Effects of Healthcare Reorganization during Coronavirus Disease-2019 on Maternal and Perinatal Outcomes: An Observational Study

Aim and background:To evaluate the effect of healthcare reorganization on obstetric complications, maternal, and fetal outcomes during the pandemic year in comparison with the preceding year. The coronavirus disease 2019 (COVID-19) pandemic, triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), demonstrated a markedly greater impact on pregnant women in comparison to their non-pregnant counterparts. As a result, there exists a pressing need for additional investigations into the implications of COVID-19 infection and the reorganization of healthcare systems and its effects on pregnancy outcomes. Materials and methods: A retrospective comparative study conducted at two tertiary healthcare facilities in Dakshina Kannada, India, for 15 months each in the prepandemic and pandemic periods. The primary data regarding the demographic details, gestational age, antenatal and intrapartum complications, mode of delivery, COVID-19 status, and the perinatal outcomes were collected from the hospital’s birth register and then subjected to comparative analysis to elucidate the changes in obstetric care and pregnancy outcomes between the two time periods. Results: The study included 16,393 participants with, 7,896 in the pre-COVID period and 8,497 in the COVID period. The pandemic saw a higher occurrence of fetal growth restriction (FGR), anemia, instrumental deliveries, cesarean sections, maternal near miss, fetal macrosomia, and stillbirths. However, there was no significant difference in the incidence of preeclampsia and gestational diabetes mellitus (GDM). Conclusion: The disruption of standard antenatal practices due to the pandemic may have contributed to these adverse outcomes. Although patients who were positive for COVID-19 did not exhibit significant adverse maternal or perinatal outcomes, the study highlights the broader implications of the pandemic on obstetric care and outcomes. Clinical significance: Through the results of this study, we need to refine pandemic crisis management frameworks and change clinical protocols to mitigate the adverse effects on maternal and neonatal health.