Antenatal care services and pregnancy outcomes during the COVID-19 pandemic in Milan, Lombardy

Background. During the COVID-19 pandemic maternity healthcare seeking and provision reduced worldwide. We explored the indirect effects of the pandemic on key pregnancy outcomes and access to antenatal care services.
Methods. Observational cross-sectional study on all pregnancies between years 2019- 2020 in Milan metropolitan area (Lombardy, Italy). Multiple logistic regression analysis was used to assess the access to antenatal care (ANC) services (timing of first contact, ultrasound examinations (US) and ANC contacts) and pregnancy outcomes (preterm births, perinatal deaths and surgically treated ectopic pregnancies). Data were retrieved from both administrative (public healthcare) and self-reported sources (public and private services).
Results. The first antenatal contact was slightly delayed in pandemic year 2020. Adequate levels of antenatal care were maintained according to self-reported data, though a decrease in public healthcare was noted (administrative data). Perinatal death and preterm birth risk did not worsen, while it increased for surgically managed ectopic pregnancies.