Maternal Characteristics and Outcomes Affected by COVID-19 Pandemic in Indonesia

Sofia Al Farizi¹ · Dewi Setyowati¹ · Azra Fauziyah Azyanti² · Dyah Ayu Fatmaningrum² · Rahayu Kusuma Candrakirana²

Sofia Al Farizi sofia.al.farizi@fk.unair.ac.id

1 Lecturer of Midwifery Study Program, Faculty of Medicine, Airlangga University, Surabaya, Indonesia

2 Student of Midwifery Study Program, Faculty of Medicine, Airlangga University, Surabaya, Indonesia

Sofia Al Farizi is an Lecturer; Dewi Setyowati is an Lecturer; Azra Fauziyah Azyanti is a Student, Dyah Ayu Fatmaningrum is a Student, Rahayu Kusuma Candrakirana is a Student

Aim Compare the impact of the intervention on the outcome of pregnancy of patients receiving obstetric care with and non-COVID-19 diagnosis at a tertiary referral hospital located in the region of East Java, Indonesia.

Methods This was a cross-sectional analysis of 694 pregnant women. These patients’ information was acquired based on the medical data obtained from the hospital. The Mann–Whitney test was used to analyze the disparities among the factors examined in this research investigation.

Results There was a statistically significant difference in length of stay (LOS). It has been shown that individuals diagnosed with COVID-19 often exhibit a longer length of stay (LOS) in healthcare facilities compared to those who do not have the infection. More than fifty percent of patients gave birth by cesarean section, 83 in COVID-19 group and 283 in non-COVID-19 group. The most prevalent complications among COVID-19 patients were maternal infectious and parasitic diseases (1.3 vs 0%), prolonged labor (12.3 vs 9.6%) and puerperal complications (0.6 vs 0%). In 40.9% of COVID-19 patients, acute respiratory distress syndrome (ARDS) was encountered. Infection due to COVID-19 had no discernible impact on the outcomes of pregnancy.

Conclusion Numerous interventions, including cesarean delivery in COVID-19 and non-COVID-19 patients, require reevaluation. It is imperative to undertake a comprehensive reassessment of the health care delivery system, with particular emphasis on enhancing the efficacy of the referral system.

Keywords : COVID-19 · Maternal outcome · Pregnancy outcome · Maternal death

The outbreak of coronavirus disease 2019 (COVID-19) originated in Wuhan, China, towards the conclusion of the year 2019, later disseminating to many nations around the globe. Furthermore, the World Health Organization (WHO) officially declared the COVID-19 pandemic in March 2020 [1]. On March 2, 2020, the novel coronavirus was introduced into Indonesia after the identification of two confirmed cases. The transmission of COVID-19 cases began on April 9, 2020, over 34 provinces in Indonesia [2]. The provision of sufficient healthcare in Indonesian hospitals is hindered by the constraints imposed by inadequate infrastructure, insufficient isolation rooms, and a scarcity of personal protective equipment (PPE) [3]. Amidst the COVID-19 outbreak, a referral hospital in Indonesia saw a surge in patient admissions, leading to overwhelming capacity. Due to a significant prevalence of COVID-19 infections among healthcare professionals, the availability of healthcare personnel for service provision has been severely constrained, leading to suboptimal efficiency in service delivery [4]. The functionality of Indonesia’s referral system has been compromised since the start of the COVID- 19 outbreak. The efficacy of primary health care preventative measures and facility coordination is suboptimal [5]. Further investigation is required to ascertain the impact of COVID-19 on maternal and neonatal health. A retrospective assessment conducted in Wuhan, China, revealed that pregnant women have similar clinical features to their nonpregnant counterparts [6]. According to a research conducted in the United Kingdom, it has been shown that pregnant women have just a negligible influence from COVID-19, with no significant adverse effects noted [7]. At now, there exist no empirical data indicating that COVID-19 has a detrimental impact on the health condition of women or facilitates vertical transmission of the virus to the developing fetus [8]. This instance has garnered attention from a number of Indonesian scholars. A previous study conducted at a secondary facility of referral in Indonesia revealed that there were similarities in the clinical symptoms and laboratory test findings between individuals diagnosed with COVID-19 and those without the virus. This investigation elucidates that individuals afflicted with COVID-19 are at a significantly elevated likelihood of mortality [5]. According to a recent investigation, expectant women who contracted COVID-19 did not exhibit significant symptoms [9].

The objective of this research is to conduct a comparative analysis of the intervention, maternal characteristics and pregnancy outcomes among obstetric patients with COVID- 19 disease and those without COVID-19 disease in a tertiary referral hospital in Indonesia.

The present research used cross-sectional design and relied on secondary records obtained from medical records of a tertiary hospital located in East Java, Indonesia, throughout the year 2020. The hospital was chosen because to its status as one of the major healthcare facilities in Indonesia, and its notable concentration of COVID-19 patients was identified.

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