RESULTS
There were a total of 1562 births from 1544 women (1526 singletons and 18 twins) in the prepandemic period (1st November 2019 to 31st January 2020) and a total of 1472 births from 1452 women (1431 singletons and 21 twins) during the pandemic (1st March to 31st May 2020) constituting 14.1% and 14.6% of total maternities (10971- prepandemic, 9950- pandemic) effectively indicating an equal proportion of women in both study periods (p= 0.3).
There was no statistically significant difference seen in induction of labour rates (38.8% pre-pandemic vs 38.3% pandemic, p= 0.78, Table 1), use of epidural anaesthesia in labour (13.2% pre-pandemic vs 15.9% pandemic, p= 0.06, Table 2). Mode of delivery was also unaffected as shown in Table 3; instrumental deliveries: vacuum and forceps- (13.0% vs 12.3%, p= 0.56) and caesarean sections: emergency and planned- (28.9% vs 31.7%, p= 0.09) during the prepandemic and pandemic periods respectively. There was a significant difference seen in use of general anaesthesia for caesarean section, with reduced rates seen during the pandemic (8.9% vs 4.9%, p= 0.03) (Table 2).
The perinatal outcome in both periods are comparable, with no significant difference seen in the rates of preterm birth, stillbirth, early neonatal deaths or neonatal unit admissions (Table 3). The proportions of in-utero admissions and transfers are similar for both periods.
As shown in Table 4, antenatal admissions were significantly reduced during the pandemic period (23.9% vs 18.5%, p= <0.0001) and an increased number of antenatal growth scans performed (18.5% vs 20.1%, p= <0.003) during the pandemic; however, no significant difference was observed for the numbers of new antenatal bookings (14.71% vs 14.65%, p= 0.87).
There was no maternal death recorded in the study period. A total of 9 women tested positive for SARS-CoV-2 infection in the study period; 5 cases were diagnosed in the 3rd trimester while the other 4 cases were diagnosed postnatally within 48 hours of delivery. Most of the women (77.8%) were less than 30 years old (IQR 19-36 years, mean 27.4 years). The majority of the affected women (66.7%) were nulliparous, which is disproportionate given that only 10% (145) of women who delivered during the pandemic period were nulliparous. More than half (55.6%) of the women were of BAME ethnicity, and only 3 women (33.3%) had associated medical co-morbidity (PIH and/or GDM). Caesarean section was the mode of delivery in more than half of the women (55.6%) and spinal epidural was employed in all cases. Maternal compromise due to SARS-CoV-2 infection necessitating urgent delivery was not observed in any of these cases.