The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review.
The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review.
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DOI：
10.1186/s12978-021-01070-6
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发表时间：
2021-01-18
影响因子：
3.4
通讯作者：
Tiemeier H
中科院分区：
文献类型：
--
作者：
Kotlar B;Gerson EM;Petrillo S;Langer A;Tiemeier H
2019冠状病毒病大流行直接和间接影响孕产妇健康，直接和间接影响相互交织。为了以一种快速的形式对这一广泛的主题提供一个全面的概述，我们进行了一次范围审查。进行了一次范围界定审查，以汇编关于这一流行病对孕产妇健康的直接和间接影响的证据，并概述迄今为止最重要的成果。工作文件和新闻文章被视为适当的证据，沿着同行审查的出版物，以捕捉迅速变化的最新情况。2020年1月1日至9月11日期间发表的英文文献，如果与COVID-19大流行对孕妇的身体、精神、经济或社会健康和福祉的直接或间接影响有关，则纳入。叙述性描述是关于作者发现最多证据的主题领域。检索得到396篇出版物，其中95篇被纳入。怀孕的人被发现比没有怀孕的人有更严重症状的风险。宫内、垂直和母乳传播不太可能。COVID-19阳性患者的分娩、分娩和母乳喂养指南各不相同。据报告，产妇心理健康问题严重增加，如临床相关的焦虑和抑郁。家庭暴力似乎激增。产前检查次数减少，医疗基础设施紧张，实施的潜在有害政策几乎没有证据。妇女比男子更有可能因这一流行病而失去收入，职业母亲难以应付日益增加的育儿需求。未发现孕妇和母亲感染COVID-19的风险高于未怀孕的人，但与未怀孕的人相比，有症状的COVID-19孕妇可能会经历更多的不良后果，并且似乎面临不成比例的不良社会经济后果。高收入和中低收入国家都面临着巨大的困难。应将更多的资源用于高质量的流行病学研究。2019冠状病毒病大流行既通过感染本身直接影响生殖和围产期健康，也通过医疗保健、社会政策或社会和经济环境的变化间接影响生殖和围产期健康。COVID-19对孕产妇健康的直接和间接影响交织在一起。为了对这一广泛的主题提供全面的概述，我们进行了范围审查。有症状的COVID-19孕妇可能比未怀孕的人经历更严重的后果。子宫内和母乳传播以及分娩期间病毒从母亲传给婴儿的可能性不大。COVID-19阳性患者的分娩、分娩和母乳喂养指南各不相同，这种可变性可能会造成不确定性和不必要的伤害。产前检查次数减少，医疗基础设施紧张，在高收入和低/中等收入国家实施的潜在有害政策几乎没有证据。COVID-19对孕产妇健康的社会和经济影响显著。据报告，许多国家在艾滋病流行期间，产妇经常出现心理健康问题，如临床上相关的焦虑和抑郁。这可能反映了问题的增加，但缺乏证明真正变化的研究。家庭暴力似乎激增。妇女比男子更容易因这一流行病而失去收入，职业母亲难以应付日益增加的育儿需求。我们提出几项建议：应将更多的资源用于流行病学研究，不应减少对孕妇和母亲的保健和社会服务，并需要在流行病期间更加重视产妇的心理健康。
The Covid-19 pandemic affects maternal health both directly and indirectly, and direct and indirect effects are intertwined. To provide a comprehensive overview on this broad topic in a rapid format behooving an emergent pandemic we conducted a scoping review. A scoping review was conducted to compile evidence on direct and indirect impacts of the pandemic on maternal health and provide an overview of the most significant outcomes thus far. Working papers and news articles were considered appropriate evidence along with peer-reviewed publications in order to capture rapidly evolving updates. Literature in English published from January 1st to September 11 2020 was included if it pertained to the direct or indirect effects of the COVID-19 pandemic on the physical, mental, economic, or social health and wellbeing of pregnant people. Narrative descriptions were written about subject areas for which the authors found the most evidence. The search yielded 396 publications, of which 95 were included. Pregnant individuals were found to be at a heightened risk of more severe symptoms than people who are not pregnant. Intrauterine, vertical, and breastmilk transmission were unlikely. Labor, delivery, and breastfeeding guidelines for COVID-19 positive patients varied. Severe increases in maternal mental health issues, such as clinically relevant anxiety and depression, were reported. Domestic violence appeared to spike. Prenatal care visits decreased, healthcare infrastructure was strained, and potentially harmful policies implemented with little evidence. Women were more likely to lose their income due to the pandemic than men, and working mothers struggled with increased childcare demands. Pregnant women and mothers were not found to be at higher risk for COVID-19 infection than people who are not pregnant, however pregnant people with symptomatic COVID-19 may experience more adverse outcomes compared to non-pregnant people and seem to face disproportionate adverse socio-economic consequences. High income and low- and middle-income countries alike faced significant struggles. Further resources should be directed towards quality epidemiological studies. The Covid-19 pandemic impacts reproductive and perinatal health both directly through infection itself but also indirectly as a consequence of changes in health care, social policy, or social and economic circumstances. The direct and indirect consequences of COVID-19 on maternal health are intertwined. To provide a comprehensive overview on this broad topic we conducted a scoping review. Pregnant women who have symptomatic COVID-19 may experience more severe outcomes than people who are not pregnant. Intrauterine and breastmilk transmission, and the passage of the virus from mother to baby during delivery are unlikely. The guidelines for labor, delivery, and breastfeeding for COVID-19 positive patients vary, and this variability could create uncertainty and unnecessary harm. Prenatal care visits decreased, healthcare infrastructure was strained, and potentially harmful policies are implemented with little evidence in high and low/middle income countries. The social and economic impact of COVID-19 on maternal health is marked. A high frequency of maternal mental health problems, such as clinically relevant anxiety and depression, during the epidemic are reported in many countries. This likely reflects an increase in problems, but studies demonstrating a true change are lacking. Domestic violence appeared to spike. Women were more vulnerable to losing their income due to the pandemic than men, and working mothers struggled with increased childcare demands. We make several recommendations: more resources should be directed to epidemiological studies, health and social services for pregnant women and mothers should not be diminished, and more focus on maternal mental health during the epidemic is needed.
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