The DOI matches its Crossref record; 9 of the 9 references it cites were found in a registry or an index.
Global changes in maternity care provision during the COVID-19 pandemic: A systematic review and meta-analysis
Open accessAbstract
Background The COVID-19 pandemic has had a profound impact on healthcare systems globally, with a worrying increase in adverse maternal and foetal outcomes. We aimed to assess the changes in maternity healthcare provision and healthcare-seeking by pregnant women during the COVID-19 pandemic. Methods We performed a systematic review and meta-analysis of studies of the effects of the pandemic on provision of, access to and attendance at maternity services (CRD42020211753). We searched MEDLINE and Embase in accordance with PRISMA guidelines from January 1st, 2020 to April 17th 2021 for controlled observational studies and research letters reporting primary data comparing maternity healthcare-seeking and healthcare delivery during compared to before the COVID-19 pandemic. Case reports and series, systematic literature reviews, and pre-print studies were excluded. Meta-analysis was performed on comparable outcomes that were reported in two or more studies. Data were combined using random-effects meta-analysis, using risk ratios (RR) or incidence rate ratios (IRR) with 95% confidence intervals (CI). Findings Of 4743 citations identified, 56 were included in the systematic review, and 21 in the meta-analysis. We identified a significant decrease in the number of antenatal clinic visits (IRR 0614, 95% CI 0486–0776, P <00001, I 2 =54.6%) and unscheduled care visits (IRR 0741, 95% CI 0602–0911, P = 00046, I 2 =00%) per week, and an increase in virtual or remote antenatal care (IRR 4656 95% CI 7762–2794, P <00001, I 2 =90.6%) and hospitalisation of unscheduled attendees (RR 1214, 95% CI 1118–1319, P <00001, I 2 =00%). There was a decrease in the use of GA for category 1 Caesarean sections (CS) (RR 0529, 95% CI 0407–0690, P <00001, I 2 =00%). There was no significant change in intrapartum epidural use ( P = 00896) or the use of GA for elective CS ( P = 079) Interpretation Reduced maternity healthcare-seeking and healthcare provision during the COVID-19 pandemic has been global, and must be considered as potentially contributing to worsening of pregnancy outcomes observed during the pandemic. Funding None.
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Cites
Cochrane Handbook for Systematic Reviews of Interventions
Higgins, J. P. T., Green, S., & Ben Van Den, A. (2020) · International Coaching Psychology Review · doi:10.53841/bpsicpr.2020.15.2.123 · Cited by 5,670
Analysing data and undertaking meta‐analyses
Deeks, J. J., Higgins, J. P., Altman, D. G., & on behalf of the Cochrane Statistical Methods Group (2019) · Cochrane Handbook for Systematic Reviews of Interventions · doi:10.1002/9781119536604.ch10 · Cited by 2,672 · cited 1×
“Statistical heterogeneity was quantified using the I(2) statistic for both analyses; I(2) <40% may not be important, 30 60% may represent moderate heterogeneity, 50 90% may represent substantial heterogeneity, and 75% represents considerable heterogeneity [19].”
Analysing Data and Undertaking Meta‐Analyses
Deeks, J. J., Higgins, J. P., & Altman, D. G. (2008) · Cochrane Handbook for Systematic Reviews of Interventions · doi:10.1002/9780470712184.ch9 · Cited by 1,800
Delay or avoidance of medical care because of COVID-19–related concerns—United States, June 2020.
Czeisler, M. É., Marynak, K., Clarke, K. E. N., Salah, Z., Shakya, I., Thierry, J. M., Ali, N., McMillan, H., Wiley, J. F., Weaver, M. D., et al. (2020) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6936a4 · Cited by 1,516 · cited 1×
“Women ’ s health-care-seeking behaviour has changed; women have reported being less willing to attend hospital due to fear of contracting COVID-19 [13,14].”
Chmielewska, B., Barratt, I., Townsend, R., Kalafat, E., van der Meulen, J., Gurol-Urganci, I., O'Brien, P., Morris, E., Draycott, T., Thangaratinam, S., et al. (2021) · The Lancet Global Health · doi:10.1016/s2214-109x(21)00079-6 · Cited by 1,092
Self-citationHunter, J. P., Saratzis, A., Sutton, A. J., Boucher, R. H., Sayers, R. D., & Bown, M. J. (2014) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2014.03.003 · Cited by 786
Goyal, M., Singh, P., Singh, K., Shekhar, S., Agrawal, N., & Misra, S. (2021) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.13457 · Cited by 282
’The impact of the coronavirus (COVID-19) pandemic on maternity care in Europe"
Coxon, K., Turienzo, C. F., Kweekel, L., Goodarzi, B., Brigante, L., Simon, A., & Lanau, M. M. (2020) · Midwifery · doi:10.1016/j.midw.2020.102779 · Cited by 232
Jardine, J., Relph, S., Magee, L., von Dadelszen, P., Morris, E., Ross‐Davie, M., Draycott, T., & Khalil, A. (2021) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.16547 · Cited by 199
Self-citation
Cited by
COVID-19 vaccination during pregnancy: coverage and safety
Blakeway, H., Prasad, S., Kalafat, E., Heath, P. T., Ladhani, S. N., Le Doare, K., Magee, L. A., O’Brien, P., Rezvani, A., von Dadelszen, P., et al. (2022) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2021.08.007 · Cited by 406
Self-citationChanges in Access to Health Services during the COVID-19 Pandemic: A Scoping Review
Pujolar, G., Oliver-Anglès, A., Vargas, I., & Vázquez, M.-L. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031749 · Cited by 284
Perinatal bereavement care during COVID-19 in Australian maternity settings
Boyle, F. M., Horey, D., Dean, J. H., Lohan, A., Middleton, P., & Flenady, V. (2022) · Journal of Perinatal Medicine · doi:10.1515/jpm-2021-0441 · Cited by 12
(2024) · doi:10.1186/s12884-024-06841-0 · Cited by 2
Metadata
- Authors
- Townsend, R., Chmielewska, B., Barratt, I., Kalafat, E., van der Meulen, J., Gurol-Urganci, I., O'Brien, P., Morris, E., Draycott, T., Thangaratinam, S., Doare, K. L., Ladhani, S., von Dadelszen, P., Magee, L. A., & Khalil, A.
- Venue
- eClinicalMedicine
- Publisher
- Elsevier BV
- Published
- 2021-07
- Volume
- 37
- Pages
- 100947
- ISSN
- 2589-5370 (ISSN-L)
- OpenAlex
- W3173726197
- Cited by
- 199
- References
- 9
- FWCI
- 9.65
- Type
- journal article
- Language
- en
- Open access
- gold
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- Townsend, R., Chmielewska, B., Barratt, I., Kalafat, E., van der Meulen, J., Gurol-Urganci, I., O'Brien, P., Morris, E., Draycott, T., Thangaratinam, S., Doare, K. L., Ladhani, S., von Dadelszen, P., Magee, L. A., & Khalil, A. (2021). Global changes in maternity care provision during the COVID-19 pandemic: A systematic review and meta-analysis. eClinicalMedicine. https://doi.org/10.1016/j.eclinm.2021.100947
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Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
