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Perinatal and Postpartum Care During the COVID-19 Pandemic: A Nationwide Cohort Study

21 Pages Posted: 6 Jan 2021

See all articles by Michael Wagner

Michael Wagner

Department of Paediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care, an Neuropaediatrics, Comprehensive Center for Paediatrics, Medical University of Vienna

Veronica Falcone

Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Comprehensive Center for Paediatrics, Medical University of Vienna

Sabrina B. Neururer

Department of Clinical Epidemiology, Tyrolean Federal Institute for Integrated Care, Tirol Kliniken GmbH

Hermann Leitner

Department of Clinical Epidemiology, Tyrolean Federal Institute for Integrated Care, Tirol Kliniken GmbH

Irmgard Delmarko

Department of Clinical Epidemiology, Tyrolean Federal Institute for Integrated Care, Tirol Kliniken GmbH

Herbert Kiss

Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Comprehensive Center for Paediatrics, Medical University of Vienna

Angelika Berger

Medical University of Vienna

Alex Farr

Medical University of Vienna - Department of Obstetrics and Gynecology

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Abstract

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

Suggested Citation

Wagner, Michael and Falcone, Veronica and Neururer, Sabrina B. and Leitner, Hermann and Delmarko, Irmgard and Kiss, Herbert and Berger, Angelika and Farr, Alex, Perinatal and Postpartum Care During the COVID-19 Pandemic: A Nationwide Cohort Study. Available at SSRN: https://ssrn.com/abstract=3745111 or http://dx.doi.org/10.2139/ssrn.3745111

Michael Wagner

Department of Paediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care, an Neuropaediatrics, Comprehensive Center for Paediatrics, Medical University of Vienna ( email )

Veronica Falcone

Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Comprehensive Center for Paediatrics, Medical University of Vienna ( email )

Sabrina B. Neururer

Department of Clinical Epidemiology, Tyrolean Federal Institute for Integrated Care, Tirol Kliniken GmbH ( email )

Hermann Leitner

Department of Clinical Epidemiology, Tyrolean Federal Institute for Integrated Care, Tirol Kliniken GmbH ( email )

Irmgard Delmarko

Department of Clinical Epidemiology, Tyrolean Federal Institute for Integrated Care, Tirol Kliniken GmbH ( email )

Herbert Kiss

Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Comprehensive Center for Paediatrics, Medical University of Vienna ( email )

Angelika Berger

Medical University of Vienna

Vienna
Austria

Alex Farr (Contact Author)

Medical University of Vienna - Department of Obstetrics and Gynecology ( email )

Vienna
Austria

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