The impact of the COVID ‐19 pandemic on the diagnosis and management of pre‐eclampsia: Identifying healthcare delays

Le résumé fourni par la source

OBJECTIVE: To compare the prevalence of pre-eclampsia with and without severe features, and maternal and perinatal outcomes before and during the COVID-19 pandemic. METHODS: Cross-sectional study based on medical chart review of pregnant women admitted to a referral maternity hospital for childbirth between September 2019 to February 2020 (before the pandemic) and March 2020 to August 2021 (during the pandemic, subdivided into three 6-month periods). The prevalence of pre-eclampsia, maternal, and perinatal outcomes were compared. RESULTS: A total of 3914 deliveries were considered, 1059 pre-pandemic and 2855 during the pandemic. The overall prevalence of pre-eclampsia was 10.9%, not differing significantly among periods (9.3%-14.3%, P = 0.144). Social and demographic characteristics were similar between groups. The use of anti-hypertensive therapy during pregnancy decreased significantly (69.9% pre-pandemic versus 47.1%-54.0% during the pandemic, P = 0.007). The diagnosis of early-onset pre-eclampsia reduced significantly (37.9% before and 19.3%-30.2% during the pandemic, P = 0.025), and so did the proportion of severe pre-eclampsia (61.1% before and 38.1%-58.3% during the pandemic, P = 0.001). However, the gestational age at birth was similar between groups, around 36 weeks. COVID-19 positivity increased from 0.9% to 12.0% during the pandemic periods (P < 0.001). There were no maternal deaths. Newborns were less often admitted to intensive care during the pandemic, and over 60% of these admissions were the result of prematurity in all periods studied. Other perinatal outcomes remained similar. CONCLUSION: The prevalence of pre-eclampsia increased during the study period, with diagnoses occurring at later gestational ages, likely due to delays in healthcare access.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.