Background COVID-19 impacted global maternal, neonatal and child health outcomes. We hypothesised that the early, strict lockdown that restricted individuals’ movements in Uganda limited access to services. Methods An observational study, using routinely collected data from Electronic Medical Records, was carried out, in Kawempe district, Kampala. An interrupted time series analysis assessed the impact on maternal, neonatal, child, sexual and reproductive health services from July 2019 to December 2020. Descriptive statistics summarised the main outcomes before (July 2019–March 2020), during (April 2020–June 2020) and after the national lockdown (July 2020–December 2020). Results Between 1 July 2019 and 31 December 2020, there were 14 401 antenatal clinic, 33 499 deliveries, 111 658 childhood service and 57 174 sexual health attendances. All antenatal and vaccination services ceased in lockdown for 4 weeks. During the 3-month lockdown, the number of antenatal attendances significantly decreased and remain below pre-COVID levels (370 fewer/month). Attendances for prevention of mother-to-child transmission of HIV dropped then stabilised. Increases during lockdown and immediately postlockdown included the number of women treated for high blood pressure, eclampsia and pre-eclampsia (218 more/month), adverse pregnancy outcomes (stillbirths, low-birth-weight and premature infant births), the rate of neonatal unit admissions, neonatal deaths and abortions. Maternal mortality remained stable. Immunisation clinic attendance declined while neonatal death rate rose (from 39 to 49/1000 livebirths). The number of children treated for pneumonia, diarrhoea and malaria decreased during lockdown. Conclusion The Ugandan response to COVID-19 negatively impacted maternal, child and neonatal health, with an increase seen in pregnancy complications and fetal and infant outcomes, likely due to delayed care-seeking behaviour. Decreased vaccination clinic attendance leaves a cohort of infants unprotected, affecting all vaccine-preventable diseases. Future pandemic responses must consider impacts of movement restrictions and access to preventative services to protect maternal and child health. Data are available in a public, open access repository.

中文翻译：

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COVID-19 对乌干达坎帕拉孕产妇、新生儿、儿童、性健康和生殖健康服务的间接影响


背景 COVID-19 影响了全球孕产妇、新生儿和儿童健康结果。我们假设乌干达早期严格的封锁限制了个人的行动，从而限制了获得服务的机会。方法 使用从电子病历中常规收集的数据，在坎帕拉 Kawempe 区进行了一项观察性研究。间断时间序列分析评估了2019年7月至2020年12月对孕产妇、新生儿、儿童、性健康和生殖健康服务的影响。描述性统计总结了之前（2019年7月至2020年3月）、期间（2020年4月至2020年6月）的主要结果以及全国封锁之后（2020年7月至2020年12月）。结果 2019年7月1日至2020年12月31日期间，产前门诊14 401人次，分娩33 499人次，儿童服务111 658人次，性健康就诊57 174人次。所有产前和疫苗接种服务在封锁期间停止 4 周。在 3 个月的封锁期间，产前检查人数显着下降，仍低于新冠疫情前的水平（每月减少 370 人）。预防艾滋病母婴传播的就诊人数先下降后趋于稳定。封锁期间和封锁结束后的增加包括接受高血压、子痫和先兆子痫治疗的妇女人数（每月增加 218 人）、不良妊娠结局（死产、低出生体重和早产儿）、新生儿比率单位入院、新生儿死亡和堕胎。孕产妇死亡率保持稳定。免疫诊所就诊人数下降，而新生儿死亡率上升（从 39/1000 活产增加到 49/1000）。封锁期间，因肺炎、腹泻和疟疾接受治疗的儿童人数有所减少。 结论 乌干达对 COVID-19 的应对措施对孕产妇、儿童和新生儿健康产生了负面影响，妊娠并发症以及胎儿和婴儿结局有所增加，这可能是由于延迟寻求护理行为所致。疫苗接种诊所就诊人数的减少导致一批婴儿得不到保护，从而影响到所有疫苗可预防的疾病。未来的大流行应对措施必须考虑行动限制和获得预防服务的影响，以保护孕产妇和儿童健康。数据可在公共、开放访问存储库中获取。