Impact of the COVID-19 pandemic on perinatal care and outcomes: A retrospective study in a tertiary hospital in Northern Ghana.

BACKGROUND: Perinatal mortality remains a global challenge. This challenge may be worsened by the negative effects of the COVID-19 pandemic on maternal and child health. OBJECTIVES: Examine the impact of the COVID-19 pandemic on perinatal care and outcomes in the Tamale Teaching Hospital in northern Ghana. METHODS: A hospital-based retrospective study was conducted in the Tamale Teaching Hospital. We compared antenatal care attendance, total deliveries, cesarean sections, and perinatal mortality before the COVID-19 pandemic (March 1, 2019 to February 28, 2020) and during the COVID-19 pandemic (March 1, 2020 to February 28, 2021). Interrupted time series analyses was performed to evaluate the impact of the COVID-19 pandemic on perinatal care and outcomes at TTH. RESULTS: A total number of 35,350 antenatal visits and 16,786 deliveries were registered at TTH from March 2019 to February 2021. Antenatal care, early neonatal death, and emergency cesarean section showed a rapid decline after the onset of the pandemic, with a progressive recovery over the following months. The total number of deliveries and fresh stillbirths showed a step change with a marked decrease during the pandemic, while the macerated stillbirths showed a pulse change, a temporary marked decrease with a quick recovery over time. CONCLUSION: The COVID-19 pandemic had a negative impact on perinatal care and outcomes in our facility. Pregnancy monitoring through antenatal care should be encouraged and continued even as countries tackle the pandemic.

Influence of Sociodemographic Factors and Obstetric History on Choice of Place of Delivery: A Retrospective Study Among Post-Natal Women in Ghana.

Background and Objectives: Even though Ghana has recorded an appreciable level of facility delivery compared to other countries in sub-Saharan Africa, the country still has a lot of regional and community variations in facility delivery where professional maternal health care is guaranteed. This study assessed the main factors associated with facility delivery in the Sagnarigu Municipal Assembly of the Northern Region of Ghana. Methods: Using a simple random sampling method, a retrospective community-based cross-sectional study was conducted from July 12, 2021 to October 17, 2021, among 306 postnatal women within 15 to 49 years who had delivered within the last six months. We conducted descriptive analyses, and the Pearson chi-square test of association between the sociodemographic factors and obstetrics history with the outcome variable, choice of place of birth. Lastly, significant variables in the chi-square test were entered into adjusted multivariate logistics regression to determine their association with the place of delivery. Data analysis was performed using the Statistical Package for Social Sciences version-25, with statistical significance set at a p-value of 0.05. Results: The study reported a facility delivery rate of 82%, which is slightly higher than the national target (80%). We observed that age group [AOR 2.34 (1.07-5.14)], marital status [AOR 0.31 (0.12-0.81)], ethnicity [AOR 3.78 (1.18-12.13)], and couple's occupation [AOR 24.74 (2.51-243.91)] were the significant sociodemographic factors influencing facility delivery. The number of antenatal care (ANC) attendance [AOR 8.73 (3.41 - 22.2)] and previous pregnancy complications [AOR 2.4 (1.11 - 5.7)] were the significant obstetrics factors influencing facility delivery. Conclusion and Global Health Implications: We found that specific sociodemographic and obstetric factors significantly influence the choice of place of delivery in the study area. To address this, the study recommends targeted interventions that focus on providing support and resources for women from different age groups, marital statuses, ethnicities, and occupational backgrounds to access facility delivery services. Additionally, improving ANC attendance and effectively managing pregnancy complications were highlighted as important measures to encourage facility-based deliveries.