A Decade Comparison between the Years 2010-2013 and 2020-2023 of Poor Neonatal Outcomes and the Associated Factors using a Single Tertiary Hospital Birth Record: An Impact of the COVID-19 Pandemic
COVID-19 Pandemic Impact on Neonatal Outcomes
Abstract
This study aims to compare the prevalence of adverse neonatal outcomes before and during the COVID-19 pandemic and the factors associated with it. A comparative cross-sectional study was conducted at Hospital Canselor Tuanku Muhriz (HCTM) by retrieving registered labour room records for the year 2010-2013 and during the COVID-19 pandemic (the year 2020-2023). HCTM started using teleconsultation and digital MyMOMS applications for antenatal monitoring during the pandemic. The dependent variable in this study was the adverse neonatal outcome, and the independent variables were maternal demographics, maternal anthropometry, obstetric risk status and mode of delivery. Records retrieved were based on Malaysian citizens and singleton while incomplete data and ambiguous genitalia were excluded. There was no difference in the prevalence of adverse neonatal outcomes for both study periods (3.9%). Maternal age >35 years (aOR:1.26, 95%CI:1.01-1.57, p=0.045), premature birth (aOR:16.95, 95%CI: 13.85-20.74, p<0.001), Caesarean delivery (aOR:2.32, 95%CI 1.87-2.88, p<0.001), multiparity (aOR: 0.73, 95%CI 0.59-0.90, p=0.003) and male neonates (aOR: 1.24 95% CI: 1.01-1.51, p<0.040) were significant risk factors during the pandemic period. Meanwhile, in the pre-pandemic (2010-2013) period, maternal age >35 years (aOR:1.30, 95% CI:1.03-1.68, p=0.032), premature birth (aOR: 15.97, 95%CI: 13.22-19.29, p<0.001), high-risk pregnancy status (aOR: 2.01, 95%CI: 1.47-2.73, p<0.001) and Caesarean delivery (aOR:2.469, 95%CI 2.04-2.99, p<0.001) were associated with adverse neonatal outcomes. Strengthening maternal health by integrating virtual consultation or digital health to ensure continuity of care for early risk identification during disasters will improve quality assurance in providing maternal care.
Keywords :
COVID-19 pandemic; low birth weight; neonatal outcome; NICU admission; stillbirth,
Abstrak
Kajian ini bertujuan untuk membandingkan prevalen hasil neonatal yang buruk sebelum dan semasa pandemik COVID-19 serta faktor-faktor yang berkaitan dengannya. Kajian perbandingan keratan rentas telah dijalankan di Hospital Canselor Tuanku Muhriz (HCTM) dengan membandingkan rekod kelahiran untuk tahun 2010-2013 dan semasa pandemik COVID-19 (tahun 2020-2023). HCTM mula menggunakan telekonsultasi dan aplikasi MyMOMS digital untuk pemantauan antenatal semasa pandemik. Pemboleh ubah bersandar dalam kajian ini adalah hasil neonatal yang buruk, manakala pemboleh ubah tidak bersandar ialah demografi ibu, antropometri ibu, status risiko obstetrik dan jenis kelahiran. Rekod terpilih adalah berdasarkan warganegara Malaysia dan kehamilan tunggal manakala sebarang data yang tidak lengkap dan jantina bayi yang tidak jelas telah dikecualikan. Tiada perbezaan dalam prevalens hasil neonatal yang buruk untuk kedua-dua tempoh kajian (prevalens 3.9%). Umur ibu >35 tahun (aOR:1.26, 95%CI:1.01-1.57, p=0.045), kelahiran pramatang (aOR:16.95, 95%CI: 13.85-20.74, p<0.001), kelahiran secara pembedahan Caesarean (aOR:2.32, 95%CI 1.87-2.88, p<0.001), multipara (aOR: 0.73, 95%CI 0.59-0.90, p=0.003) dan bayi lelaki (aOR: 1.24 95% CI: 1.511-1.01, p<0.040) merupakan faktor risiko yang signifikan semasa pandemik. Sementara itu, dalam tempoh pra-pandemik (tempoh 2010-2013) pula, umur ibu >35 tahun (aOR:1.30, 95% CI:1.03-1.68, p=0.032), kelahiran pramatang (aOR: 15.97, 95 %CI: 13.22-19.29, p<0.001), ibu berisiko tinggi (aOR: 2.01, 95%CI: 1.47-2.73, p<0.001) dan kelahiran Caesarean (aOR:2.469, 95%CI 2.04-2.99, <0.001) dikaitkan dengan hasil neonatal yang buruk. Pemantapan kesihatan ibu dengan mengintegrasi perundingan virtual atau kesihatan digital dalam memastikan kesinambungan penjagaan bagi pengecaman risiko awal semasa bencana akan meningkatkan jaminan kualiti dalam menyediakan penjagaan ibu.
Kata Kunci :
Bayi kurang berat lahir; hasil neonatal; kemasukan NICU; lahir mati; pandemik COVID-19,
Correspondance Address
Rosnah Sutan. Department of Public Health Medicine. Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +6019-3212256 Email: rosnah.sutan@ppukm.ukm.edu.my
