ABSTRACT
Background: Obesity and excessive gestational weight gain are associated with adverse pregnancy outcomes. The impact of the COVID-19 pandemic on weight and weight gain during pregnancy are unknown. Methods: Retrospective cohort study of all singleton pregnancies before (January 2018-January 2020) and during the low prevalence first year of COVID-19 (February 2020-January 2021). Demographic data, booking BMI and rate of weight gain were compared between time periods. Results: 14908 patients (9544 before and 5364 during the COVID-19 first year) met the inclusion criteria. There was a trend towards higher booking BMI (25.5 ± 0.1 kg/m2 during vs 25.3 ± 0.1 kg/m2 before COVID-19, p = 0.08) and higher rate of obesity (17.0% vs 16.5%, p = 0.08) during the COVID-19 first year. Rate of weight gain in pregnancy was greater during COVID-19 (0.539 ± 0.006 kg/week vs 0.505 ± 0.004 kg/week, p < 0.001), driven by the greater difference in rate of 2nd trimester weight gain (0.664 ± 0.010 kg/week during vs 0.571 ± 0.007 kg/week before COVID-19, p < 0.001). After adjusting for maternal age, ethnicity, socioeconomic status and booking BMI, the COVID-19 first year was associated with significantly greater rate of weight gain (β = 0.02, p = 0.001). Rate of weight gain recommended for BMI was achieved in fewer pregnancies during COVID-19 (14.4% vs 16.3%, p = 0.007). Conclusions: The first year of COVID-19 was associated with a greater rate of gestational weight gain and a lower proportion of patients achieving recommended weight gain. This likely reflects the impact of COVID-19 restrictions in the community of Western Sydney and may have contributed to adverse pregnancy outcomes during the low prevalence first year of the COVID-19 pandemic.
ABSTRACT
Background: Evidence demonstrates Digital Health Interventions (DHI) successfully support health promotion. We had developed a bank of text messages for a DHI postpartum trial (SmartMums) for women with gestational diabetes, this study was delayed because of the COVID pandemic. Instead, we repurposed these text-messages to address mental health, parenting and healthy lifestyle to support post-partum women as part of our pandemic response. From October to December 2020, women at our hospital discharged with term babies were sent a text invitation to register for the HealthyMums@Westmead program, and 97% registered completed the six-month program. The aim of this research is to assess acceptability of this DHI during the pandemic. Methods: Text-invitation to complete evaluation survey was sent to pre-registered participants. Questions included demographics and Likert response to message content and delivery. Results: 38 of 105 participants provided feedback. Most respondents were primiparous (62%) and born overseas (54%). All agreed the messages were easy to understand with 87% agreeing the text-support gave valuable information they could use. Three messages per week were considered just right for 89%. Half felt the messages helped increase physical activity and improve their diet. Free text responses included: 'Thanks for supporting in this difficult time','?made me feel like someone still cared for us', '?a major role in improving my mental health', 'It inspired me and helped me in weight loss', '?links to COPE and PANDA where very timely'. Conclusions: Text-messaging was an acceptable and valued support during COVID-19 interrupted services. Further research should review ongoing use of DHI postpartum.
ABSTRACT
Background: Australia experienced a low prevalence of COVID-19 in 2020 compared to many other countries. However, maternity care has been impacted with hospital policy driven changes in practice. Little qualitative research has investigated maternity clinicians' perception of the impact of COVID-19 in a high-migrant population. We investigate maternity clinicians' perceptions of patient experience, service delivery and personal experience in a high-migrant population. Methods We conducted semi-structured in-depth interviews with 14 maternity care clinicians in Sydney, New South Wales, Australia. Interviews were conducted from November to December 2020. A reflexive thematic approach was used for data analysis Results: A key theme in the data was 'COVID-19 related travel restrictions result in loss of valued family support for migrant families. However, partners were often 'stepping-up' into the role of missing overseas relatives. The main theme in clinical care was a shift in healthcare delivery away from optimising patient care to a focus on preservation and safety of health staff. Conclusions: Clinicians were of the view migrant women were deeply affected by the loss of traditional support. However, the benefit may be the potential for greater gender equity and bonding opportunities for partners. Conflict with professional beneficence principles and values may result in bending rules when a disconnect exists between relaxed community health orders and restrictive hospital protocols during different phases of a pandemic. This research adds to the literature that migrant women require individualised culturally safe care because of the ongoing impact of loss of support during the COVID-19 pandemic.