Impact of Covid-19 on attendances for a 1st episode of reduced fetal movements: A retrospective observational study.

Laia Marques-Fernandez,Una Mannu,Hsu Phern Chong,Swati Sharma,Kazumichi Fujioka

doi:10.1371/journal.pone.0253796

Laia Marques-Fernandez, Una Mannu + Show 3 more

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https://doi.org/10.1371/journal.pone.0253796

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Abstract

BackgroundPrior studies have demonstrated an increased stillbirth rate. It was suggested that the COVID-19 pandemic may have impacted on attendances for reduced fetal movements. Thus, we sought to ascertain the impact of the pandemic on attendances for reduced fetal movements (RFM) in our unit, ultrasound provision for reduced fetal movements, and the stillbirth rate.MethodsThis was a single site retrospective cohort study involving all women complaining of a 1st episode of reduced fetal movements between 01/03/2020-30/04/2020 (COVID) to 01/03/2019-30/04/2019 (Pre-COVID). Data were retrieved from computerised hospital records and statistical analyses were performed using GraphPad Prism and SPSS.Results22% (179/810) of women presented with a 1st episode of reduced fetal movements Pre-COVID compared to 18% (145/803) during COVID (p = 0.047). Primiparous women were significantly over-represented in this population with a 1.4-fold increase in attendances during COVID (67% vs 48%, p = 0.0005). Neither the total stillbirth rate nor the stillbirth rate amongst women who presented with reduced fetal movements changed during COVID. Ultrasound provision was not impacted by COVID with 95% of the scans performed according to local guidelines, compared to Pre-COVID (74%, p = 0.0001).ConclusionsThere is a significant decrease in 1st attendances for reduced fetal movements during COVID-19 pandemic. Primiparous women were 1.4 times more likely to attend with RFM. Women should be reassured that COVID-19 has not resulted in a decreased provision of care for RFM, and has not impacted on the stillbirth rate.

Highlights

The first reported case of a novel coronavirus infection was reported at the end of 2019 and occurred in Wuhan, China
This was a single site retrospective cohort study involving all women complaining of a 1st episode of reduced fetal movements between 01/03/2020-30/04/2020 (COVID) to 01/03/ 2019-30/04/2019 (Pre-COVID)
There is a significant decrease in 1st attendances for reduced fetal movements during COVID-19 pandemic

Summary

Introduction

The first reported case of a novel coronavirus infection was reported at the end of 2019 and occurred in Wuhan, China. On the 11th of March 2020, the World Health Organisation (WHO) declared a pandemic [1]. On the 23rd of March 2020, the UK government declared a lockdown and outdoor excursions were limited to those strictly necessary [2]. Health care provision changed dramatically in both primary and secondary care. Prior studies have demonstrated an increased stillbirth rate. It was suggested that the COVID-19 pandemic may have impacted on attendances for reduced fetal movements. We sought to ascertain the impact of the pandemic on attendances for reduced fetal movements (RFM) in our unit, ultrasound provision for reduced fetal movements, and the stillbirth rate

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