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Perinatal and Postpartum Care During the COVID-19 Pandemic: A Nationwide Cohort Study
21 Pages Posted: 6 Jan 2021More...
Background: The coronavirus disease (COVID-19) pandemic limited services during pregnancy, labour, and childbirth that affected families worldwide. However, data on the effects of limiting obstetrical care during the pandemic’s first wave are sparse.
Methods: This nationwide cohort study analysed birth registry data from all obstetric departments in Austria. Women who delivered between January and June 2020 were classified as cases, whereas those who delivered between January and June 2015–2019 were classified as controls. We excluded data concerning preterm delivery, birthweight below 500 g, multiple fetuses, fetal malformations and chromosomal anomalies, intrauterine fetal death, maternal cancer, or HIV-infection, and inter-hospital transfers. Perinatal outcomes, postpartum hospitalisation and adverse events were assessed.
Findings: Of 33.198 cases and 188.225 controls, data analysis showed significantly increased rates of labour induction, instrumental delivery, obstetric anaesthesia, NICU transfer, and 5-min Apgar score below 7 during the COVID-19 period. There was a significantly shorter length of postpartum hospitalisation during the COVID-19 period compared to the non-COVID-19 period (3·1 ± 1·4 vs. 3·5 ± 1·5 days p< 0·001). Significantly more women opted for outpatient delivery during the COVID-19 period (3·7% vs. 2·4% p < 0·001). Those who delivered during the COVID-19 period were also more likely to experience postpartum adverse events (3·0% vs. 2·6% p < 0·001), which was confirmed in the logistic regression model (odds ratio, 2·137; 95% confidence interval, 1·805–2·530 p < 0·001).
Interpretation: Perinatal and postpartum care during the first wave of the COVID-19 pandemic differed significantly from that provided before. Increased rates of adverse events underline the need to ensure access to high-quality obstetrical care in order to prevent collateral damage.
Funding Statement: None.
Declaration of Interests: The authors report no conflict of interest in connection with this article.
Ethics Approval Statement: The study was approved by the Ethics Committee of the Medical University of Vienna (reference number 1637/2020). Due to the retrospective study design, patient informed consent was not required. All patient data were handled anonymously.
Keywords: adverse events, coronavirus, COVID-19, pandemic, postpartum, SARS-CoV-2
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