•List of pregnant women who had USS surveillance for IUGR based on SGA Green-top Guideline (No. 31) obtained from imaging data team of Walsall Manor Hospital

•Pre-pandemic: July to September 2019

•Post-pandemic: July to September 2021

•Duplicated and missing data excluded

•Women who delivered babies with birth weight below 10th centile identified – demographics reviewed on electronic maternity record

•The actual total number of registered births, stillbirths and NND pre-and post-pandemic obtained from electronic maternity record

•Pregnant women with confirmed positive COVID test not identified – people could be asymptomatic and would not have been tested

 

Results

Table 1: Demographic profiles of women with antenatally detected IUGR babies pre- and post-COVID period.

Table 2: Number of babies born with birth weight below the 10th and the 3rd centile among women who had regular growth scans during pre- and post-COVID period.

Table 3: Number of total registered births, antenatally detected IUGR, actual total number of IUGR, stillbirths, and NNDs during pre- and post-COVID period.

Conclusions

Similar profiles between pre- and post-COVID groups apart from 12% increase of BMI above 35 in post-COVID group.

A significant rise in incidence of IUGR among pregnant women after COVID pandemic outbreak.

Traditional-risk-assessment-based ultrasound screening resulted in 42 IUGR babies being missed during pandemic, as opposed to 27 babies in pre-pandemic.

Recommendations

Women with maternal COVID infection require enhanced antenatal vigilance.

Rapid adaptations need to be made to existing screening criteria when the world is faced with similar health emergencies in the future.

Abbreviations

SGA: small for gestational age, PIH: pregnancy-induced hypertension, PET: preeclampsia, HTN: hypertension, CKD: chronic kidney disease, SLE: systemic lupus erythematosus, APLS: antiphospholipid syndrome, BMI: body mass index, FHx: family history