Investigating the impact of the Covid-19 epidemic on mortality and fertility indicators in Qom province and comparing it with national indicators from 2019 to 2023

Abstract

Objective (s): Communicable and non-communicable diseases are always associated with many impacts on fertility rates, mortality, and disease burden. The present study aimed to investigate the impact of COVID-19 on fertility and mortality indicators. Methods: The present study was a mixed-method study that was conducted in two phases: a descriptive cross-sectional study and a review study. In the descriptive phase, statistical data were reviewed during 3 time periods before the COVID epidemic (March 2017 to March 2020), during the epidemic (March 2020 to March 2021), and after the epidemic (March 2021 to March 2023) for 24 months. In the second phase, a review study was conducted on the impact of the COVID-19 epidemic on mortality and fertility indicators, as well as maternal-fetal outcomes in Iran over the past years, which was searched through the electronic databases PubMed, Scopus, Web of Science, and the Persian Database (SID) for articles up to 2023. The source of the study of outcomes and complications related to the mother and newborn was obtained through a review study. Data analysis was performed using descriptive statistics in SPSS software and expressed using numbers, percentages, and graphs. Results: The general fertility rate in the pre-epidemic period was estimated at about 3.5%, which decreased to 1.3% during and after the epidemic . The stillbirth rate in the pre-epidemic period was reported to be approximately 4.6%, which decreased to 3.8% in the post-epidemic period. The crude birth rate in the pre-epidemic and post-epidemic periods was also 1.4% and 1.05%, respectively. In terms of maternal outcomes during and after the COVID-19 epidemic , most pregnant mothers faced the risk of cesarean section, premature birth, and prolonged hospital stay. In terms of neonatal outcomes, fetal heart rate abnormalities, hospitalization in the neonatal intensive care unit, and the need for resuscitation in the first minute were the most reported outcomes. Vaccination coverage decreased during and after the epidemic . Conclusion: The study findings showed that fertility and crude birth rates have decreased during and after the epidemic . Also, during the Covid-19 period, maternal and fetal complications such as respiratory complications, preterm labor, premature rupture of membranes, preeclampsia, coagulation disorders, and cardiopulmonary disorders of pregnant mothers and newborns increased. Therefore, awareness raising to prevent any type of infection during pregnancy that can affect the occurrence of pathological consequences in the mother and newborn, as well as improving and continuing prenatal care, seems necessary.