Results of Pregnancy Control before and during the Covid-19 Pandemic: A Comparison of Two Cohorts

COVID-19 pandemic put pregnant women in high risk, but behavioural changes has also led to lower rates of preterm births in high-income countries. The main goal in this article is to study the impact that COVID-19 pandemic is having on pregnancy control and outcomes. This is a joint analysis of two cohorts. A pre-pandemic one includes 969 pregnant women recruited in 2018. The pandemic cohort comprises 1168 pregnant women recruited in 2020. Information on demographic and socio-economic characteristics, reproductive history, characteristics of the current pregnancy and its outcome were obtained from medical records. Caesarean section was more frequent in the pre-pandemic cohort (24% vs. 18%, p = 0.004). Birth with less than 37 weeks of gestational age was more frequent in the pre-pandemic cohort (6% vs. 5%, p = 0.04). Weight at birth lower than 2500 grams occurred more frequently in the pre-pandemic cohort (9% vs. 6%, p = 0.001). Exclusive breastfeeding at hospital discharge was more frequent in the pandemic cohort than in the pre-pandemic one (60% vs. 54%, p = 0.005). We are reporting reductions in Caesarean section and preterm birth during the pandemic in a hospital located Northern of Spain. Further analysis would clarify if these lessening are related to changes in health-related behaviour or health-care functioning.

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Results of Pregnancy Control before and during the COVID-19 Pandemic: A Comparison of Two Cohorts

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158182 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8182

Author(s):

Javier Llorca ◽

Carolina Lechosa-Muñiz ◽

Pelayo Frank de Zulueta ◽

Sonia López-Gómez ◽

Victoria Orallo ◽

...

Keyword(s):

Birth Weight ◽

Pregnant Women ◽

Medical Records ◽

Preterm Births ◽

Joint Analysis ◽

Northern Spain ◽

Socioeconomic Characteristics ◽

Low Birth Weight Babies ◽

Health Related ◽

Health Related Behaviour

The COVID-19 pandemic placed pregnant women at high risk, but behavioural changes have also led to lower rates of preterm births in high-income countries. The main goal of this article is to study the ongoing impact of the COVID-19 pandemic on pregnancy control and outcomes; this is a joint analysis of two cohorts. The pre-pandemic cohort includes 969 pregnant women recruited in 2018. The pandemic cohort comprises 1168 pregnant women recruited in 2020. Information on demographic and socioeconomic characteristics, reproductive history, characteristics of the current pregnancy and its outcome were obtained from medical records. Birth by Caesarean section was more frequent in the pre-pandemic cohort (adjusted odds ratio (OR) = 0.71, 95% confidence interval (CI): 0.55–0.92). A birth weight lower than 2500 g and higher than 4000 g occurred more frequently in the pre-pandemic cohort (adjusted OR = 0.62, 95% CI: 0.41–0.93 for lower than 2500 g and adjusted OR = 0.30, 95% CI: 0.20–0.46 for higher than 4000 g). Exclusive breastfeeding upon hospital discharge was more frequent in the pandemic cohort than in the pre-pandemic cohort (60% vs. 54%, p = 0.005), with adjusted OR = 0.67, 95% CI: 0.52–0.86 for mixed breastfeeding and infant formula. In conclusion, we report reductions in Caesarean sections and reduced numbers of low birth weight babies during the pandemic in a hospital located in northern Spain. Further analysis will clarify if these reductions are related to changes in health-related behaviour or healthcare operation.

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Reducing Surgical Length of Stay: Quantifying the Impact

Healthcare Management Forum ◽

10.1016/s0840-4704(10)60929-5 ◽

1995 ◽

Vol 8 (4) ◽

pp. 29-35 ◽

Cited By ~ 1

Author(s):

Brian Louie ◽

John Guy ◽

Michael Quinn ◽

Randy Reid

Keyword(s):

Health Care ◽

Caesarean Section ◽

Length Of Stay ◽

Medical Records ◽

Community Hospital ◽

Hospital Department ◽

Resource Limited ◽

Reduction Program ◽

The Impact ◽

The Relationship

Length-of-stay (LOS) reduction is a strategy encouraged at all levels of health care to manage within a resource limited environment. However, few organizations have attempted to quantitatively understand the impact of reducing LOS. This study examines the relationship between reducing LOS and cost through a retrospective, medical records analysis of three surgical procedures (appendectomy, cholecystectomy and caesarean section) at an Ontario community hospital Department of Surgery. Hypotheses are presented and a methodology is described. The results are discussed with a focus on the factors that hospitals, adminstrators and physicians might consider in a LOS reduction program.

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Benefit-risk of Patients' Online Access to their Medical Records: Consensus Exercise of an International Expert Group

Yearbook of Medical Informatics ◽

10.1055/s-0038-1641202 ◽

2018 ◽

Vol 27 (01) ◽

pp. 156-162 ◽

Cited By ~ 1

Author(s):

Harshana Liyanage ◽

Siaw-Teng Liaw ◽

Emmanouela Konstantara ◽

Freda Mold ◽

Richard Schreiber ◽

...

Keyword(s):

Health Care ◽

Medical Informatics ◽

Medical Records ◽

Panel Discussion ◽

Care Quality ◽

Care Providers ◽

Consensus Statements ◽

Online Access ◽

The Impact

Background: Patients' access to their computerised medical records (CMRs) is a legal right in many countries. However, little is reported about the benefit-risk associated with patients' online access to their CMRs. Objective: To conduct a consensus exercise to assess the impact of patients' online access to their CMRs on the quality of care as defined in six domains by the Institute of Medicine (IoM), now the National Academy of Medicine (NAM). Method: A five-round Delphi study was conducted. Round One explored experts' (n = 37) viewpoints on providing patients with access to their CMRs. Round Two rated the appropriateness of statements arising from Round One (n = 16). The third round was an online panel discussion of findings (n = 13) with the members of both the International Medical Informatics Association and the European Federation of Medical Informatics Primary Health Care Informatics Working Groups. Two additional rounds, a survey of the revised consensus statements and an online workshop, were carried out to further refine consensus statements. Results: Thirty-seven responses from Round One were used as a basis to initially develop 15 statements which were categorised using IoM's domains of care quality. The experts agreed that providing patients online access to their CMRs for bookings, results, and prescriptions increased efficiency and improved the quality of medical records. Experts also anticipated that patients would proactively use their online access to share data with different health care providers, including emergencies. However, experts differed on whether access to limited or summary data was more useful to patients than accessing their complete records. They thought online access would change recording practice, but they were unclear about the benefit-risk of high and onerous levels of security. The 5-round process, finally, produced 16 consensus statements. Conclusion: Patients' online access to their CMRs should be part of all CMR systems. It improves the process of health care, but further evidence is required about outcomes. Online access improves efficiency of bookings and other services. However, there is scope to improve many of the processes of care it purports to support, particularly the provision of a more effective interface and the protection of the vulnerable.

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Changes in pregnancy outcomes during the COVID-19 lockdown in Iran

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04050-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fahimeh Ranjbar ◽

Leila Allahqoli ◽

Soheila Ahmadi ◽

Robab Mousavi ◽

Maryam Gharacheh ◽

...

Keyword(s):

Health Care ◽

Birth Weight ◽

Low Birth Weight ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Health Care Services ◽

Mode Of Delivery ◽

Preterm Births ◽

Future Health ◽

Significant Difference

Abstract Background The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran. Methods We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women’s hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period. Results We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods. Conclusions In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.

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RELATIONSHIP OF MATERNAL VITAMIN B12 STATUS IN PREGNANCY WITH PRETERM BIRTH AND MATERNAL HEALTH RISKS

International Medical Journal ◽

10.37436/2308-5274-2020-2-7 ◽

2020 ◽

pp. 32-38

Author(s):

VICTORIA LAZAROVA SPASOVA ◽

LILIA IVANOVA KOLEVA ◽

MARIETA ANTONOVA POPOVA ◽

VALENTINA BOYANOVA PETKOVA ◽

MILEN VENTZISLAVOV DIMITROV

Keyword(s):

Preterm Birth ◽

Vitamin B12 ◽

Pregnant Women ◽

Serum Vitamin ◽

Vitamin B12 Deficiency ◽

Inverse Association ◽

Maternal Vitamin ◽

B12 Deficiency ◽

The Impact ◽

In Pregnancy

Vitamin B12 is known to be vital for cell growth and population during pregnancy. This retrospective and prospective case−control study was aimed to disclose a health risk for pregnant women with vitamin B12 deficiency, as well as the one of the preterm birth. The main tasks set and performed in this research were as follows: to compare the obstetrics anamnesis between the women who gave birth on term and women who gave birth before term; to find the prevalence of vitamin B12 insufficiency in pregnancy; to determine its association with preterm birth and low birth weight; to examine its association with spontaneous abortions, and to investigate its relationship with obesity and hemoglobin levels in pregnant women. The conducted investigation involved 107 women who gave birth before the 37th week of gestation and 101 women who gave birth after the 37th week of gestation at the outpatient clinic of the University Hospital "Maichin Dom" in Bulgaria. Our study revealed a correlation between maternal vitamin B12 deficiency, overweight and low hemoglobin level. Our results showed no significant correlation between serum vitamin B12 level and the risk of preterm birth. However, we found an inverse association between vitamin B12 level and overweight before pregnancy and at the time of giving birth. As well there was confirmed the strong connection between meat consumption and vitamin B12 level. The paper emphasizes that the deficiency of the vitamin occurs most likely in the women with inadequate diets. Such a deficiency is actually confirmed to have serious health consequences for pregnant women and their offspring. Therefore further profound and numerous studies should be performed to properly assess the correlation between vitamin B12 and preterm birth, as well as to understand better the impact of vitamin B12 over pregnant women. Key words: vitamin B12, preterm birth, pregnancy, overweight, hemoglobin.

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The impact of pregnancy on women’s oral health-related quality of life: a qualitative investigation

BMC Oral Health ◽

10.1186/s12903-020-01290-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Omid Fakheran ◽

Mahmoud Keyvanara ◽

Zahra Saied-Moallemi ◽

Abbasali Khademi

Keyword(s):

Quality Of Life ◽

Oral Health ◽

Pregnant Women ◽

Social Life ◽

Well Being ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

The Impact

Abstract Background Complex psychological and physiological changes occur in women’s body during pregnancy. These changes affect both oral health status and oral health-related quality of life (OHRQoL). In almost all of the previous cross-sectional design studies on pregnant women, generic OHRQoL instruments have been used to measure OHRQoL. While such instruments may be reliable, they may not be appropriate to evaluate the OHRQoL in special populations like pregnant women. The purpose of this study was to investigate the self-perceived factors affecting the OHRQoL among pregnant women. Methods In this qualitative descriptive study, twenty- seven pregnant women were recruited from four healthcare centers located in Isfahan city, Iran. The interpretative phenomenological analysis was used to collect and analyze the data. Four criteria of credibility, dependability, transferability, and confirmability were implemented through established procedures to confirm the study rigor. Results Three major themes and six sub-themes capturing the impacts of pregnancy on women’s OHRQoL were identified. They covered all areas of life, including daily life, psychological well-being, social life, physical impact, and also barriers to utilization of dental care services. Some new domains such as “dentists’ refusal to treat pregnant women”, “negative feelings about pregnancy” and “concerns about fetal health” were found as important factors which could influence the OHRQoL during pregnancy. Conclusion The findings help to better understand the oral health issues impacting women during pregnancy and to achieve person-centered care and improved oral health outcomes in pregnant women. The conceptual framework created based on the results of this study may help health care workers and policy makers for improving the health of pregnant women.

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The impact of Medicaid expansion on postpartum health care utilization among pregnant women with opioid use disorder

Substance Abuse ◽

10.1080/08897077.2019.1573209 ◽

2019 ◽

Vol 40 (3) ◽

pp. 371-377 ◽

Cited By ~ 1

Author(s):

Briana P. Patton ◽

Elizabeth E. Krans ◽

Joo Yeon Kim ◽

Marian Jarlenski

Keyword(s):

Health Care ◽

Health Care Utilization ◽

Pregnant Women ◽

Opioid Use Disorder ◽

Care Utilization ◽

Medicaid Expansion ◽

Opioid Use ◽

Postpartum Health ◽

The Impact

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Analysis of the Impact of the Confinement Resulting from COVID-19 on the Lifestyle and Psychological Wellbeing of Spanish Pregnant Women: An Internet-Based Cross-Sectional Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165933 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5933 ◽

Cited By ~ 7

Author(s):

Gemma Biviá-Roig ◽

Valentina Lucia La Rosa ◽

María Gómez-Tébar ◽

Lola Serrano-Raya ◽

Juan José Amer-Cuenca ◽

...

Keyword(s):

Quality Of Life ◽

Pregnant Women ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Eating Pattern ◽

Before And After ◽

Related Quality ◽

Health Related ◽

The Impact

(1) Background: This study aimed to analyze the impact of the confinement due to the COVID-19 pandemics on the eating, exercise, and quality-of-life habits of pregnant women. (2) Methods: This was an internet-based cross-sectional survey which collected information about adherence to the Mediterranean diet, physical exercise, health-related quality of life (HRQoL), and perceived obstacles (in terms of exercise, preparation for delivery, and medical appointments) of pregnant women before and after the confinement. The survey was conducted in 18–31 May 2020. (3) Results: A total of 90 pregnant women participated in this study. There was a significant decrease in the levels of physical activity (p < 0.01) as well as in HRQoL (p < 0.005). The number of hours spent sitting increased by 50% (p < 0.001), 52.2% were unable to attend delivery preparation sessions because these had been cancelled. However, there were no significant differences in the eating pattern of these women (p = 0.672). Conclusions: These results suggest the need to implement specific online programs to promote exercise and reduce stress, thus improving the HRQoL in this population, should similar confinements need to occur again for any reason in the future.

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