Impact of covid 19 pandemic on severe maternal outcomes -An observational study from a referral institute of India

Introduction: Covid 19 pandemic has taken the world by storm. As far as maternal health is concerned, it has been affected both directly and indirectly. Not only are the women getting affected by COVID disease but also the health services are suffering in terms of availability, approachability and a...

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Main Authors: Geetika Thakur, Aashima Arora, Pooja Sikka, Vanita Jain
Format: Article
Language:English
Published: Elsevier 2022-09-01
Series:Clinical Epidemiology and Global Health
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2213398422001634
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author Geetika Thakur
Aashima Arora
Pooja Sikka
Vanita Jain
author_facet Geetika Thakur
Aashima Arora
Pooja Sikka
Vanita Jain
author_sort Geetika Thakur
collection DOAJ
description Introduction: Covid 19 pandemic has taken the world by storm. As far as maternal health is concerned, it has been affected both directly and indirectly. Not only are the women getting affected by COVID disease but also the health services are suffering in terms of availability, approachability and access. The study aimed to analyze the change in the trends of maternal near and maternal mortality comprising severe maternal outcome (SMO) between 2019 and 2020 in the department of obstetrics and gynaecology of our hospital due to COVID pandemic. Methods: This retrospective study was conducted in the Obstetrics and Gynaecology department of Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. The maternal death review data and maternal near miss statistics were analysed. This included assessing the change in the number of maternal deaths and obstetric near miss, their respective causes, and case fatality rate specific to COVID during pregnancy. Results: The total births decreased from 6056 in 2019–4140 in 2020 whereas women with severe maternal outcomes increased from 4.6% in 2019 to 6.5% in 2020(p value < 0.001). The incidence of nearmiss increased significantly from 3.5% in 2019 to 5.1% in 2020(p value < 0.0001) and maternal mortality ratio increased from 1122 per 1 lakh births to 1425 per 1 lakh births. Haemorrhage was the most common cause of maternal near miss with 45.8% in 2019 and an increase to 50.2% in 2020. The percentage of illiterate patients with near miss statistically reduced in 2020(p value - 0.004). Average hospital stay also reduced from 16.5+/-2.1 days to 12.6+/-6.3 days (p value < 0.0001). The average time taken to reach the hospital, however, increased from 27+/-3 h to 36+/-4 h (p value < 0.0001). The rate of direct maternal deaths increased from 45.6% to 52.5% between 2019 and 2020(p-value-0.434). Conclusion: Covid 19 pandemic has affected both maternal mortality and morbidity. Keeping the current situation in mind, it becomes increasingly important to develop patient education via electronic media and teleconsultations. One-stop portals and helplines which involve multidisciplinary teams should be available to all such pregnancies.
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spelling doaj.art-4e9941be7fa24afb89445d571c46e70c2022-12-22T02:53:37ZengElsevierClinical Epidemiology and Global Health2213-39842022-09-0117101121Impact of covid 19 pandemic on severe maternal outcomes -An observational study from a referral institute of IndiaGeetika Thakur0Aashima Arora1Pooja Sikka2Vanita Jain3Corresponding author. Dept. Of Obstetrics and Gynaecology, PGIMER, Sector 12, Chandigarh, India.; Dept. of Obstetrics and Gynaecology, PGIMER, Chandigarh, IndiaDept. of Obstetrics and Gynaecology, PGIMER, Chandigarh, IndiaDept. of Obstetrics and Gynaecology, PGIMER, Chandigarh, IndiaDept. of Obstetrics and Gynaecology, PGIMER, Chandigarh, IndiaIntroduction: Covid 19 pandemic has taken the world by storm. As far as maternal health is concerned, it has been affected both directly and indirectly. Not only are the women getting affected by COVID disease but also the health services are suffering in terms of availability, approachability and access. The study aimed to analyze the change in the trends of maternal near and maternal mortality comprising severe maternal outcome (SMO) between 2019 and 2020 in the department of obstetrics and gynaecology of our hospital due to COVID pandemic. Methods: This retrospective study was conducted in the Obstetrics and Gynaecology department of Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. The maternal death review data and maternal near miss statistics were analysed. This included assessing the change in the number of maternal deaths and obstetric near miss, their respective causes, and case fatality rate specific to COVID during pregnancy. Results: The total births decreased from 6056 in 2019–4140 in 2020 whereas women with severe maternal outcomes increased from 4.6% in 2019 to 6.5% in 2020(p value < 0.001). The incidence of nearmiss increased significantly from 3.5% in 2019 to 5.1% in 2020(p value < 0.0001) and maternal mortality ratio increased from 1122 per 1 lakh births to 1425 per 1 lakh births. Haemorrhage was the most common cause of maternal near miss with 45.8% in 2019 and an increase to 50.2% in 2020. The percentage of illiterate patients with near miss statistically reduced in 2020(p value - 0.004). Average hospital stay also reduced from 16.5+/-2.1 days to 12.6+/-6.3 days (p value < 0.0001). The average time taken to reach the hospital, however, increased from 27+/-3 h to 36+/-4 h (p value < 0.0001). The rate of direct maternal deaths increased from 45.6% to 52.5% between 2019 and 2020(p-value-0.434). Conclusion: Covid 19 pandemic has affected both maternal mortality and morbidity. Keeping the current situation in mind, it becomes increasingly important to develop patient education via electronic media and teleconsultations. One-stop portals and helplines which involve multidisciplinary teams should be available to all such pregnancies.http://www.sciencedirect.com/science/article/pii/S2213398422001634COVID-19Severe maternal outcome(SMO)Maternal mortalityMaternal near miss(MNM)
spellingShingle Geetika Thakur
Aashima Arora
Pooja Sikka
Vanita Jain
Impact of covid 19 pandemic on severe maternal outcomes -An observational study from a referral institute of India
Clinical Epidemiology and Global Health
COVID-19
Severe maternal outcome(SMO)
Maternal mortality
Maternal near miss(MNM)
title Impact of covid 19 pandemic on severe maternal outcomes -An observational study from a referral institute of India
title_full Impact of covid 19 pandemic on severe maternal outcomes -An observational study from a referral institute of India
title_fullStr Impact of covid 19 pandemic on severe maternal outcomes -An observational study from a referral institute of India
title_full_unstemmed Impact of covid 19 pandemic on severe maternal outcomes -An observational study from a referral institute of India
title_short Impact of covid 19 pandemic on severe maternal outcomes -An observational study from a referral institute of India
title_sort impact of covid 19 pandemic on severe maternal outcomes an observational study from a referral institute of india
topic COVID-19
Severe maternal outcome(SMO)
Maternal mortality
Maternal near miss(MNM)
url http://www.sciencedirect.com/science/article/pii/S2213398422001634
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AT poojasikka impactofcovid19pandemiconseverematernaloutcomesanobservationalstudyfromareferralinstituteofindia
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