Effect of restrictions imposed due to COVID-19 pandemic on the antenatal care and pregnancy outcomes: a prospective observational study from rural North India

• Published in: BMJ open Vol. 12; no. 4; p. e059701
• Main Authors: Goyal, Lajya Devi, Garg, Priyanka, Verma, Madhur, Kaur, Navdeep, Bakshi, Dapinder, Arora, Jatinder
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 06-04-2022; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Communicable Disease Control; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; Disease transmission; epidemiology; Female; Humans; Infant, Newborn; maternal medicine; Maternal mortality; Observational studies; Obstetrics and Gynaecology; Pandemics; Pandemics - prevention & control; Population; Pregnancy; Premature Birth; Prenatal Care; Public health; Rural areas; Sampling techniques; Severe acute respiratory syndrome coronavirus 2; Social distancing; Sociodemographics; Telemedicine; Womens health; China; India; COVID-19; epidemiology; maternal medicine; public health
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2021-059701

ObjectivesTo assess the difficulties faced by the pregnant women in seeking appropriate antenatal care due to the restrictions imposed during the COVID-19 pandemic; assess the difficulties encountered during delivery and postpartum period; the suitability of the teleconsultation services offered; effect of COVID-19 infection on pregnancy outcomes and the effect of restrictions on the nutrition profile of the pregnant women.DesignProspective observational study.Setting and participantsWe included 1374 pregnant women from the rural areas of three districts of Punjab, India registered at government health centres before the implementation of lockdown due to the COVID-19 pandemic on 24 March 2020.Primary and secondary outcome measuresThe primary outcome was the difficulties faced by the women during their pregnancies due to restrictions imposed during the lockdown. The secondary outcomes included the effect of COVID-19 infections on pregnancy outcomes, satisfaction from the telemedicine services and restrictions on the nutrition profile of the pregnant women.ResultsOne-third of the women (38.4%) considered their last pregnancy unplanned. Women faced difficulties due to the restrictions in getting adequate nutrition (76.5%), accessing transportation facilities (35.4%), consultations from doctors (22.4%) or getting an ultrasonography scan (48.7%). One-fifth (21.9%) of women could not access safe abortion services. Only 3.6% of respondents ever took any teleconsultation services offered by the government. Most of them felt unsatisfied compared with routine visits (77.5%). COVID-19-infected women were primarily asymptomatic (76.1%), but there was a high incidence of preterm birth (42.8%). Frontline workers could visit 64.3% of the women in the postpartum period despite restrictions.ConclusionsLockdown compromised the antenatal care in our study area while the frontline workers attempted to minimise the inconvenience. Telemedicine services did not prove to be of many benefits to pregnant women and should only work as a supplement to the existing protocols of antenatal care.