Abstract
BackgroundIn the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, consultations and pregnancy monitoring examinations had to be reorganised urgently. In addition, women themselves may have postponed or cancelled their medical monitoring for organisational reasons, for fear of contracting the disease caused by SARS-CoV-2 (COVID-19) or for other reasons of their own. Delayed care can have deleterious consequences for both the mother and the child. Our objective was therefore to study the impact of the SARS-CoV-2 pandemic and the first lockdown in France on voluntary changes by pregnant women in the medical monitoring of their pregnancy and the associated factors.MethodsA cross-sectional study was conducted in July 2020 using a web-questionnaire completed by 500 adult (> 18 years old) pregnant women during the first French lockdown (March–May 2020). A robust variance Poisson regression model was used to estimate adjusted prevalence ratios (aPRs).ResultsAlmost one women of five (23.4%) reported having voluntarily postponed or foregone at least one consultation or pregnancy check-up during the lockdown. Women who were professionally inactive (aPR = 1.98, CI95%[1.24–3.16]), who had experienced serious disputes or violence during the lockdown (1.47, [1.00–2.16]), who felt they received little or no support (1.71, [1.07–2.71]), and those who changed health professionals during the lockdown (1.57, [1.04–2.36]) were all more likely to have voluntarily changed their pregnancy monitoring. Higher level of worry about the pandemic was associated with a lower probability of voluntarily changing pregnancy monitoring (0.66, [0.46–0.96]).ConclusionsOur results can guide prevention and support policies for pregnant women in the current and future pandemics.
Highlights
In the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, consul‐ tations and pregnancy monitoring examinations had to be reorganised urgently
Doncarli et al BMC Pregnancy and Childbirth (2021) 21:799 fact, together with recommendations of learned societies [3, 4], prompted several countries, including France, to declare in March/April 2020 that pregnant women should be considered a population at greater risk of severe forms of COVID-19, the disease caused by SARS-CoV-2 [5,6,7,8,9]
Pregnancy monitoring during the first lockdown (Table 1) A total of 14.9% of women reported that they had been followed by a professional other than the one who usually followed them, 39.4% reported that they had teleconsultations, and 91.8% reported that their partner or a person providing support had not been allowed to attend at least one pregnancy check-up or consultation due to pandemic-related restrictions
Summary
In the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, consul‐ tations and pregnancy monitoring examinations had to be reorganised urgently. In the absence of vaccines and effective pharmaceutical treatments at that time, most governments decided to reduce the spread of the virus by implementing strict lockdowns of their entire population for several months These actions together with to the increased influx of patients suffering from COVID-19 brought about major changes in the organisation of health systems [10,11,12], including the organisation of hospital gynaecological departments [10,11,12,13]. A decrease in onsite consultations for abortion follow-up was observed, prompting an increase in teleconsultations and medical abortion at home [13] Another U.S study, conducted between mid-March and mid-May 2020 showed that nearly one-third of pregnancy monitoring visits were modified, cancelled or rescheduled [14]. In France, a longitudinal study on the surgical management of gynaecological cancers reported a change in medical management for 27% of its participants, including 23.2% for whom surgery was either postponed or cancelled due to the influx of patients infected with SARS-CoV-2 during the first lockdown [15], which took place between 16 March and 11 May 2020
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