(474) Impact of COVID-19 on Maternal and Neonatal Outcomes

Thursday, February 9, 2023

4:00 PM – 5:30 PM

Objective: There is limited data exploring the impact of COVID-19 on perinatal outcomes in African countries and no studies from Ghana. We aimed to describe total number of births, Caesarean section (CS) rates and maternal-neonatal outcomes before and after the COVID-19 pandemic in facilities across Ghana.

Study Design: Using the Ghana District Health Information Management System (DHIMS), we extracted data from 2019 (pre-pandemic) and 2020-2021 (post pandemic). Data included facility characteristics (facility level, ownership, and geographical region) facility work volume (total number of annual admissions, overall births, CS) and adverse obstetric outcomes (annual maternal mortality (MMR), intrapartum stillbirth rate (IPS), and early neonatal death rate (END)). Continuous variables were summarized as means and standard deviations; categorical variables were summarized as frequencies and percentages. Differences pre- and post-pandemic were compared using Pearson's Chi-square test.

Results: There were 1,350,403 births (60.1% of all national births) across 1,654 facilities between 2019 and 2021 (Table 1). Most births occurred at district facilities, (n=645,665, 47.8%), government-owned facilities (n=768,915, 56.9%) and in the Ashanti region (n= 272,770, 20.2%). Compared to 2019, the mean annual hospital admissions, maternity admissions, births, and CS in 2020-2021 decreased by 13.6% (P=0.05), 12.5% (P=0.2), 12.3 % (P=0.3) and 3.4% (P=0.9), respectively (Figure1). The mean annual CS rate increased from 31% to 39.2% (+8.2%, (p=0.04) and MMR from 93 to 101/100,000 (+ 9.2% (P=0.7). IPS and END decreased by 2.9% (P= 0.5) and 10% (P=0.7) respectively.

Conclusion: Following the COVID-19 pandemic in Ghana, there were fewer hospital and maternity admissions, overall births and CS but a higher CS rate at facilities with no differences in facility-based maternal or perinatal mortality. Further studies are required to elucidate the impact of the pandemic on rates of home births and associated outcomes and the ongoing effect of the pandemic on facility-based births.

Primary & Presenting Author(s)

Grace Newman, BSc, MD
Resident Doctor
KORLE-BU TEACHING HOSPITAL
Accra, Ghana, Ghana

Coauthor(s)

Isioma Okolo, MBChB MRCOG DTMH
Research Fellow
Massachusetts General Hospital
Boston, Massachusetts, United States
HK
Henry Kumi, MBBS
KORLE-BU TEACHING HOSPITAL
Accra, Ghana, Ghana
CF
Chris Fofie, MBBS
Ghana Health Service
Accra, Ghana, Ghana
AE
Anam Ehsan, MBBS
Massachusetts General Hospital
Boston, Massachusetts, United States
PD
Paola Del Cueto, MD
Research Fellow
Massachusetts General Hospital
Boston, Massachusetts, United States
AM
Abonie Maclean, MBBS
KORLE-BU TEACHING HOSPITAL
Accra, Ghana, Ghana
SA
Solomon Armah, MBBS
KORLE-BU TEACHING HOSPITAL
Accra, Ghana, Ghana
Henry Mark Mark Lugobe, MBBCH
Obstetrician and Gynecologist
Mbarara University of Science and Technology
Mbarara, Uganda, Uganda
IN
Isaac Nsiah, MBBS
KORLE-BU TEACHING HOSPITAL
Accra, Ghana, Ghana
Adeline A. Boatin, MD, MPH (she/her/hers)
Assistant Professor
Massachusetts General Hospital, Harvard Medical School
Boston, Massachusetts, United States
KA
Kwame Adu-Bonsaffoh, MBBCH
Lecturer
Department of Obstetrics and Gynecology
Accra, Ghana, Ghana