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Global Maternal, Fetal Outcomes Worsened During COVID-19 Pandemic

THURSDAY, April 1, 2021 -- Global maternal and fetal outcomes have worsened overall during the COVID-19 pandemic, according to a review published online March 31 in The Lancet Global Health.

Barbara Chmielewska, M.B.B.Chir., from St. George's University Hospitals NHS Foundation Trust in London, and colleagues conducted a systematic review and meta-analysis of studies on the effects of the pandemic on maternal, fetal, and neonatal outcomes. Data were included from 40 studies.

During versus before the pandemic, the researchers observed significant increases in stillbirths (pooled odds ratio, 1.28) and maternal deaths (pooled odds ratio, 1.37). There was no significant change seen in preterm births before 37 weeks of gestation overall, but a decrease was seen in high-income countries (pooled odds ratio, 0.91), which also experienced a decrease in spontaneous preterm birth (pooled odds ratio, 0.81). Higher mean Edinburgh Postnatal Depression Scale scores were seen during versus before the pandemic, indicating poorer mental health (pooled mean difference, 0.42). During the pandemic, the investigators observed an increase in surgically managed ectopic pregnancies (pooled odds ratio, 5.81).

"We have an unprecedented opportunity to learn from the experiences of the COVID-19 pandemic to plan for a future of inclusive and equitable maternity care worldwide," a coauthor said in a statement. "One such learning opportunity will be to investigate the mechanisms underlying the apparent reduction in preterm births observed in high-income settings during the pandemic, with a view to identifying new preventative interventions that could potentially benefit all women worldwide."

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