Differences in obstetric healthcare utilization and delivery complications before and after the COVID-19 pandemic – a retrospective study

Abstract

Purpose

To investigate the effect of the COVID-19 pandemic on healthcare utilization related to labor and delivery and to assess the effect of the COVID-19 pandemic on intra-partum and delivery complications.

Methods

This retrospective study was performed at a university-affiliated, tertiary medical center. It included women admitted to the delivery room from 1 March 2020 to 23 July 2020 during the first wave of the COVID-19 pandemic. They were compared against women who were admitted to the delivery room during the same time period in 2019. The outcomes of 2701 deliveries during the pre-pandemic period were compared to those of 2668 deliveries during the pandemic period. Main outcomes were pregnancy and delivery outcomes.

Results

The mean number of emergency department visits before admission for delivery was higher in the pre-pandemic period than in the pandemic period (2.3 ± 1.5 and 2.1 ± 1.3 visits, respectively; p < .01). There were no significant differences in other intra- and postpartum complications. The incidence of a prolonged third stage of labor was higher in the pre-pandemic than in the pandemic period (225 (10%) and 182 (8.1%), respectively; p = .03). The mean duration of post-partum maternal hospitalization was longer in the pre-pandemic than in the pandemic period (3.6 ± 0.9 and 3.4 ± 1.0 days, respectively; p < .01). Neonatal outcomes were comparable for Apgar scores, birth weight, and newborn intensive care unit admission for both periods; however, the mean duration of neonatal hospitalization was longer in the pre-pandemic than in the pandemic period (3.5 ± 3.2 and 3.2 ± 1.1 days, respectively; p < .01).

Conclusions

In our study population, in the presence of public and accessible obstetric medicine, the first wave of the COVID-19 pandemic did not affect pregnancy or early delivery outcomes.

Keywords:

• Birth
• complications
• COVID-19
• obstetric management
• pandemic
• SARS-CoV-2

Acknowledgements

The authors would like to make special thanks to Navah Jelin for her statistical assistance with the study.

Ethical approval

The study was approved by the local ethics committee of Meir Medical Center affiliated to Sackler faculty of medicine Tel Aviv University Israel (approval number MMC-0220-20).

Disclosure statement

The authors declare that they have no conflict of interest.

This study was performed in line with the principles of the Declaration of Helsinki.