a finding echoed in Nepal
Possible explanations for this observation include indirect effects, such as reluctance of pregnant women to attend hospital because of fear of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or changes in obstetric services.
We aimed to investigate changes in obstetric attendance and activities at a large London teaching hospital during the first peak of the COVID-19 pandemic in the UK.
We compared the number of women booking for prenatal care, attendances at obstetric triage service for unscheduled care, and number of births at St George’s University Hospital, London, UK, in two epochs: Feb 1–June 15, 2020, and Feb 1–June 15, 2019. The first case of COVID-19 in the UK was reported at the end of January; lockdown was implemented on March 23 and eased in mid-June.
The mean number of pregnant women booking for antenatal care per week was 117·2 (95% CI 114·5 to 119·9) during the 2020 epoch compared with 119·6 (112·4 to 126·7) during the 2019 epoch (mean difference −2·4, 95% CI −2·5 to −2·3). The mean number of women attending obstetric triage per week was 96·6 (95% CI 88·9 to 104·3) for 2020 and 119·4 (117·0 to 121·6) for 2019 (mean difference −22·7, 95% CI −22·8 to −22·6). The number of births was 88·8 (95% CI 85·0 to 92·5) for 2020 versus 94·2 (89·7 to 98·6) for 2019 (mean difference −5·4, 95% CI −5·4 to −5·3).
could be due to reduced care-seeking. A possible explanation for the greater fall in triage attendance (19%) than in births (6%) is that women might have perceived triage attendance as avoidable, whereas obviously labour and birth are not. However, it is possible that a small percentage of women opted for home deliveries or delivery in a private health-care setting, which would explain the slight decrease in birth rates.
However, the absence of data from years before 2019 limits the model’s capability to capture seasonality. We cannot rule out that the observed trend was present before the beginning of the pandemic.
We believe there is an urgent need to evaluate maternity service delivery, care-seeking, and pregnancy outcomes nationally, so as to plan for both immediate post-pandemic care and future health system shocks.
We declare no competing interests.
Change in the incidence of stillbirth and preterm delivery during the COVID-19 pandemic.
JAMA. 2020; 324: 705-706
Effect of the COVID-19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: a prospective observational study.
Lancet Glob Health. 2020; 8: e1273-e1281
COVID-19 outbreak and decreased hospitalisation of pregnant women in labour.
Lancet. 2020; 8: e1116-e1117
Coronavirus (COVID-19) infection in pregnancy. Version 11.
All data related to deaths.
A&E attendances and emergency admissions.
Published: October 05, 2020
© 2020 Elsevier Ltd. All rights reserved.