A Decade Comparison between the Years 2010-2013 and 2020-2023 of Poor Neonatal Outcomes and the Associated Factors using a Single Tertiary Hospital Birth Record: An Impact of the COVID-19 Pandemic

This study aims to compare the prevalence of adverse neonatal outcomes before and during the COVID-19 pandemic and the factors associated with it. A comparative cross-sectional study was conducted at Hospital Canselor Tuanku Muhriz (HCTM) by retrieving registered labour room records for the year 2010-2013 and during the COVID-19 pandemic (the year 2020-2023). HCTM started using teleconsultation and digital MyMOMS applications for antenatal monitoring during the pandemic. The dependent variable in this study was the adverse neonatal outcome, and the independent variables were maternal demographics, maternal anthropometry, obstetric risk status and mode of delivery. Records retrieved were based on Malaysian citizens and singleton while incomplete data and ambiguous genitalia were excluded. There was no difference in the prevalence of adverse neonatal outcomes for both study periods (3.9%). Maternal age >35 years (aOR:1.26, 95%CI:1.01-1.57, p=0.045), premature birth (aOR:16.95, 95%CI: 13.85-20.74, p<0.001), Caesarean delivery (aOR:2.32, 95%CI 1.87-2.88, p<0.001), multiparity (aOR: 0.73, 95%CI 0.59-0.90, p=0.003) and male neonates (aOR: 1.24 95% CI: 1.01-1.51, p<0.040) were significant risk factors during the pandemic period. Meanwhile, in the pre-pandemic (2010-2013) period, maternal age >35 years (aOR:1.30, 95% CI:1.03-1.68, p=0.032), premature birth (aOR: 15.97, 95%CI: 13.22-19.29, p<0.001), high-risk pregnancy status (aOR: 2.01, 95%CI: 1.47-2.73, p<0.001) and Caesarean delivery (aOR:2.469, 95%CI 2.04-2.99, p<0.001) were associated with adverse neonatal outcomes. Strengthening maternal health by integrating virtual consultation or digital health to ensure continuity of care for early risk identification during disasters will improve quality assurance in providing maternal care.