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Introduction The coronavirus disease 2019 (COVID-19) pandemic created a crisis in health care systems worldwide. The maternity services were restricted due to the pandemic regulations. The psychological burden on the pregnant women was to various extents. Individuals and organizations implemented support schemes to understand and support their mental health. In our study, the psychological impact of pregnant women who contracted COVID-19 during pregnancy was compared with pregnancy of the same population before the pandemic as it could be a précised and helpful method to counsel pregnant women effectually. Study design This retrospective study included 111 women and was conducted at Bahrain Defense Force Hospital from January 2021 until December 2021. The researchers distributed a Hospital Anxiety and Depression Scale (HADS) questionnaire to women who delivered babies during the pandemic. The researchers then analyzed these scores and compared them with the scores of a control group of women who completed their pregnancies before the pandemic. The data were analyzed using SPSS Version 25.0 (IBM Corp., Armonk, NY). P-values of less than 0.05 were considered statistically significant. Results The HADS questionnaire results demonstrated that women's anxiety and depression during their pregnancy during the COVID-19 pandemic were significantly higher than that during their pregnancy before the pandemic, with a mean score of 14.97 (95% CI: 14.5 to 15.4) and 9.4 (95% CI: 8.8 to 9.9), respectively, and a p-value of <0.001. Additionally, during the COVID-19 pandemic, 100% of participants were "abnormal" in the anxiety category, and 86.5% were "abnormal" in the depression category, whereas before the pandemic, 0.9% of the studied population were abnormal, 3.6% were borderline abnormal, and 95.5% were normal in the depression category. The comparison of these scores highlighted that the pandemic had a significant negative psychological effect on the mothers during pregnancy, thus increasing their anxiety and depression. The correlated personal, social, and clinical factors were fear of delivery, fear of disease transmission, loss of family support, social isolation, uncertainty of life, and economic crises. Depression scores were significantly correlated to factors such as fear of disease transmission to the baby (p=0.027), fear of delivery (p=0.008), and loss of family support (p=0.001). Contributing factors and anxiety scores yielded significant correlations with fear of delivery (rs =0.258), fear of transmission (rs=0.198), and uncertainty of disease life (rs=0.247). As for depression, it was significantly correlated to one factor: loss of family support (rs=-0.335). Conclusion The mental health, in terms of anxiety and depression, of pregnant women was significantly affected during the COVID-19 pandemic.
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OBJECTIVE: Hypertensive disorders during pregnancy being the leading causes of maternal and fetal morbidity and mortality remains a serious health issue worldwide due to the high rate of adverse maternal outcomes and close association with neonatal morbidity and mortality. The purpose of our study was to ascertain the perinatal outcomes of preeclampsia (PE) in a tertiary care hospital in Bahrain. METHODS: A retrospective cohort study was conducted from January 2018 to December 2019 in the department of Gynecology and Obstetrics in Bahrain Defense Hospital. The process of data collection included a baseline review of all women who had delivered during the study period in order to identify those with PE. Additionally, the postdelivery records of the mothers and newborns were reviewed to identify relevant maternal and neonatal outcomes. RESULTS: During the research period, records revealed 142 patients with PE with a rate of 1.95%. The mean gestational age at diagnosis was 35.61 (± 3.69) weeks, ranging between 20 and 42 weeks. The mean birth weight was 2.64 ± 0.79 kg, ranging from 0.5-4.5 kg. Furthermore, most babies had an Apgar score of 9 at 5 minutes. The preterm delivery rate was (16.3%) and intrauterine growth restriction (IUGR) was seen in 19 patients (13.5%) and it was significantly higher in patients who presented between 30 and 34 gestational weeks P < 0.001. Twenty-one infants were admitted to the NICU primarily for prematurity and low birth weight. There was only one early neonatal death of a hydrops baby. One infant was stillborn with extreme prematurity at 24 weeks+4 days. Maternal complications included five abruption placentae (3.5%) cases, five HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) cases (3.5%), four eclampsia (2.8%) cases, and four patients had ICU admission. Other maternal complications included acute renal failure (ARF) in two patients (1.4%), pulmonary edema in one patient, and peripartum cardiomyopathy in one patient. Data showed that adverse pregnancy outcomes were significantly more common in those with PE as compared to other pregnant populations. CONCLUSION: Preeclampsia causes a remarkable increase in adverse maternal and perinatal outcomes as compared to the normotensive pregnant population. A regular goal-oriented clinical audit into perinatal morbidity and mortality associated with this condition and an active multidisciplinary approach to the management of pre-eclampsia patients in the hospital might improve the clinical outcomes.
