Comparison of adverse pregnancy and birth outcomes using archival medical records before and during the first wave of the COVID-19 pandemic in Kinshasa, Democratic Republic of Congo: a facility-based, retrospective cohort study

BMC Pregnancy and Childbirth

Research

Anne W. Rimoin¹  Patrick J. Arena¹  Adva Gadoth¹  Nicole A. Hoff¹  Didine Kaba²  Dalau Mukadi Nkamba²  Hui-Lee Wong³  Steven A. Anderson³  David Kampilu⁴  Michael Beia⁴  Camille Dzogang⁴ 

[1] Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA;Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo;Office of Biostatistics and Pharmacovigilance, U.S. Food and Drug Administration, Silver Spring, Maryland, USA;UCLA-DRC Health Research and Training Program, Kinshasa, Democratic Republic of Congo;

关键词: Adverse birth outcomes;    GAIA;    Democratic Republic of Congo;    Medical records;    COVID-19;    Maternal immunization;   

DOI  :  10.1186/s12884-022-05291-w

 received in 2022-06-16, accepted in 2022-12-07,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundLittle research has been conducted on the impact of the coronavirus disease 2019 (COVID-19) pandemic on either birth outcomes or the ability of archival medical records to accurately capture these outcomes. Our study objective is thus to compare the prevalence of preterm birth, stillbirth, low birth weight (LBW), small for gestational age (SGA), congenital microcephaly, and neonatal bloodstream infection (NBSI) before and during the first wave of the COVID-19 pandemic in Kinshasa, Democratic Republic of Congo (DRC).MethodsWe conducted a facility-based retrospective cohort study in which identified cases of birth outcomes were tabulated at initial screening and subcategorized according to level of diagnostic certainty using Global Alignment of Immunization Safety Assessment in pregnancy (GAIA) definitions. Documentation of any birth complications, delivery type, and maternal vaccination history were also evaluated. The prevalence of each birth outcome was compared in the pre-COVID-19 (i.e., July 2019 to February 2020) and intra-COVID-19 (i.e., March to August 2020) periods via two-sample z-test for equality of proportions.ResultsIn total, 14,300 birth records were abstracted. Adverse birth outcomes were identified among 22.0% and 14.3% of pregnancies in the pre-COVID-19 and intra-COVID-19 periods, respectively. For stillbirth, LBW, SGA, microcephaly, and NBSI, prevalence estimates were similar across study periods. However, the prevalence of preterm birth in the intra-COVID-19 period was significantly lower than that reported during the pre-COVID-19 period (8.6% vs. 11.5%, p < 0.0001). Furthermore, the level of diagnostic certainty declined slightly across all outcomes investigated from the pre-COVID-19 to the intra-COVID-19 period. Nonetheless, diagnostic certainty was especially low for certain outcomes (i.e., stillbirth and NBSI) regardless of period; still, other outcomes, such as preterm birth and LBW, had moderate to high levels of diagnostic certainty. Results were mostly consistent when the analysis was focused on the facilities designated for COVID-19 care.ConclusionThis study succeeded in providing prevalence estimates for key adverse birth outcomes using GAIA criteria during the COVID-19 pandemic in Kinshasa, DRC. Furthermore, our study adds crucial real-world data to the literature surrounding the impact of the COVID-19 pandemic on maternal and neonatal services and outcomes in Africa.

【 授权许可】

CC BY   
© The Author(s) 2023

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