Gestational Weight Gain During the COVID-19 Pandemic

The early COVID-19 pandemic period and associated gestational weight gain

OBJECTIVES

The aim of this study was to investigate if gestational weight gain was altered during the early COVID-19 pandemic period.

METHODS

This a retrospective cohort study evaluating gestational weight gain among individuals delivering during the early COVID-19 pandemic epoch (March 10-December 31, 2020) compared to temporally matched pre-pandemic (matched months in 2018 and 2019) controls using electronic medical record data from a large tertiary care hospital. The primary outcome was gestational weight gain defined as a categorical measure representing below, meeting, or above Institute of Medicine (IOM) criteria with further adjustment for gestational age at delivery. The early-pandemic exposure group was also categorized by gestational age at the start period (<14 weeks' and 14-20 weeks') to assess if duration of exposure affected gestational weight gain risks with the use of multinominal logistic regression.

RESULTS

Among 5,377 individuals 3,619 (67.3 %) and 1,758 (32.7 %) were in the pre and early pandemic epochs respectively. Overall, 934 (17.4 %) individuals gained below recommended, 1,280 (23.8 %) met recommendations, and 3,163 (58.8 %) gained above IOM recommended gestational weight gain. Compared to the pre-pandemic epoch, the early pandemic period was not associated with weight gain below (OR 1.06, 95 % Cl 0.89-1.27) or above (OR 1.03, 95 % Cl 0.89-1.19) IOM recommendations. This was also true when the early pandemic group was stratified based on gestational age at the start of the early pandemic period (<14 weeks' and 14-20 weeks').

CONCLUSIONS

This study demonstrated no significant difference in maternal weight gain between pre and early COVID-19 pandemic periods.

Pandemic-induced healthcare shifts: an observational analysis of maternal and neonatal outcomes in adolescent pregnancies

Introduction

The COVID-19 pandemic caused widespread changes in healthcare delivery, particularly affecting vulnerable populations such as pregnant adolescents. These patients faced additional challenges, including developmental and gestational changes, stress from isolation, and altered healthcare access, which may have impacted the incidence and prevalence of maternal and neonatal complications. This study aims to compare maternal and neonatal outcomes in adolescent pregnancies before and during the pandemic, focusing on how shifts in healthcare delivery influenced these outcomes.

Methodology

A retrospective cohort study was conducted, including 340 adolescent pregnant patients who received prenatal care at a tertiary care institution. Patients were divided into two groups: pre-pandemic (n = 209) and pandemic (n = 131). Maternal data, including pre-BMI and gestational weight gain (GWG), were collected to evaluate maternal and neonatal outcomes. Statistical analysis was performed using chi-square tests, Fisher's exact tests, and odds ratio (OR) calculations.

Results

The pandemic group showed a statistically significant increase in cesarean deliveries (p = 0.002; OR = 1.99) and cervicovaginitis, particularly caused by Ureaplasma spp. Conversely, the pre-pandemic group had higher rates of psychoactive substance use, maternal urinary tract infections, and neonatal transient tachypnea. In the pandemic group, overweight pre-gestational BMI and cervicovaginitis were more prevalent in patients with adequate GWG, while inadequate GWG was associated with an increased risk of urinary tract infection (UTI). A significant association between pre-gestational overweight/obesity and excessive GWG was also observed (p < 0.05).

Conclusion

The COVID-19 pandemic altered both healthcare delivery and maternal and neonatal outcomes in adolescent pregnancies. Changes in healthcare access, isolation, and shifts in medical management during the pandemic resulted in higher cesarean rates and infection rates among pregnant adolescents. These findings underscore the need for adaptable, resilient healthcare systems capable of maintaining comprehensive care even in the face of global crises. Further studies are needed to explore long-term effects on adolescent maternal and neonatal health.

Reducing intervention- and research-induced inequalities to tackle the digital divide in health promotion

Social inequalities are an important contributor to the global burden of disease within and between countries. Using digital technology in health promotion and healthcare is seen by some as a potential lever to reduce these inequalities; however, research suggests that digital technology risks re-enacting or evening widening disparities. Most research on this digital health divide focuses on a small number of social inequality indicators and stems from Western, educated, industrialized, rich, and democratic (WEIRD) countries. There is a need for systematic, international, and interdisciplinary contextualized research on the impact of social inequality indicators in digital health as well as the underlying mechanisms of this digital divide across the globe to reduce health disparities. In June 2023, eighteen multi-disciplinary researchers representing thirteen countries from six continents came together to discuss current issues in the field of digital health promotion and healthcare contributing to the digital divide. Ways that current practices in research contribute to the digital health divide were explored, including intervention development, testing, and implementation. Based on the dialogue, we provide suggestions for overcoming barriers and improving practices across disciplines, countries, and sectors. The research community must actively advocate for system-level changes regarding policy and research to reduce the digital divide and so improve digital health for all.