Continuity of maternal care during COVID-19 pandemic in Qatar: Aiming to reduce neonatal morbidity

Abstract

Introduction: The COVID-19 pandemic had a significant impact on medical and maternity services across the world. The reported increase in maternal and neonatal morbidity and mortality is not only attributable to the disease itself but also the disruptions in the health services during lockdowns1,2. Qatar maintained continuity of maternity services during the peak of the pandemic by telephone consultations3. It played a vital role in minimizing the community's spread of the disease. This study is a review to determine the frequency of patient contacts/visits during the COVID-19 pandemic and assessed pregnancy outcomes. Methods: A retrospective chart review was conducted at Al-Wakra Hospital using the electronic records of women who delivered between February-July 2020, during the peak of the pandemic in Qatar. COVID-19 positive patients were excluded. Data on the number of visits at Primary Health Care Corporation (PHCC) centers, Emergency Departments (ED), and Outpatient departments (OPD/Telephone consultations were collected. Pregnancy outcomes were noted and then compared with women who delivered pre-pandemic during a similar timeframe in the preceding year. Odds ratio was evaluated using MedCalcs’ online software. Results: A 40% increase in the number of births and an increase in patient visits to PHCC by 39.34% and ED by 44.04% were noted during the pandemic. Nearly all OPD consultations (3572) were performed by telephone in the study period during the pandemic (Figure 1). Rates of miscarriages and preterm birth, were unchanged (p>0.05). There were fewer admissions to Neonatal Intensive Care Unit (p < 0.05) as compared to the pre-pandemic period (Figure 2). Despite an increase in the number of births, there was no negative impact outcomes noted on neonatal during the pandemic. Conclusion: During the COVID-19 pandemic, poor pregnancy outcomes were noted across the world. In Qatar, the services were adapted to provide continuity of care. This presented challenges but there was no increase in adverse neonatal outcomes.