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The Global Network COVID-19 studies: a review.

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Summary

COVID-19 in pregnancy had minimal impact on healthcare use and birth outcomes in low- and middle-income countries. However, knowledge about COVID-19 and vaccination was poor, with low vaccine uptake among pregnant women.

Keywords:
COVID-19attitudeepidemiologygeneral obstetricknowledgelow and middle income countriespracticepregnancyvaccination

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Area of Science:

  • Global Health
  • Maternal Health
  • Infectious Diseases

Background:

  • Limited data on COVID-19 in pregnancy in low- and middle-income countries (LMICs) at the pandemic's start.
  • Global Network for Women's and Children's Health Research initiated studies across eight LMIC sites.

Purpose of the Study:

  • Evaluate changes in health service utilization during the pandemic.
  • Assess pregnant women's knowledge, attitudes, and practices regarding COVID-19 and vaccination.
  • Determine changes in antibody status and its relation to pregnancy outcomes.

Main Methods:

  • Four distinct studies conducted across Asia, Africa, and Central America.
  • Data collection on healthcare utilization, knowledge/attitudes/practices, and antibody status at delivery.
  • Longitudinal monitoring of antibody status and pregnancy outcomes.

Main Results:

  • Little reduction in healthcare utilization; no significant change in pregnancy outcomes observed.
  • Variable and generally poor knowledge of COVID-19 and vaccines among pregnant women.
  • Low COVID-19 vaccination rates in pregnant women, lower than national averages.
  • Substantial increase in COVID-19 infection rates over time, mostly asymptomatic or mild.
  • No increased adverse pregnancy outcomes associated with COVID-19 infection.

Conclusions:

  • COVID-19 pandemic had minimal direct adverse impact on pregnancy outcomes in the studied LMICs.
  • Significant gaps in knowledge and very low vaccine acceptance highlight public health challenges.
  • Asymptomatic or mild COVID-19 infections in pregnant populations may explain the lack of observed adverse outcomes.