AFJOG

African Journal of Obstetrics and Gynaecology | Volume 3 | Issue 2 | 2025 | 27 ORIGINAL RESEARCH African Journal of Obstetrics and Gynaecology | Volume 3 | Issue 2 | 2025 | The impact of the Covid -19 pandemic on Obstetric care in a resource limited setting: A 12- month retrospective chart review ABSTRACT Objective: COVID-19 was declared a public health emergency (PHE) in 2020. PHEs significantly disrupt the provision of public health services in low-to-middle-income (LMIC) settings. The resultant shift in resource allocation from vulnerable populations such as pregnant women and their new-borns, to the general population increases adverse outcomes. This study looked at the impact of COVID-19 on obstetric care, maternal, and neonatal outcomes. Methods: A retrospective chart review from 1 March 2019 to 29 February 2020 (controls), and 1 March 2020 to 28 February 2021 (study) was conducted at Grey’s Hospital, KwaZulu-Natal, South Africa. All pregnant women who were not infected with COVID-19 were recruited. Descriptive statistics in the form of frequencies and percentages were computed and a test of proportions were conducted to determine significance of changes. A p-value of ≤0.05 was considered significant. Results: The proportion of unemployed women increased from 912 (78.8%) to 764 (83.1%) (p=0.03), neonatal birthweight in the category 2501 to 3999g increased from 473 (40.9%) to 515 (52.4%) (0.0003), and stillbirths increased from 71 to 76 (6.5%). There was a reduction in the proportion of women who had 5 or more antenatal visits from 863 (74.6%) to 625 (70.1%) (p=0.05), caesarean deliveries from 942 (81.4%) to 707 (76.9%) (p=0.03), neonates with NICU admission from 434 (37.5%) to 265 (27.0%) (p=0.004), cardiac comorbidities from 59 (25.9%) to 25 (7.1%) (p=0.05), and diabetic comorbidities from 63 (27.6%) to 33 (9.4%) (p=0.04) during the pandemic. Conclusion: The economic consequence of COVID-19 was evident by the increase in unemployment levels, and despite the improvement in neonatal outcomes and maternal comorbidities, the uptake of antenatal visits declined. Keywords: COVID-19; maternal comorbidities; maternal outcomes; neonatal outcomes INTRODUCTION Coronavirus disease (COVID-19) is an infectious respiratory disease caused by the Severe Acute Respiratory Syndrome Cornonavirus-2 (SARS-CoV-2) virus that is spread by liquid droplets 1 . It can lead to mild or moderate illness in infected persons, recovery can occur without seeking medical attention, or become seriously ill and require medical attention. The COVID-19 pandemic, may cause severe disease in individuals of all ages, including neonates and pregnant women, with pregnant women at a higher risk of developing complications such as spontaneous abortion and preterm labour 2 . The COVID-19 pandemic and subsequent restrictions hugely affected maternal and neonatal care resource deployment, resulting in shortfalls in the delivery of essential medical supplies, deteriorating healthcare workforce capacity, and undermined access to life-supporting services for maternal and neonatal care. During the COVID-19 pandemic, resource diversion for Bangladesh, Nigeria, and South Africa was moved to pandemic-related response 3 . There was a decline in maternal and neonatal care services due to this reallocation since healthcare units shifted focus towards COVID-19. There were drastic declines in the use of major services including antenatal care and immunization due to lockdowns and fear of infections, coupled with an absence of support for frontline workers and low safety measures 3 . Our study aimed to assess changes in trends of antenatal care (ANC) utilisation, as well as maternal and neonatal outcomes during the COVID-19 pandemic (the pandemic). To achieve this, the following objectives were assessed: determine the proportion of patients delaying booking for ANC, determine the changes in the number of overall antenatal visits per patient, assess maternal outcomes and neonatal outcomes. MATERIALS AND METHODS Study Design A retrospective chart review was conducted over two study periods: before Covid-19 (01 March 2019 – 29 February 2020) and during Covid-19 (01 March 2020 – 28 February 2021). Data collected before the pandemic was used as the control data while that collected during the pandemic was used as our study data. Study Population The study was conducted at Grey’s Hospital, a tertiary hospital in Pietermaritzburg, KwaZulu-Natal, South Africa. All parturients at Grey’s Hospital during the study period as well as those referred in up to six weeks postpartum were included. Women with confirmed Covid-19 infection were excluded. Study Population The study was conducted at Grey’s Hospital, a tertiary hospital in Pietermaritzburg, KwaZulu-Natal, South Africa. All parturients at Grey’s Hospital during the study period as well as those referred in up to six weeks postpartum were included. Women with confirmed Covid-19 infection were excluded. Dr Sinovuyo Madikane 1 , Prof Thinagrin Dhasarathun Naidoo 2 1 .Registrar Department of obstetrics and gynaecology, Pietermaritzburg Hospitals complex and Nelson R Mandela School of medicine, University of KwaZulu Natal, Durban, South Africa 2 . Associate Professor Department of obstetrics and gynaecology, Greys Hospital Pietermaritzburg and Nelson R Mandela School of medicine, University of KwaZulu Natal, Durban, South Africa CORRESPONDENCE: Dr S Madikane | Email: sinovuyomadikane4@gmail.com The impact of the Covid -19 pandemic on Obstetric care in a resource limited setting: A 12- month retrospective chart review