AFJOG

African Journal of Obstetrics and Gynaecology | Volume 3 | Issue 2 | 2025 | 32 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 South Africa does have a child support grant available to those in need which is only available from birth 23 . However, there is no pregnancy support grant available to assist expectant mothers to achieve healthy pregnancies. During the pandemic, the government implemented the Special COVID-19 Social Relief of Distress grant which provided qualifying individuals with R350 per month 24 . This grant may have resulted in an increase in maternal and foetal nutritional status thus leading to improvement in neonatal birthweights. The differences found between neonatal outcomes of our study versus those in other studies may be due to geographical location and differences in healthcare management styles during the pandemic. However, the improvement of neonatal outcomes in our study may have been due to maternal lifestyle changes during the pandemic. These lifestyle changes included, but were not limited to, improved quality of sleep, the uptake of healthy eating behaviours, as well as engagement in more physical activities 25 . During the pandemic, there was a great decline in the proportion of women who had cardiac conditions as well as diabetes. As noted in our results, there was a decrease in the number of women who attended antenatal care during the pandemic. This decrease may have been in women with comorbidities and may thus have been reflected as a decline in comorbidities subsequently making it seem as if there was a decline in comorbidities when this was not in fact the case. However, a study from a tertiary referral centre in Israel found that there was in fact an increase in hypertensive disorders (from 4.0% to 7.5%, p=0.005) and gestational diabetes mellitus (from 10.0% to 13.0%, p=0.03) 19 . A study comparing maternal and neonatal outcomes of various Covid-19 waves in Malawi found that there were no differences in comorbidities across the various waves17. The reduction in maternal comorbidities can be attributed to attempts to improve quality of life in a bid to mitigate the negative impacts of being infected by COVID-19 through improvements in maternal quality of sleep, healthier eating behaviour, and increased engagement in physical activity 25 as is with the improvement in neonatal outcomes above. The findings from this study suggests that, in contrast to the case with most discoveries at the global level, the COVID-19 pandemic lockdown benefited obstetric services at Grey's Hospital. One initiative in six low- and middle- income countries (Haiti, Lesotho, Liberia, Malawi, Mexico, and Sierra Leone) documented innovations such as offering PPEs, changing facilities to accommodate social distancing interventions, maintaining the services of community health workers, effective communicationmethods, and augmenting staff capacity. South Africa also adopted the same strategy, which have likely contributed to the improved maternal health outcomes witnessed at Grey's Hospital throughout the pandemic, demonstrating the value of anticipatory healthcare interventions in emergency situations. The following limitations were noted in our study: our study was only conducted at one hospital, within one province of the nine South African provinces. Therefore, this limits the generalisability of our results as our findings cannot be inferred to the entire KZN or even South African context. Data analysis was only limited to the comparison of the pre-covid era and a year-long Covid-19 period. However, perhaps more informative results would have been obtained if the year-long Covid period were split into the various Covid-19 waves such as the delta, beta, and omicron waves. That would have allowed us to produce comprehensive trends of outcomes and not simply included the peri- Covid-19 results into one “wave.” This was a retrospective chart review meaning that the data was not collected for purposes of this study but for use by medical staff at Grey’s Hospital. This may have affected the quality of the data collected, resulting in charts with missing data. Ultimately, some files were either not retrieved or excluded, which may have resulted in selection bias. Despite increased unemployment due to the COVID-19 pandemic, our study found improved neonatal outcomes and fewer maternal comorbidities, including fewer NICU admissions, more normal birthweight babies, and decreases in cardiac disease, diabetes, and caesarean sections. Fewer women did attend the recommended number of antenatal visits. These findings urge health authorities and healthcare providers in the next public health emergency to take targeted measures to encourage routine antenatal care and safeguard pregnant women from losing access to essential maternal health services in the event of external barriers. AUTHORS CONTRIBUTIONS Both Dr S Madikane and Prof TD Naidoo meet all four ICMJE criteria for authorship Dr S Madikane Prof TD Naidoo Design Drafted Contributed to the concept and draft Planning Drafted Reviewed Conduct Collected all data - Data analysis Analysed statistician report Reviewed Manuscript writing Drafted Reviewed and corrected the work critically. Edited. Approved the final version to be published Funding : None Conflict of interest : The authors have no conflicts of interest. Data availability statement: The data that support the findings of this study are available from the corresponding author upon reasonable request. REFERENCES ¦ ¦¡ ¤ ¡ ¦¡ ¤