Antenatal care and COVID-19
On 25 January 2020, Australia recorded its first cases of coronavirus (SARS-CoV-2) disease 2019 (COVID-19). As the number of cases increased, physical distancing, restrictions on activities and businesses, and border closures were implemented to slow the spread of the virus (Grattan Institute 2020). Figure 1 provides an overview of some key Australian COVID-19 events.
In 2020, during the height of the COVID-19 pandemic, Australians were urged to stay at home where possible to reduce the risk of transmission. While pregnant women are not listed by the Australian Government Department of Health as a medium or high risk group for COVID-19 (DoH 2020), RANZCOG consider pregnant women a vulnerable group, and advised pregnant women take precautions and follow government guidance on physical distancing and hygiene measures (RANZCOG 2020).
Shutdowns and service disruptions during this period may have affected the ability of pregnant women to attend face-to-face antenatal care visits. Additionally, because of personal safety concerns, women may have opted not to attend face-to-face appointments, as health advice encouraged avoiding public spaces except for the essential purposes (RANZCOG 2020; RCOG 2020). On 13 March 2020, the Australian Government added services to the MBS to cover antenatal services delivered via telehealth (DoH 2020b).
A global perspective
International reporting raised concerns that COVID-19 and associated service disruptions could contribute to changes in pregnancy outcomes, including change to stillbirth and pre-term birth rates, and risks to mothers’ wellbeing (Casadio et al. 2020; CDC 2020; KC et al. 2020; Khalil 2020; Kumari et al. 2020; UNICEF et al. 2020; RCOG 2020; WHO 2020). However, other international investigations reported COVID-19 mitigation measures may have assisted in managing potential adverse pregnancy outcomes such as reduced preterm rates (Been et al. 2020; Hedermann et al. 2020; Phillip et al. 2020). These reports demonstrate the complex effects of COVID-19 and associated response efforts on mothers and babies.
The impacts of COVID-19 on outcomes for Australian mothers and babies is currently unknown, and will be explored in the future once data is available through the National Perinatal Data Collection.
Figure 1: Key COVID-19 dates 2020
Chart: Australian Institute of Health and Welfare
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Kc A, Guring R, Kinney MV, Sunny AK, Moinuddin M, Basnet O, Paudel P, Bharattarai P, Subedi K, Shrestha MP, Lawn JE & Målqvist M. 2020. Effect of the COVID-19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: a prospective observational study. The Lancet Global Health 8(10):e1273-e1281. DOI: 10.1016/S2214-109X(20)30345-4
Khalil A, von Dadelszen P, Draycott T, Ugwumadu A, O’Brien P & Magee L. 2020. Change in the Incidence of Stillbirth and Preterm Delivery During the COVID-19 Pandemic. JAMA. 324(7):705–706. DOI:10.1001/jama.2020.12746
Kumari V, Mehta K & Choudhary R. 2020. COVID-19 outbreak and decreased hospitalisation of pregnant women in labour. The Lancet Global Health 8(9):E1116-E1117. DOI: 10.1016/S2214-109X(20)30319-3
Philip RK, Purtill H, Reidy E. Daly M, Imcha M, McGrath D, O’Connell NH & Dunne CP. 2020. Unprecedented reduction in births of very low birth weight (VLBW) and extremely low birthweight (ELBW) infants during the COVID-19 lockdown in Ireland: a 'natural experiment' allowing analysis of data from the prior two decades. BMJ Global Health 5(9): e003075. DOI: 10.1136/bmjgh-2020-003075
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