ABSTRACT
Background: Although there is a significant increase of evidence regarding the prevalence and impact of COVID-19 on maternal and perinatal outcomes, data on the effects of the pandemic on the obstetric population in sub-Saharan African countries are still scarce. Therefore, the study aims were to assess the prevalence and impact of COVID-19 on maternal and neonatal outcomes in the obstetric population at Central Hospital of Maputo (HCM), Mozambique. Methods Prospective cohort study conducted at teaching and referral maternity, HCM, from 20 October 2020 to 22 July 2021. We collected maternal and perinatal outcomes up to six weeks postpartum of eligible women (pregnant and postpartum women - up to the 14th day postpartum) screened for COVID-19 (individual test for symptomatic participants and pool testing for asymptomatic). The primary outcome was maternal death, SARS and UCI admission. We estimated the COVID-19 prevalence and the unadjusted RR (95% CI) for maternal and perinatal outcomes. We used the chi-square or Fisher's exact test to compare qualitative variables (two-sided p-value
Subject(s)
COVID-19 , Postpartum HemorrhageABSTRACT
Background: The SARS-CoV-2 (COVID-19) pandemic has put the health care system under severe strain. Sexual and reproductive health services, including contraception provision, were one of the most disrupted. Our objective was to assess the impact of the COVID-19 pandemic on the sales of modern contraceptive methods in Brazil.Methods: We analysed monthly data of short-acting, long-acting reversible contraceptives (LARCs; implants and intrauterine devices [IUD]), and COVID-19 related deaths. We categorised the sales in: i) emergency contraceptive (EC), ii) oral contraceptives, rings and patches, iii) injectable contraceptives, iv) LARC methods, including copper-IUD, and v) LARC methods, except Cu-IUDs.Findings: Contraceptives sales had a non-significant increase in the year 2020 compared to the year 2019, and the annual average ranged from 12·8 to 13·0 million units/month. We observed an increase in the sales of injectable contraceptives for the February-May/2020 and EC pills for the June-July/2020 and a non-significant variation for pills, patches and rings. The hormonal-IUD/ENG-implant had three patterns: a decrease in sales between February-April, which coincides with the closure of family planning services; an increment of sales since April, which coincide with the first COVID-19 related deaths and an important increment of sales since July/2020.Interpretation: The COVID-19 pandemic has disrupted the Brazilian healthcare system and due to the fact that many family planning clinics were closed, the sales of most of the modern contraceptives fall over the year 2020; however, the increment of sales of the LNG-IUD/ENG-implant at private sector indicated the inequity in access of contraception.Funding Information: This study received partial financial support from the Fundação de Apoio à Pesquisa do Estado de São Paulo (FAPESP; award number 2015/20504‐9) and from the Brazilian National Research Council (CNPq; grant number 573747/2008‐3). Moreover, CMC and AM received funding from SRH, part of the UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a cosponsored programme executed by the World Health Organisation (WHO), to complete their Post-graduate studies. This article represents the views of the named authors only and does not represent the views of the mentioned organisations.Declaration of Interests: LB received honoraria as lecturer from Bayer Healthcare and MSD. The other authors declared no conflict of interest.