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Pandemics and maternal health: the indirect effects of COVID-19

Journal

ANAESTHESIA
Volume 76, Issue -, Pages 69-75

Publisher

WILEY
DOI: 10.1111/anae.15408

Keywords

anaesthesia; COVID-19; indirect effects; maternal health

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Infectious diseases like COVID-19 can have different direct impacts on men and women, with higher case fatality rates observed in men. However, the organizational changes in healthcare delivery to protect vulnerable groups may have indirect consequences, particularly for pregnant women.
Infectious diseases can directly affect women and men differently. During the COVID-19 pandemic, higher case fatality rates have been observed in men in most countries. There is growing evidence, however, that while organisational changes to healthcare delivery have occurred to protect those vulnerable to the virus (staff and patients), these may lead to indirect, potentially harmful consequences, particularly to vulnerable groups including pregnant women. These encompass reduced access to antenatal and postnatal care, with a lack of in-person clinics impacting the ability to screen for physical, psychological and social issues such as elevated blood pressure, mental health issues and sex-based violence. Indirect consequences also encompass a lack of equity when considering the inclusion of pregnant women in COVID-19 research and their absence from vaccine trials, leading to a lack of safety data for breastfeeding and pregnant women. The risk-benefit analysis of these changes to healthcare delivery remains to be fully evaluated, but the battle against COVID-19 cannot come at the expense of losing existing quality standards in other areas of healthcare, especially for maternal health.

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