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Article ; Online: COVID-19 Deliveries: Maternal Features and Neonatal Outcomes.

Zlochiver, Viviana / Tilkens, Blair / Perez Moreno, Ana Cristina / Aziz, Fatima / Jan, M Fuad

Journal of patient-centered research and reviews

2021 Volume 8, Issue 3, Page(s) 286–289

Abstract: ... symptoms, and 4 (5%) presented severe COVID-19 symptoms that required hospitalization. Patients ... reported, and all neonatal intensive care unit admissions were related to prematurity. Overall, maternal ... pandemic. This study analyzed maternal demographics, clinical characteristics, treatments, and delivery ...

Abstract	Integrated, data-driven criteria are necessary to evaluate delivery outcomes in pregnancies affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing COVID-19 pandemic. This study analyzed maternal demographics, clinical characteristics, treatments, and delivery outcomes of 85 ethnically diverse, adult pregnant women who tested positive for SARS-CoV-2 at the time of delivery. Median maternal and gestational ages were 27 years (interquartile range [IQR]: 23-31) and 39 weeks (IQR: 37.3-40.0), respectively. Of the 85 SARS-CoV-2-positive participants, 67 (79%) had no COVID-19 symptoms at the time of routine COVID-19 admission testing, 14 (16%) reported mild COVID-19 symptoms, and 4 (5%) presented severe COVID-19 symptoms that required hospitalization. Patients in the severe COVID-19 group had significantly longer hospitalizations than those with nonsevere COVID-19 (7 [IQR: 4.5-9.5] vs 2 [IQR: 2-3] days; P<0.01). Neonatal outcomes included 100% live births with a median 1-minute Apgar score of 8 and 15% preterm births. No neonatal deaths or vertical transmissions were reported, and all neonatal intensive care unit admissions were related to prematurity. Overall, maternal symptom prevalence and peripartum complication rates were low, suggesting a generally good prognosis for pregnant women with SARS-CoV-2 infections at the time of delivery.
Language	English
Publishing date	2021-07-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	3022292-8
ISSN	2330-0698 ; 2330-068X
ISSN (online)	2330-0698
ISSN	2330-068X
DOI	10.17294/2330-0698.1848
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Article ; Online: Analysis of placental pathology after COVID-19 by timing and severity of infection.

Corbetta-Rastelli, Chiara M / Altendahl, Marie / Gasper, Cynthia / Goldstein, Jeffrey D / Afshar, Yalda / Gaw, Stephanie L

American journal of obstetrics & gynecology MFM

2023 Volume 5, Issue 7, Page(s) 100981

Abstract: ... based on the timing or severity of COVID-19. There was a higher frequency of placental features ... Demographic, placental, delivery, and neonatal outcomes were collected through medical record review ... diagnosed with COVID-19 who delivered between April 2020 and September 2021 at 3 university hospitals ...

Abstract	Background: COVID-19 during pregnancy can have serious effects on pregnancy outcomes. The placenta acts as an infection barrier to the fetus and may mediate adverse outcomes. Increased frequency of maternal vascular malperfusion has been detected in the placentas of patients with COVID-19 compared with controls, but little is known about how the timing and severity of infection affect placental pathology. Objective: This study aimed to examine the effects of SARS-CoV-2 infection on placental pathology, specifically whether the timing and severity of COVID-19 affect pathologic findings and associations with perinatal outcomes. Study design: This was a descriptive retrospective cohort study of pregnant people diagnosed with COVID-19 who delivered between April 2020 and September 2021 at 3 university hospitals. Demographic, placental, delivery, and neonatal outcomes were collected through medical record review. The timing of SARS-CoV-2 infection was noted, and the severity of COVID-19 was categorized on the basis of the National Institutes of Health guidelines. The placentas of all patients with positive nasopharyngeal reverse transcription-polymerase chain reaction COVID-19 testing were sent for gross and microscopic histopathologic examinations at the time of delivery. Nonblinded pathologists categorized histopathologic lesions according to the Amsterdam criteria. Univariate linear regression and chi-square analyses were used to assess how the timing and severity of SARS-CoV-2 infection affected placental pathologic findings. Results: This study included 131 pregnant patients and 138 placentas, with most patients delivered at the University of California, Los Angeles (n=65), followed by the University of California, San Francisco (n=38) and Zuckerberg San Francisco General Hospital (n=28). Most patients were diagnosed with COVID-19 in the third trimester of pregnancy (69%), and most infections were mild (60%). There was no specific placental pathologic feature based on the timing or severity of COVID-19. There was a higher frequency of placental features associated with response to infection in the placentas from infections before 20 weeks of gestation than that from infections after 20 weeks of gestation (P=.001). There was no difference in maternal vascular malperfusion by the timing of infection; however, features of severe maternal vascular malperfusion were only found in the placentas of patients with SARS-CoV-2 infection in the second and third trimesters of pregnancy, not in the placentas of patients with COVID-19 in the first trimester of pregnancy. Conclusion: Placentas from patients with COVID-19 showed no specific pathologic feature, regardless of the timing or severity of the disease. There was a higher proportion of placentas from patients with COVID-19-positive tests in earlier gestations with evidence of placental infection-associated features. Future studies should focus on understanding how these placental features in SARS-CoV-2 infections go on to affect pregnancy outcomes.
MeSH term(s)	United States ; Infant, Newborn ; Pregnancy ; Humans ; Female ; COVID-19/complications ; COVID-19/diagnosis ; COVID-19/epidemiology ; Placenta/pathology ; COVID-19 Testing ; Retrospective Studies ; SARS-CoV-2 ; Pregnancy Complications, Infectious/diagnosis ; Pregnancy Complications, Infectious/epidemiology ; Pregnancy Complications, Infectious/pathology ; Pregnancy Outcome
Language	English
Publishing date	2023-04-23
Publishing country	United States
Document type	Journal Article
ISSN	2589-9333
ISSN (online)	2589-9333
DOI	10.1016/j.ajogmf.2023.100981
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Article: Multisystem inflammatory syndrome in a neonate secondary to COVID-19: a case report.

Upadhyay, Sristi / Devkota, Sagar

Annals of medicine and surgery (2012)

2023 Volume 85, Issue 10, Page(s) 5191–5195

Abstract: ... to coronavirus disease 2019 (COVID-19) (MIS-C) is very common and may present with clinical features similar ... revealed high IgG COVID-19 antibody titers.: Clinical findings and investigation: Admitted ... to the Neonatal Intensive Care Unit as he received bag and mask ventilation for 30 s following delivery, he was ...

Abstract	Introduction and importance: Multisystem inflammatory syndrome in children secondary to coronavirus disease 2019 (COVID-19) (MIS-C) is very common and may present with clinical features similar to Kawasaki disease but is rarely reported in neonates (MIS-N). Any history of maternal upper respiratory tract infection should raise suspicion of MIS-N secondary to COVID-19 in critically ill neonates. Case presentation: The authors present a term neonate with gradually progressive respiratory distress requiring mechanical ventilation with marked improvement after starting immunoglobulin and steroids after blood investigations revealed high IgG COVID-19 antibody titers. Clinical findings and investigation: Admitted to the Neonatal Intensive Care Unit as he received bag and mask ventilation for 30 s following delivery, he was kept under oxygen via nasal prongs; but he still had nasal flaring, subcostal retraction, and tachypnea. All the blood investigations were within normal limits except for elevated C-reactive protein. Intervention and outcome: With no improvement despite oxygen via nasal prongs, he was kept under bubble continuous positive airway pressure with positive end-expiratory pressure of 5 cm of H Conclusion: Multisystem inflammatory syndrome in neonates is rare but should always be considered in neonates with multisystem involvement and a history of maternal upper respiratory tract infection after excluding all other causes.
Language	English
Publishing date	2023-08-16
Publishing country	England
Document type	Case Reports
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1097/MS9.0000000000001178
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Article ; Online: COVID-19 Deliveries

Viviana Zlochiver / Blair Tilkens / Ana Cristina Perez Moreno / Fatima Aziz / M. Fuad Jan

Journal of Patient-Centered Research and Reviews, Vol 8, Iss 3, Pp 286-

Maternal Features and Neonatal Outcomes

2021 Volume 289

Abstract: ... symptoms, and 4 (5%) presented severe COVID-19 symptoms that required hospitalization. Patients ... pandemic. This study analyzed maternal demographics, clinical characteristics, treatments, and delivery ... of delivery. Median maternal and gestational ages were 27 years (interquartile range [IQR]: 23–31) and 39 ...

Abstract	Integrated, data-driven criteria are necessary to evaluate delivery outcomes in pregnancies affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing COVID-19 pandemic. This study analyzed maternal demographics, clinical characteristics, treatments, and delivery outcomes of 85 ethnically diverse, adult pregnant women who tested positive for SARS-CoV-2 at the time of delivery. Median maternal and gestational ages were 27 years (interquartile range [IQR]: 23–31) and 39 weeks (IQR: 37.3–40.0), respectively. Of the 85 SARS-CoV-2–positive participants, 67 (79%) had no COVID-19 symptoms at the time of routine COVID-19 admission testing, 14 (16%) reported mild COVID-19 symptoms, and 4 (5%) presented severe COVID-19 symptoms that required hospitalization. Patients in the severe COVID-19 group had significantly longer hospitalizations than those with nonsevere COVID-19 (7 [IQR: 4.5–9.5] vs 2 [IQR: 2–3] days; P < 0.01). Neonatal outcomes included 100% live births with a median 1-minute Apgar score of 8 and 15% preterm births. No neonatal deaths or vertical transmissions were reported, and all neonatal intensive care unit admissions were related to prematurity. Overall, maternal symptom prevalence and peripartum complication rates were low, suggesting a generally good prognosis for pregnant women with SARS-CoV-2 infections at the time of delivery.
Keywords	covid-19 symptoms ; pregnancy ; maternal health ; neonatal outcomes ; sars-cov-2 ; Medicine ; R
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	Advocate Aurora Health
Document type	Article ; Online
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Article ; Online: Correlation between placental histopathology and perinatal outcome in COVID-19.

Arora, Devendra / Rajmohan, K S / Singh, Sanjay / Nair, Vinod / Barui, Sanghita / Dey, Madhusudan / Kumar, Abhijeet

Tzu chi medical journal

2022 Volume 34, Issue 3, Page(s) 329–336

Abstract: ... those results concurred by both were reported. Histopathological features and corresponding neonatal outcome ... 37-40 weeks) were analyzed in our study. Features of maternal vascular malperfusions (MVM) were ... of etiological factors and pathogenesis of adverse perinatal outcomes in SARS-CoV-2 infection. ...

Abstract	Objectives: An alarming rate of adverse perinatal outcomes as well as maternal deaths has been reported worldwide during this pandemic. It would be prudent to start thinking on the lines of acute or chronic intrauterine fetal hypoxia due to placental microvascular pathology or villitis caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection. Autopsy studies of deceased patients with severe COVID-19 have revealed the presence of diffuse pulmonary alveolar damage, thrombosis, and microvascular injuries. It is expected that similar pathological features such as microvascular injuries could be found in the placenta of infected pregnant women. Materials and methods: Placentas of singleton pregnancies from 42 SARS-CoV-2 positive mothers delivered at term were submitted for histopathological examination. Those with multifetal gestation, hypertensive disorder, fetal growth restriction, structural or chromosomal anomalies in the fetus, thrombophilia, prolonged prelabor rupture of membranes, and placenta accreta spectrum were excluded from the study. Histopathological examination was done by two pathologists independently and only those results concurred by both were reported. Histopathological features and corresponding neonatal outcome were analyzed. Results: Reports of 42 placentas from patients with SARS-CoV-2, delivered at term (37-40 weeks) were analyzed in our study. Features of maternal vascular malperfusions (MVM) were present in 45% ( Conclusion: The main findings of our study include maternal as well as fetal vascular malperfusions and placental inflammatory pathology. These findings provide an outline for better understanding of etiological factors and pathogenesis of adverse perinatal outcomes in SARS-CoV-2 infection.
Language	English
Publishing date	2022-01-10
Publishing country	India
Document type	Journal Article
ZDB-ID	2452925-4
ISSN	2223-8956 ; 2223-8956
ISSN (online)	2223-8956
ISSN	2223-8956
DOI	10.4103/tcmj.tcmj_233_21
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Article ; Online: Examining the impact of trimester of diagnosis on COVID-19 disease progression in pregnancy.

Schell, Rachel C / Macias, Devin A / Garner, W Holt / White, Alesha M / McIntire, Donald D / Pruszynski, Jessica / Adhikari, Emily H

American journal of obstetrics & gynecology MFM

2022 Volume 4, Issue 6, Page(s) 100728

Abstract: ... severe, or critical illness, and stratified by trimester of COVID-19 diagnosis. Primary outcomes included ... progression of COVID-19 disease severity and a composite obstetrical outcome, which included delivery at <37 ... maternal and neonatal outcomes. Little is currently known about how the timing of infection during ...

Abstract	Background: COVID-19 infection is associated with increased morbidity in pregnancy and adverse maternal and neonatal outcomes. Little is currently known about how the timing of infection during pregnancy affects these outcomes. Objective: This study aimed to evaluate the effect of trimester of COVID-19 infection on disease progression and severity in pregnant patients. Study design: This was a prospective cohort study of pregnant patients diagnosed with COVID-19 infection who delivered at a single urban hospital. Universal testing for SARS-CoV-2 was performed at hospital admission and for symptomatic patients in inpatient, emergency department, and outpatient settings. Disease severity was defined as asymptomatic, mild, moderate, severe, or critical on the basis of National Institutes of Health criteria. We evaluated disease progression from asymptomatic to symptomatic infection and from asymptomatic or mild infection to moderate, severe, or critical illness, and stratified by trimester of COVID-19 diagnosis. Primary outcomes included progression of COVID-19 disease severity and a composite obstetrical outcome, which included delivery at <37 weeks, preeclampsia with severe features, abruption, excess blood loss at delivery (>500 mL for vaginal or >1000 mL for cesarean delivery), and stillbirth. Results: From March 18, 2020 to September 30, 2021, 1326 pregnant patients were diagnosed with COVID-19 and delivered at our institution, including 103 (8%) first-, 355 (27%) second-, and 868 (65%) third-trimester patients. First-trimester patients were older and had more medical comorbidities; 86% of patients in all trimesters were Hispanic. Among patients admitted within 14 days of a positive test, 3 of 18 (17%) first-trimester, 20 of 47 (43%) second-trimester, and 34 of 574 (6%) third-trimester patients were admitted for the indication of COVID-19 illness. Across all trimesters, 1195 (90%) of 1326 COVID-19 infections were asymptomatic or mild, and 45 (10%) of 436 initially asymptomatic patients developed symptoms. Of patients with asymptomatic or mild symptoms at diagnosis, 4 (4%) of 93 first-, 18 (5%) of 337 second-, and 49 (6%) of 836 third-trimester patients developed moderate, severe, or critical illness (P=.80). There was no significant difference in composite obstetrical outcome with respect to trimester of COVID-19 diagnosis (24% first-trimester, 28% second-trimester, 28% third-trimester patients; P=.69). Conclusion: Moderate, severe, or critical illness develops in almost 10% of pregnant patients. The frequency of COVID-19 disease progression in pregnancy does not differ by trimester of diagnosis.
Language	English
Publishing date	2022-08-20
Publishing country	United States
Document type	Journal Article
ISSN	2589-9333
ISSN (online)	2589-9333
DOI	10.1016/j.ajogmf.2022.100728
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Article ; Online: COVID-19 infection in pregnancy: a single center experience with 75 cases.

Damar Çakırca, Tuba / Torun, Ayşe / Hamidanoğlu, Melek / Portakal, Reyhan Derya / Ölçen, Merhamet / Çakırca, Gökhan / Haksever, Murat

Ginekologia polska

2021 Volume 93, Issue 5, Page(s) 410–415

Abstract: Objectives: This study aimed to summarize the clinical features, maternal, fetal, and perinatal ... and radiological findings, and maternal and perinatal outcomes were analyzed using medical records ... diagnosed of coronavirus disease 2019 (COVID-19). Demographic characteristics, clinical courses, laboratory ...

Abstract	Objectives: This study aimed to summarize the clinical features, maternal, fetal, and perinatal outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) proven infections of pregnancies. Material and methods: This retrospective single center study was conducted on 75 pregnant patients diagnosed of coronavirus disease 2019 (COVID-19). Demographic characteristics, clinical courses, laboratory and radiological findings, and maternal and perinatal outcomes were analyzed using medical records. Results: Of the 75 pregnant women infected with COVID-19, 49 had mild infections. The most common initial symptoms were myalgia (61.4%), cough (57.9%), headache (50.9%), and dyspnea (49.1%). More than half of the patients (57.3%) on admission were in their third trimester. Three patients had pre-existing chronic illnesses (hypothyroidism, asthma and rheumatoid arthritis) and three patients had gestational diabetes. There were two cases admitted to intensive care unit, one of whom was due to COVID-19 infection. No maternal mortality was recorded. The mode of delivery was a cesarean section in 20 cases among the 35 labors. Six gestations ended in a miscarriage and 11 women gave birth prematurely. One stillbirth occurred at the 38th week of gestation. Among 37 neonates, 14 necessitated admission to neonatal intensive care unit. Neonatal mortality, congenital malformation, and mother to child transmission were not seen in the newborns. Conclusions: The results of our study suggest that the clinical course of COVID-19 infection in pregnant women was mostly asymptomatic/mild. There was also no evidence of vertical transmission of COVID-19 infection.
MeSH term(s)	Child ; Female ; Pregnancy ; Infant, Newborn ; Humans ; COVID-19/epidemiology ; SARS-CoV-2 ; Pregnancy Outcome/epidemiology ; Retrospective Studies ; Cesarean Section ; Pregnancy Complications, Infectious/diagnosis ; Infectious Disease Transmission, Vertical
Language	English
Publishing date	2021-07-15
Publishing country	Poland
Document type	Journal Article
ZDB-ID	130894-4
ISSN	2543-6767 ; 0017-0011
ISSN (online)	2543-6767
ISSN	0017-0011
DOI	10.5603/GP.a2021.0118
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Article ; Online: COVID-19 as an independent risk factor for subclinical placental dysfunction.

Jaiswal, Nishtha / Puri, Manju / Agarwal, Kiran / Singh, Smita / Yadav, Reena / Tiwary, Narendra / Tayal, Prerna / Vats, Barkha

European journal of obstetrics, gynecology, and reproductive biology

2021 Volume 259, Page(s) 7–11

Abstract: ... in symptomatic cases of COVID-19 pregnancies and its consequences on the outcomes need to be analysed. ... fetus are still being explored. SARS-CoV2 can potentially compromise maternal and neonatal outcomes and ... pregnancies with either no symptoms or mild coronavirus disease (COVID)-19 related symptoms and ...

Abstract	Background: The pandemic of the severe acute respiratory distress syndrome-associated Coronavirus-2 (SARS-CoV-2) has affected millions around the world. In pregnancy the dangers to the mother and fetus are still being explored. SARS-CoV2 can potentially compromise maternal and neonatal outcomes and this may be dependent on the pregnancy stage during which the infection occurs. Objective: The present study was done to find the histopathological alterations in the placenta of SARS-CoV-2 positive pregnancies with either no symptoms or mild coronavirus disease (COVID)-19 related symptoms and its association with neonatal outcomes. Study design: This was a prospective analytical study. Twenty seven asymptomatic or mildly symptomatic SARS-CoV-2 positive pregnant women with a singleton pregnancy delivered between 1 Results: The baseline characteristics were comparable between the cases and controls. The following features of maternal vascular malperfusion (MVM) were significantly higher in the placentae of COVID-19 positive pregnancies: retroplacental hematomas (RPH), accelerated villous maturation (AVM), distal villous hyperplasia (DVH), atherosis, fibrinoid necrosis, mural hypertrophy of membrane arterioles (MHMA), vessel ectasia and persistence of intramural endovascular trophoblast (PIEVT). Fetal vascular malperfusion (FVM) significantly associated with the positive pregnancies were chorioangiosis, thrombosis of the fetal chorionic plate (TFCP), intramural fibrin deposition (IMFD) and vascular ectasia. Additionally, perivillous fibrin deposition was also significantly higher in the placentae of cases. The percentage of spontaneously delivered women was comparable in the two groups. The sex and weight of the newborn and the number of live births were comparable between the two groups. Conclusions: Asymptomatic or mildly symptomatic SARS-CoV-2 positive pregnant women, with otherwise uncomplicated pregnancies, show evidence of placental injury at a microscopic level. Similar findings have been demonstrated in other studies too. This placental injury apparently does not lead to poor pregnancy outcomes. The extent of this injury in symptomatic cases of COVID-19 pregnancies and its consequences on the outcomes need to be analysed.
MeSH term(s)	Adult ; Birth Weight ; COVID-19/complications ; COVID-19/pathology ; COVID-19/physiopathology ; Carrier State ; Case-Control Studies ; Female ; Humans ; Infant, Newborn ; Male ; Placenta/blood supply ; Placenta/pathology ; Placenta Diseases/etiology ; Placenta Diseases/pathology ; Placenta Diseases/physiopathology ; Pregnancy ; Pregnancy Complications, Infectious/pathology ; Pregnancy Complications, Infectious/physiopathology ; Pregnancy Outcome ; Prospective Studies ; SARS-CoV-2 ; Severity of Illness Index ; Young Adult
Language	English
Publishing date	2021-01-29
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	190605-7
ISSN	1872-7654 ; 0301-2115 ; 0028-2243
ISSN (online)	1872-7654
ISSN	0301-2115 ; 0028-2243
DOI	10.1016/j.ejogrb.2021.01.049
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Article ; Online: Maternal and Neonatal Outcomes of Pregnant Women with COVID-19 in İstanbul, Turkey

İbrahim Polat / Merve Aldıkaçtıoğlu Talmaç / Pınar Yalçın Bahat / Ayşegül Bestel / Aysu Akça / Ozan Karadeniz / Seda Yılmaz Semerci / Merih Çetinkaya

Cam & Sakura Medical Journal, Vol 2, Iss 3, Pp 90-

A Single-center, Descriptive Study

2022 Volume 96

Abstract: ... Maternal and neonatal outcomes of COVID-19 pregnant women are illustrated by looking at the following ... COVID-19) and to determine the maternal and neonatal consequences of the disease. Material and Methods ... of COVID-19 were included in the study. The most common complaint at admission was cough (50%), and ...

Abstract	Objective: This study aimed to define the approach to pregnant women with coronavirus disease-2019 (COVID-19) and to determine the maternal and neonatal consequences of the disease. Material and Methods: Maternal and neonatal outcomes of COVID-19 pregnant women are illustrated by looking at the following parameters: Real-time reverse transcription polymerase chain reaction test, complete blood count, D-dimer and ferritin concentration, lymphocyte count, aspartate aminotransferase, C-reactive protein, and alanine aminotransferase level, neonatal umbilical blood gas analysis, admission to the neonatal intensive care unit (NICU), and lung computed tomography images. Results: Forty-three trimester pregnant women with a diagnosis of COVID-19 were included in the study. The most common complaint at admission was cough (50%), and the most common accompanying finding was shortness of breath and fever. The delivery method was 34 patients cesarean section and 6 patients vaginal delivery. Two neonates were admitted to the NICU due to respiratory distress. There were no maternal or infant deaths. The patients were hospitalized for approximately 5 days. Conclusion: To sum up, our study is a preliminary study and there is a need for studies involving a much larger number of patients in terms of clinical features and follow-up treatment of pregnant women with COVID-19. In this regard, long-term patient follow-up results will be extremely important.
Keywords	covid-19 ; maternal and neonatal outcomes ; pregnant ; obstetrics and gynecology ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	Galenos Publishing House
Document type	Article ; Online
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Article ; Online: Maintaining Continuity of Care for Expectant Mothers in Kenya During the COVID-19 Pandemic: A Study of MomCare.

Sanctis, Teresa De / Etiebet, Mary-Ann / Janssens, Wendy / van der Graaf, Mark H / van Montfort, Colette / Waiyaiya, Emma / Spieker, Nicole

Global health, science and practice

2022 Volume 10, Issue 4

Abstract: ... in MomCare during the COVID-19 lockdowns, while quality of care and outcomes were maintained. Public health ... SMS messages to inform mothers of open facilities and COVID-19 protocols, and training for clinic ... staff in managing COVID-19 patients and infection prevention. We compare data collected ...

Abstract	In Kenya, early coronavirus disease (COVID-19) modeling studies predicted that disruptions in antenatal care and hospital services could increase indirect maternal and neonatal deaths and stillbirths. As the Kenyan government enforced lockdowns and a curfew, many mothers-to-be were unable to safely reach hospital facilities, especially at night. Fear of contracting COVID-19, increasing costs of accessing care, stigma, and falling incomes forced many expectant mothers to give birth at home. MomCare, which primarily serves communities in remote areas and urban slums, links mothers-to-be with payers and health care providers, following a standardized pregnancy program based on World Health Organization guidelines at a predetermined cost and quality. Expectant mothers gain access to care through a mobile wallet on their feature phone (voice, text, and basic internet), and providers are paid after appropriate care is given. Within the first 3 weeks of the pandemic in Kenya, the following services were added to the MomCare bundle: emergency ambulance services during curfew hours, extended bed allowances to encourage early care, phone calls to check on mothers approaching their delivery dates and to promote the generation of a birth plan, SMS messages to inform mothers of open facilities and COVID-19 protocols, and training for clinic staff in managing COVID-19 patients and infection prevention. We compare data collected through the MomCare platform during the 6 months before the first confirmed COVID-19 case in Kenya (September 2019-February 2020) with data collected during the 6 months that followed. This study shows that care-seeking behaviors (enrollment, antenatal/postnatal care, skilled deliveries) increased for mothers-to-be enrolled in MomCare during the COVID-19 lockdowns, while quality of care and outcomes were maintained. Public health practitioners can promote interactive, patient-driven technology like MomCare to augment traditional responses, quickly linking payments with patients and providers in times of crisis.
MeSH term(s)	COVID-19/epidemiology ; Communicable Disease Control ; Continuity of Patient Care ; Female ; Humans ; Infant, Newborn ; Kenya/epidemiology ; Mothers ; Pandemics ; Pregnancy
Language	English
Publishing date	2022-08-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2710875-2
ISSN	2169-575X ; 2169-575X
ISSN (online)	2169-575X
ISSN	2169-575X
DOI	10.9745/GHSP-D-21-00665
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