{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T22:12:54Z","timestamp":1787782374112,"version":"build-2784847793"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T00:00:00Z","timestamp":1655683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess, on a population basis, the medical care for pregnant women in specific geographic regions of six countries before and during the first year of the coronavirus disease 2019 (COVID\u201019) pandemic in relationship to pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective, population\u2010based study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Communities in Kenya, Zambia, the Democratic Republic of the Congo, Pakistan, India and Guatemala.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Pregnant women enrolled in the Global Network for Women's and Children's Health's Maternal and Newborn Health Registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Pregnancy\/delivery care services and pregnancy outcomes in the pre\u2010COVID\u201019 time\u2010period (March 2019\u2013February 2020) were compared with the COVID\u201019 time\u2010period (March 2020\u2013February 2021).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Stillbirth, neonatal mortality, preterm birth, low birthweight and maternal mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across all sites, a small but statistically significant increase in home births occurred between the pre\u2010COVID\u201019 and COVID\u201019 periods (18.9% versus 20.3%, adjusted relative risk [aRR] 1.12, 95% CI 1.05\u20131.19). A small but significant decrease in the mean number of antenatal care visits (from 4.1 to 4.0,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0&lt;0.0001) was seen during the COVID\u201019 period. Of outcomes evaluated, overall, a small but significant decrease in low\u2010birthweight infants in the COVID\u201019 period occurred (15.7% versus 14.6%, aRR 0.94, 95% CI 0.89\u20130.99), but we did not observe any significant differences in other outcomes. There was no change observed in maternal mortality or antenatal haemorrhage overall or at any of the sites.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Small but significant increases in home births and decreases in the antenatal care services were observed during the initial COVID\u201019 period; however, there was not an increase in the stillbirth, neonatal mortality, maternal mortality, low birthweight, or preterm birth rates during the COVID\u201019 period compared with the previous year. Further research should help to elucidate the relationship between access to and use of pregnancy\u2010related medical services and birth outcomes over an extended period.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.17175","type":"journal-article","created":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T10:57:43Z","timestamp":1649069863000},"page":"1298-1307","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Health care in pregnancy during the\n                    <scp>COVID<\/scp>\n                    \u201019 pandemic and pregnancy outcomes in six\n                    <scp>low\u2010 and\u2010middle\u2010income<\/scp>\n                    countries: Evidence from a prospective, observational registry of the Global Network for Women\u2019s and Children\u2019s Health"],"prefix":"10.1111","volume":"129","author":[{"given":"Seemab","family":"Naqvi","sequence":"first","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farnaz","family":"Naqvi","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Saleem","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa R.","family":"Thorsten","sequence":"additional","affiliation":[{"name":"RTI International  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lester","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Instituto de Nutrici\u00f3n de Centroam\u00e9rica y Panam\u00e1  Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manolo","family":"Mazariegos","sequence":"additional","affiliation":[{"name":"Instituto de Nutrici\u00f3n de Centroam\u00e9rica y Panam\u00e1  Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Garces","sequence":"additional","affiliation":[{"name":"Instituto de Nutrici\u00f3n de Centroam\u00e9rica y Panam\u00e1  Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2558-7421","authenticated-orcid":false,"given":"Archana","family":"Patel","sequence":"additional","affiliation":[{"name":"Lata Medical Research Foundation  Nagpur India"},{"name":"Datta Meghe Institute of Medical, Sciences  Sawangi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabir","family":"Das","sequence":"additional","affiliation":[{"name":"Lata Medical Research Foundation  Nagpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avinash","family":"Kavi","sequence":"additional","affiliation":[{"name":"KLE Academy Higher Education and Research J N Medical College Belagavi  Belagavi Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8680-7053","authenticated-orcid":false,"given":"Shivaprasad S.","family":"Goudar","sequence":"additional","affiliation":[{"name":"KLE Academy Higher Education and Research J N Medical College Belagavi  Belagavi Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Esamai","sequence":"additional","affiliation":[{"name":"Moi University School of Medicine  Eldoret Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musaku","family":"Mwenchanya","sequence":"additional","affiliation":[{"name":"University of Zambia University Teaching Hospital  Lusaka 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