Maternal characteristics and neonatal outcomes during the covid-19 health emergency in a maternal and perinatal care referral hospital in Medellín-Colombia. Cross-sectional study
DOI:
https://doi.org/10.17533/udea.rfnsp.e353547Keywords:
Covid-19, health care outcome evaluation, pandemic, infant health, maternal health, child health servicesAbstract
Objective: Compare maternal characteristics and neonatal outcomes during the Covid-19 health emergency against the same epidemiological period of the year prior to the pandemic.
Methodology: Cross-sectional study at two moments in time, of 970 maternal-neonatal binomials during January-December 2020 (pandemic group) and the same period in 2019 (pre-pandemic group), in a tertiary hospital in Medellín, Colombia. Information was obtained from medical records for the variables of interest; Then, their frequency was compared in both groups, calculating prevalence ratios and chi squared.
Results: 483 pairs were included in pre-pandemic and 487 in pandemic. In the latter, there was lower neonatal vaccination coverage (9.7 vs. 4.6%; p < 0.001; RP:1.49; 95% CI: 1.26-1.76) and prevalence of congenital malformations (8 .2 vs. 14.2%; p = 0.002; RP: 0.73; 95% CI: 0.57-0.94). There were no differences in preterm birth, mortality, neonatal hospitalization or rehospitalization. In the pandemic, adequate prenatal control was lower (19.1 vs. 28.6%; p = 0.001; RP: 1.41; 95% CI: 1.19-1.67) and comorbidities detected at delivery (6, 4 vs. 10.8%; p = 0.014; RP: 0.69; 95% CI: 0.52-0.93), and a higher frequency of obesity (6.6 vs. 3.5%; p = 0. .03, RP: 1.42, 95% CI: 1.13-1.79).
Conclusions: The Covid-19 pandemic impacted the care of the maternal-neonatal binomial, especially with the decrease in vaccination coverage, the reduction in the detection of maternal comorbidities and congenital malformations, and in the adequate performance of prenatal controls, so it is important to strengthen primary care programs and focus strategies on determinants that modify neonatal outcomes.
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