Marked variability in institutional deliveries and neonatal outcomes during the COVID-19 lockdown in Nigeria

Ezenwa, BN, Fajolu, IB, Pius, S, Ezeanosike, OB, Iloh, K, Umoru, D, Tongo, O, Abdulkadir, I, Okolo, AA, Nabwera, Helen, Oleolo-Ayodeji, K, Daniel, N, Abubakar, Ismaela, Obu, C, Onwe-Ogah, E, Daniyan, O, Adeke, A, Nwegbu, O, Bisumang, JD, Hassan, L, Abdullahi, F, Mohammad, A, Nasir, U, Ezeaka, VC and Allen, Stephen ORCID: https://orcid.org/0000-0001-6675-249X (2023) 'Marked variability in institutional deliveries and neonatal outcomes during the COVID-19 lockdown in Nigeria'. Transactions of The Royal Society of Tropical Medicine and Hygiene, Vol 117, Issue 11, pp. 780-787.

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Abstract

Background
The coronavirus disease 2019 (COVID-19) pandemic and the interventions to mitigate its spread impacted access to healthcare, including hospital births and newborn care. This study evaluated the impact of COVID-19 lockdown measures on newborn service utilization in Nigeria.

Methods
The records of women who delivered in hospitals and babies admitted to neonatal wards were retrospectively reviewed before (March 2019–February 2020) and during (March 2020–February 2021) the COVID-19 pandemic lockdown in selected facilities in Nigeria.

Results
There was a nationwide reduction in institutional deliveries during the COVID-19 lockdown period in Nigeria, with 14 444 before and 11 723 during the lockdown—a decrease of 18.8%. The number of preterm admissions decreased during the lockdown period (30.6% during lockdown vs 32.6% pre-lockdown), but the percentage of outborn preterm admissions remained unchanged. Newborn admissions varied between zones with no consistent pattern. Although neonatal jaundice and prematurity remained the most common reasons for admission, severe perinatal asphyxia increased by nearly 50%. Neonatal mortality was significantly higher during the COVID-19 lockdown compared with pre-lockdown (110.6/1000 [11.1%] vs 91.4/1000 [9.1%], respectively; p=0.01). The odds of a newborn dying were about four times higher if delivered outside the facility during the lockdown (p<0.001).

Conclusions
The COVID-19 lockdown had markedly deleterious effects on healthcare seeking for deliveries and neonatal care that varied between zones with no consistent pattern.

Item Type:	Article
Subjects:	WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 506 COVID-19 WS Pediatrics > By Age Groups > WS 420 Newborn infants. Neonatology WS Pediatrics > By Age Groups > WS 421 Diseases of newborn infants WY Nursing > WY 157.3 Maternal-child nursing. Neonatal nursing. Perinatal nursing
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1093/trstmh/trad030
Depositing User:	Jane Rawlinson
Date Deposited:	12 Jun 2023 15:01
Last Modified:	09 Nov 2023 16:03
URI:	https://archive.lstmed.ac.uk/id/eprint/22616

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