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Comparison of adverse pregnancy and birth outcomes using archival medical records before and during the first wave of the COVID-19 pandemic in Kinshasa, Democratic Republic of Congo: a facility-based, retrospective cohort study.
Arena, Patrick J; Dzogang, Camille; Gadoth, Adva; Nkamba, Dalau Mukadi; Hoff, Nicole A; Kampilu, David; Beia, Michael; Wong, Hui-Lee; Anderson, Steven A; Kaba, Didine; Rimoin, Anne W.
  • Arena PJ; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA. patarena@ucla.edu.
  • Dzogang C; UCLA-DRC Health Research and Training Program, Kinshasa, Democratic Republic of Congo.
  • Gadoth A; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.
  • Nkamba DM; Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
  • Hoff NA; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.
  • Kampilu D; UCLA-DRC Health Research and Training Program, Kinshasa, Democratic Republic of Congo.
  • Beia M; UCLA-DRC Health Research and Training Program, Kinshasa, Democratic Republic of Congo.
  • Wong HL; Office of Biostatistics and Pharmacovigilance, U.S. Food and Drug Administration, Silver Spring, Maryland, USA.
  • Anderson SA; Office of Biostatistics and Pharmacovigilance, U.S. Food and Drug Administration, Silver Spring, Maryland, USA.
  • Kaba D; Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
  • Rimoin AW; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.
BMC Pregnancy Childbirth ; 23(1): 31, 2023 Jan 16.
Article in English | MEDLINE | ID: covidwho-2196108
ABSTRACT

BACKGROUND:

Little research has been conducted on the impact of the coronavirus disease 2019 (COVID-19) pandemic on either birth outcomes or the ability of archival medical records to accurately capture these outcomes. Our study objective is thus to compare the prevalence of preterm birth, stillbirth, low birth weight (LBW), small for gestational age (SGA), congenital microcephaly, and neonatal bloodstream infection (NBSI) before and during the first wave of the COVID-19 pandemic in Kinshasa, Democratic Republic of Congo (DRC).

METHODS:

We conducted a facility-based retrospective cohort study in which identified cases of birth outcomes were tabulated at initial screening and subcategorized according to level of diagnostic certainty using Global Alignment of Immunization Safety Assessment in pregnancy (GAIA) definitions. Documentation of any birth complications, delivery type, and maternal vaccination history were also evaluated. The prevalence of each birth outcome was compared in the pre-COVID-19 (i.e., July 2019 to February 2020) and intra-COVID-19 (i.e., March to August 2020) periods via two-sample z-test for equality of proportions.

RESULTS:

In total, 14,300 birth records were abstracted. Adverse birth outcomes were identified among 22.0% and 14.3% of pregnancies in the pre-COVID-19 and intra-COVID-19 periods, respectively. For stillbirth, LBW, SGA, microcephaly, and NBSI, prevalence estimates were similar across study periods. However, the prevalence of preterm birth in the intra-COVID-19 period was significantly lower than that reported during the pre-COVID-19 period (8.6% vs. 11.5%, p < 0.0001). Furthermore, the level of diagnostic certainty declined slightly across all outcomes investigated from the pre-COVID-19 to the intra-COVID-19 period. Nonetheless, diagnostic certainty was especially low for certain outcomes (i.e., stillbirth and NBSI) regardless of period; still, other outcomes, such as preterm birth and LBW, had moderate to high levels of diagnostic certainty. Results were mostly consistent when the analysis was focused on the facilities designated for COVID-19 care.

CONCLUSION:

This study succeeded in providing prevalence estimates for key adverse birth outcomes using GAIA criteria during the COVID-19 pandemic in Kinshasa, DRC. Furthermore, our study adds crucial real-world data to the literature surrounding the impact of the COVID-19 pandemic on maternal and neonatal services and outcomes in Africa.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications / Premature Birth / COVID-19 / Microcephaly Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Female / Humans / Infant, Newborn / Pregnancy Country/Region as subject: Africa Language: English Journal: BMC Pregnancy Childbirth Journal subject: Obstetrics Year: 2023 Document Type: Article Affiliation country: S12884-022-05291-w

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications / Premature Birth / COVID-19 / Microcephaly Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Female / Humans / Infant, Newborn / Pregnancy Country/Region as subject: Africa Language: English Journal: BMC Pregnancy Childbirth Journal subject: Obstetrics Year: 2023 Document Type: Article Affiliation country: S12884-022-05291-w