Impact of the Covid-19 pandemica on maternal and perinatal health at the Antonio Skrabonja Antoncich Hospital in Pisco, part of the Ica Essalud healthcare network. 2019-2021
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Abstract
The COVID-19 pandemic may have compromised the continuity of obstetric and neonatal care. The objective was to compare maternal and perinatal outcomes before and during the pandemic at the Antonio Skrabonja Antoncich Hospital I in Pisco, Peru. The methodology used was a retrospective, analytical, observational cohort study based on records of 1,409 women with singleton pregnancies and their newborns. The periods from March 2019 to February 2020 (n=769) and from March 2020 to February 2021 (n=640) were compared. Frequencies, odds ratios (OR), 95% confidence intervals, and the chi-square and logistic regression analyses described in the thesis were used. For perinatal mortality, an additional verification was performed using Fisher’s exact two-sided test based on the published counts. The results showed that maternal complications increased from 60.7% to 84.4% (OR=3.492; 95% CI: 2.698–4.519) and perinatal complications from 42.0% to 82.0% (OR = 6.304; 95% CI: 4.922–8.073). Higher rates of preeclampsia, maternal urinary tract infection, postpartum hemorrhage, jaundice, neonatal urinary tract infection, and neonatal sepsis were observed. Cesarean section rates were similar (44.9% and 44.5%; p=0.901). No maternal deaths were recorded. There was one perinatal death before the pandemic and six during it; Fisher’s exact test yielded p=0.051. Gestational weight gain ≤11 kg was associated with maternal complications during the pandemic (adjusted OR=2.009; 95% CI: 1.135–3.556). We conclude that the pandemic period was associated with a higher frequency of maternal and perinatal complications in this hospital population. The retrospective design and limitations of the registry prevent us from establishing causality or distinguishing the effects of infection from changes in healthcare.
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