The impacts of the COVID-19 pandemic on the burden of maternal and neonatal disorders: A counterfactual modeling based on the global burden of disease study (2021)

Objectives: During the COVID-19 pandemic, global health systems faced unprecedented challenges, as well as in maternal and neonatal health, thus this study aims to clarify the impacts of COVID-19 on maternal and neonatal disorders (MNDs), regional variations, and the role of economic support.

Methods: We have developed a counterfactual model integrating Autoregressive Integrated Moving Average and Long Short-Term Memory models to forecast the burden of MNDs from 2020 To et al., 2021, which was compared with the actual burden to quantify the specific impact of the COVID-19 pandemic on MNDs.

Results: During the COVID-19 pandemic, the burden of MNDs surpassed predictions, particularly in Russia, where incidence was about 10.20% higher than expected. In Tokelau, neonatal disorders increased by 412.35% in DALYs. The incidence of maternal disorders in Russia has increased by 12.00%, with maternal abortion and miscarriage increasing by 23.08%. The incidence and prevalence of maternal hypertensive disorders, the incidence of hemolytic disease and other neonatal jaundice and neonatal preterm birth accelerated. In low and low-middle Socio-demographic Index countries, mortality rates from maternal abortion and miscarriage, maternal obstructed labor and uterine rupture, neonatal encephalopathy due to birth asphyxia and trauma significantly increased. Similarly, countries with a low economic support index saw higher burden for these conditions, with the burden decreasing as economic support improved.

Conclusion: The COVID-19 pandemic has disproportionately increased the burden of MNDs in countries with lower economic support, highlighting the critical need for strengthened global economic support, particularly in low- and middle-income countries.