Did the COVID-19 pandemic have an impact on pregnant women's participation in routine antenatal care and on pregnancy and neonatal outcomes? Impact of COVID-19 on antenatal care and pregnancy outcomes

Murat Gözüküçük; Özge Saygılı Irhan; Sena Münire Kaya Kaya; Süheyla Aydoğmuş; Yusuf Üstün

doi:10.28982/josam.8274

Authors

Murat Gözüküçük University of Health Sciences, Ankara Training and Education Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey https://orcid.org/0000-0002-4418-7570
Özge Saygılı Irhan University of Health Sciences, Ankara Training and Education Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey https://orcid.org/0000-0002-6866-2305
Sena Münire Kaya Kaya University of Health Sciences, Ankara Training and Education Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey https://orcid.org/0000-0002-7213-5022
Süheyla Aydoğmuş University of Health Sciences, Ankara Training and Education Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey https://orcid.org/0000-0003-3441-4597
Yusuf Üstün University of Health Sciences, Ankara Training and Education Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey https://orcid.org/0000-0003-1529-2555

DOI:

https://doi.org/10.28982/josam.8274

Keywords:

Antenatal care, COVID-19, Pandemic

Abstract

Background/Aim: The COVID-19 pandemic disrupted healthcare systems, affecting pregnant women's access to routine antenatal care. Changes in health policies and heightened anxiety may have influenced care utilization and outcomes. This study aimed to assess the pandemic's impact on antenatal attendance and compare pregnancy and neonatal outcomes with the pre-pandemic period in a tertiary center.

Methods: We retrospectively included all women who delivered at Ankara Training and Research Hospital between September 2020 and January 2021 (pandemic period) and those who delivered between September 2019 and January 2020 (pre-pandemic control). Pregnancies with any documented SARS-CoV-2 infection were excluded. Demographics, number of antenatal visits, antenatal screening tests, obstetric complications, and perinatal outcomes were compared.

Results: A total of 532 women delivered during the pandemic and 650 before the pandemic. The cesarean section rate was higher during the pandemic (40.4% vs 33.8%; P=0.020), with a higher primary cesarean rate (18.4% vs 11.2%; P<0.001). Antenatal visit categories were <4, 4–10, and >10 visits for pandemic vs pre-pandemic groups as follows: 39.4% vs 38.5%, 36.8% vs 42.1%, and 23.8% vs 19.4%, respectively (overall comparison P=0.087). While not statistically significant, there was a trend toward fewer women having 4–10 visits and more having >10 visits during the pandemic. Antenatal screening tests (Down syndrome screening, gestational diabetes screening, and second-trimester anomaly screening) were performed more frequently during the pandemic (all P<0.05). The mean gestational age at delivery was higher during the pandemic (39.25 (1.42) vs 38.65 (2.84) weeks; P<0.001), with fewer preterm (<37 weeks) births and more post-term (>41 weeks) births (P=0.012). Other neonatal outcomes were comparable, except for a small but statistically significant difference in 1-minute Apgar scores (9.02 (0.71) vs 9.10 (1.19); P=0.001).

Conclusion: During the pandemic, overall antenatal attendance did not differ significantly from the pre-pandemic period, although screening tests were utilized more frequently and cesarean delivery was more common. Despite these changes, pregnancy and neonatal outcomes were largely similar between periods.

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