to the World Bank classification.…”

“…21 of the 31 studies included in the quantitative analysis were from high-income countries (HICs) according to the World Bank classification. 4 , 12 , 14 , 16 , 17 , 19 , 20 , 23 , 28 , 30 , 31 , 32 , 33 , 34 , 42 , 45 , 46 , 49 The reported outcomes and outcome measures are listed with the relevant studies in the appendix (p 31) .

Figure 1 PRISMA flow chart

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“…The main weaknesses were inconsistent definition and reporting of outcomes, inconsistency in selection of control groups, and retrospective study design. For example, although 18 papers 4 , 5 , 14 , 15 , 16 , 17 , 19 , 20 , 21 , 26 , 28 , 30 , 31 , 32 , 33 , 38 , 47 , 49 reported on preterm birth, variation in the gestational age cutoffs and use of ranges limited their comparability.…”