Effect of inadequate antenatal care during the pandemic on maternal and fetal outcomes

Year 2022, Volume: 39 Issue: 2, 420 - 423, 18.03.2022

Zekiye Soykan Sert

Abstract

Objectives: To evaluate the effects of inadequate antenatal care (ANC) caused by the COVID-19 pandemic on pregnant women.
Methods: In this retrospective study, pregnant women were divided into two groups as those presenting during the pandemic and non-pandemic periods. The pandemic period was selected as March 11, 2020- December 10, 2020 and the pre-pandemic period as March 11, 2019- December 10, 2019 corresponding to the same period a year earlier. Pregnant women receiving ANC three times or less was defined as inadequate ANC. The pregnant women were evaluated in terms of obstetric complications, including premature rupture of membranes, premature birth, placental abruption. gestational diabetes mellitus (GDM), preeclampsia, fetal or neonatal death, and maternal death.
Results: The study included 276 patients presenting during the pandemic period and 229 patients presenting during the non-pandemic period. When the pandemic and non-pandemic periods were compared, it was determined that the rates of fetal death, preeclampsia and GDM statistically significantly increased in the former. The rate of adequate ANC was 72.5% (n=166) in the non-pandemic period and 58.3% (n=161) in the pandemic period. When pregnancy complications were compared according to ANC during the pandemic, it was observed that the rates of fetal death, preeclampsia and GDM were higher among the pregnant women with inadequate ANC.
Conclusion: Complications due to inadequate ANC may have more significant consequences than complications caused by a possible COVID-19 infection. During the pandemic period, healthcare professionals should ensure that women receive safe and effective care during both pregnancy and childbirth.

Keywords

Antenatal care, pandemic period, complications, pregnancy

Supporting Institution

YOK

Project Number

2020/13-42

Thanks

The authors thank all the participants in this study.

References

• 1. World Health Organization. WHO | New guidelines on antenatal care for a positive pregnancy experience. [cited 2018 Nov 29]. Available from: http://www.who.int/reproductivehealth/news/antenatal-care/en/.
• 2. World Health Organization, editor. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016. p. 152
• 3. Doğum Öncesi Bakım Yönetim Rehberi T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü Kadın ve Üreme Sağlığı Dairesi Başkanlığı Ankara, 2018.
• 4. T.C. Sağlık Bakanlığı. Stratejik plan 2013-2017. Ankara: T. C. Sağlık Bakanlığı; 2012.
• 5. T.C. Sağlık Bakanlığı. Ulusal anne ölümleri çalışması 2005. Ankara: Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, ICON-Institute Public Sector GmbH ve BNB Danışmanlık; 2006.
• 6. Hacettepe Üniversitesi Nüfus Etüdleri Enstitüsü (HÜNEE). Türkiye nüfus ve sağlık araştırması, 2008. Ankara: HÜNEE, Sağlık Bakanlığı AÇSAP Genel Müdürlüğü, Başbakanlık DPT Müsteşarlığı ve TÜBİTAK; 2009.
• 7. Nisingizwe MP, Tuyisenge G, Hategeka C, Karim ME. Are perceived barriers to accessing health care associated with inadequate antenatal care visits among women of reproductive age in Rwanda? BMC Pregnancy Childbirth. 2020;20(1):88.
• 8. WHO. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Interim guidance. [Internet]. Geneva: World Health Organization. [updated 2020 Mar 13; cited 2020 Mar 13]. Available from: https://apps.who.int/iris/handle/10665/331446
• 9. Yan J, Guo J, Fan C, Juan J, Yu X, Li J, et al. Coronavirus disease 2019 in pregnant women: a report based on 116 cases. Am J Obstet Gynecol 2020;223(1):111.e111-111.e114.
• 10. Dell'Utri C, Manzoni E, Cipriani S, Spizzico C, Dell'Acqua A, Barbara G, et al. Effects of SARS Cov-2 epidemic on the obstetrical and gynecological emergency service accesses. What happened and what shall we expect now? Eur J Obstet Gynecol Reprod Biol 2020;254:64-68.
• 11. Goyal M, Singh P, Singh K, Shekhar S, Agrawal N, Misra S. The effect of the COVID-19 pandemic on maternal health due to delay in seeking health care: Experience from a tertiary center. Int J Gynaecol Obstet 2021;152(2):231-235.
• 12. Gestational Diabetes Mellitus. ACOG Practice Bulletin. Practice Guideline Obstet Gynecol Practice Guideline Obstet Gynecol. Obstet Gynecol 2018; 131(2):e49-e64.
• 13. Rashidi Fakari F, Simbar M. Coronavirus Pandemic and Worries during Pregnancy; a Letter to Editor. Arch Acad Emerg Med 2020;8(1):e21.