Impact of COVID-19 on perinatal outcomes in First Nations and all other mothers and their offspring in Manitoba

This is the authors' abstract. We don't add key points for this paper.

PURPOSE OF RESEARCH: COVID-19 substantially disrupted healthcare, but its impact on perinatal outcome in Manitoba remains unclear. METHODS: The present study examined perinatal outcomes in First Nations and all other women and infants in Manitoba during COVID-19 (March 2020-December 2021) compared to a control period (March 2018-March 2020) using a retrospective database study. PRINCIPAL RESULTS: First Nations pregnancies had significantly higher rates of gestational diabetes, pre-pregnancy diabetes (PPD), preterm birth, stillbirth, large-for-gestational-age infants, neonatal intensive care unit (NICU) admission and formula feeding, and lower rates of exclusive breastfeeding compared to all other pregnancies during COVID-19 or the control period. Age-adjusted odds ratio (aORs) for preterm birth (aOR 1⋅17, 95% confidence interval or CI: 1⋅06, 1⋅30) and shoulder dystocia (aOR 1⋅33, 95% CI: 1⋅08, 1⋅64) among First Nations, but not all other, newborns were increased during COVID-19 compared to the control period. The aORs for preeclampsia, eclampsia, and spontaneous abortion were increased in all other, but not First Nations, pregnancies during COVID-19 versus the control period. Logistic linear regression analyses indicated that PPD was the leading contributor to the increase of preterm birth, stillbirth, shoulder dystocia and NICU admission. CONCLUSIONS: The findings imply that COVID-19 caused more profound adverse neonatal outcomes in First Nations offspring. Maternal diabetes played an important role in the unfavorable neonatal outcomes. Prevention of maternal diabetes by strengthening perinatal education and care may help to reduce the risk of adverse neonatal outcomes in First Nations population in future pandemic.