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.