Main findings
In this study, there was no significant difference in adverse obstetric
outcome before and during the pandemic. Although a trend towards an
increase in poor perinatal outcome (preterm births, stillbirth, early
neonatal deaths, and neonatal unit admissions), epidural in labour, and
caesarean delivery was noted during the pandemic. It is possible that
the short duration of this study may have played a role in this finding
and that over an extended time period, these differences might be
significant. A recent study found a significant increase in the
incidence of stillbirth during the pandemic as compared to before the
pandemic, however, no significant differences in preterm births,
neonatal unit admission, or caesarean delivery were
noted9.
While the number of antenatal booking remained largely unchanged during
the pandemic, it is interesting to note that there was a significant
reduction in the proportion of antenatal inpatient admissions. This is
consistent with recommendations on reducing inpatient attendances and
encouraging remote consultations where possible as part of measures
aimed at reducing the risk of transmission of the
infection3,8,9. There is no doubt that changes in
obstetric care introduced following the pandemic consequently led to
significant reduction in inpatient admission. Despite this reduction, it
is worthy to note that this study did not demonstrate significant
increase in adverse perinatal and maternal outcomes arising from service
modification in obstetric care during the pandemic. The reduction in
inpatient antenatal admissions may have been compensated for by an
increase in fetal growth scans during the pandemic seen in this study;
which in essence represents increased outpatient surveillance. This is
contrary to previous studies6,8, It therefore stands
to reason that adverse obstetric outcomes due to reduction in antenatal
face-to-face attendances and inpatient admissions can be compensated for
possibly by increasing local scanning capacity and enhanced outpatient
management.