Amos Mapesa, University of Nairobi. Containment Measures Against COVID-19 Pandemic Possibly Eclipsed the Magnitude of Stillbirth Incidence Rates in Thika Level-5 Hospital

Background: COVID-19 pandemic and its containment measures indirectly exposed perinatal life to risk through disruption of health services. The unintended effect was rise in stillbirth cases evidenced by studies mostly in high-income countries. This study aimed to examine stillbirth incidence rates in a facility serving low to middle-income population with COVID-19 pandemic and its containment measures as exposure of interest.Methods: This was a retrospective cohort study that compared the stillbirth incidence rate in three epochs i.e. pre-pandemic (control windows) and during pandemic period grouped into two; high positivity test period (Risk Window 1), and during cessation of movement (Risk Window 2).Findings: Stillbirth incidence rates in the 15-day during prepandemic period (23 stillbirths; rate = 626·73 per 1000 PY) were 0·328 times higher (95% CI, 0·134-0·801) compared with the same 15-day period during high positivity rate (6 stillbirths; rate =205·63 per 1000 PY) as well as 0·452 higher (95% CI, 0·196-1·049) compared with the same 15-day period during cessation of movement in and out of Nairobi Metropolitan Area (7 stillbirths; rate =283·88 per 1000 PY).Interpretation: There was reduction in stillbirth incidence rate during high positivity test period and during the cessation of movement period when compared with prepandemic period. This is inconsistent with most studies around the globe which indicated increase in stillbirth incidence rates. Though speculative, the plausible explanation to these findings is possibly because of reduced facility-based deliveries, inefficient written health records, and overwhelmed healthcare system that led to missed documentations.Funding: Personal resourcesDeclaration of Interest: The authors declare no competing interests. Ethical Approval: Ethical approval to perform this study was sought and obtained from Thika Level 5 Hospital’s Training, Research & Ethics Committee (permit number MOH/TKA/GEN/VOL/662).