Marked variability in institutional deliveries and neonatal outcomes during the COVID-19 lockdown in Nigeria
Marked variability in institutional deliveries and neonatal outcomes during the COVID-19 lockdown in Nigeria
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DOI：
10.1093/trstmh/trad030
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发表时间：
2023-06-02
影响因子：
2.2
通讯作者：
Allen，Stephen
中科院分区：
文献类型：
--
作者：
Ezenwa，Beatrice N.;Fajolu，Iretiola B.;Allen，Stephen
2019年冠状病毒病（COVID-19）大流行以及为缓解其传播而采取的干预措施影响了医疗保健的获得，包括医院分娩和新生儿护理。本研究评估了COVID-19封锁措施对尼日利亚新生儿服务利用率的影响。方法回顾性分析了在医院分娩的妇女和新生儿病房收治的婴儿的记录，（2019年3月至2020年2月）和（2020年3月至2021年2月）新冠肺炎疫情-尼日利亚选定设施的19大流行封锁。结果在尼日利亚的COVID-19封锁期间，全国范围内的机构分娩减少，封闭前有14444宗，封闭期间则有11723宗，减少18.8%。在封锁期间，早产儿入院人数下降（封锁期间为30.6%，封锁前为32.6%），但早产儿入院的比例保持不变。新生儿入院率在不同地区之间变化，没有一致的模式。虽然新生儿黄疸和早产仍然是最常见的入院原因，但严重的围产期窒息增加了近50%。与封锁前相比，COVID-19封锁期间的新生儿死亡率显著较高（分别为110.6/1000 [11.1%] vs 91.4/1000 [9.1%]; p=0.01）。如果在封锁期间在设施外分娩，新生儿死亡的几率约为4倍（p<0. 001）。结论COVID-19封锁对医疗保健寻求分娩和新生儿护理产生了明显的有害影响，这些影响在不同区域之间变化，没有一致的模式。
BackgroundThe coronavirus disease 2019 (COVID-19) pandemic and the interventions to mitigate its spread impacted access to healthcare, including hospital births and newborn care. This study evaluated the impact of COVID-19 lockdown measures on newborn service utilization in Nigeria.MethodsThe records of women who delivered in hospitals and babies admitted to neonatal wards were retrospectively reviewed before (March 2019–February 2020) and during (March 2020–February 2021) the COVID-19 pandemic lockdown in selected facilities in Nigeria.ResultsThere was a nationwide reduction in institutional deliveries during the COVID-19 lockdown period in Nigeria, with 14 444 before and 11 723 during the lockdown—a decrease of 18.8%. The number of preterm admissions decreased during the lockdown period (30.6% during lockdown vs 32.6% pre-lockdown), but the percentage of outborn preterm admissions remained unchanged. Newborn admissions varied between zones with no consistent pattern. Although neonatal jaundice and prematurity remained the most common reasons for admission, severe perinatal asphyxia increased by nearly 50%. Neonatal mortality was significantly higher during the COVID-19 lockdown compared with pre-lockdown (110.6/1000 [11.1%] vs 91.4/1000 [9.1%], respectively; p=0.01). The odds of a newborn dying were about four times higher if delivered outside the facility during the lockdown (p<0.001).ConclusionsThe COVID-19 lockdown had markedly deleterious effects on healthcare seeking for deliveries and neonatal care that varied between zones with no consistent pattern.