COVID-19 Pandemisinin Kadın Sağlığı Üzerindeki Etkisi

Son yüzyılın en önemli sağlık sorunlarından biri haline gelen COVID-19 enfeksiyonu, 2019 yılında ortaya çıkmış ve dünya çapında bir salgına dönüşmüştür. COVID-19 ciddi solunum sistemi ve kardiyovasküler sorunlar yaşanmasına hatta ölüme yol açabilmektedir. Salgın sürecinde kadınlar yüksek riskli grup olarak kabul edilmektedirler. Solunum sistemi hastalıkları ve enfeksiyonların gebe kadın ve fetüsün sağlığını önemli ölçüde etkilediği bilinmektedir. Maternal solunum sıkıntısı ve enfeksiyonlar; hipoksi, fetal stres, erken doğum, fetal ölüm gibi olumsuz sonuçlara yol açabilmektedir. Bunun yanı sıra salgın nedeniyle sağlık hizmeti sunumunda yaşanan aksaklıklar riskli gebelikler ve acil obstetrik durumlar açısından anne ve yenidoğan sağlığını tehdit etmektedir. Diğer taraftan pandemi sürecinde cinsel sağlık veya üreme sağlığı hizmetlerinin salgınla mücadele kapsamına dâhil edilmesi anne ve yenidoğanın sağlık sorunlarının artmasının yanı sıra, aile planlaması hizmetlerinin yetersizliği, istenmeyen gebelik, sağlıksız koşullarda düşük yapma gibi durumlara yol açarak kadın sağlığını olumsuz etkilemektedir. Bu derlemede COVID-19 pandemisinin kadın sağlığı üzerindeki etkileri gebelik ve aile planlaması hizmetleri açısından ele alınmıştır.

The Impact of the COVID-19 Pandemic on Women's Health

COVID-19 infection, which has become one of the most important health problems of the last century, emerged in 2019 and turned into a worldwide epidemic. COVID-19 can lead to serious respiratory and cardiovascular problems and even death. Women are considered to be a high-risk group during the epidemic. It is known that respiratory system diseases and infections significantly affect the on pregnant women and fetuses. Maternal respiratory distress and infections can result in hypoxia, fetal stress, preterm labor and fetal death.In addition, disruptions in health service delivery due to the epidemic threaten maternal and neonatal health in terms of risky pregnancies and emergency obstetric situations. Directing sexual and reproductive health services to fight against the epidemic during the pandemic process negatively affects women's health by causing situations such as insufficiency of family planning services, unwanted pregnancy, miscarriage in unhealthy conditions, as well as increasing health problems of the mother and newborn. This study, the effects of the COVID-19 pandemic on women's health are discussed in terms of pregnancy and family planning services.

___

  • 1. Pollard CA, Morran MP, Nestor-Kalinoski AL. The COVID-19 pandemic: a global health crisis. Physiol Genomics. 2020;52(11):549-57.
  • 2. Connor J, Madhavan S, Mokashi M, Amanuel H, Johnson NR, Pace LE, et al. Health risks and outcomes that disproportionately affect women during the Covid-19 pandemic: A review. Soc Sci Med. 2020:113364.
  • 3. Lindberg LD, VandeVusse A, Mueller J, Kirstein M. Early impacts of the COVID-19 pandemic: Findings from the 2020 Guttmacher Survey of Reproductive Health Experiences. New York, NY: Guttmacher Institute. 2020;(10.2020.31482.).
  • 4. Stein D, Ward K, Cantelmo C. Estimating the potential impact of COVID-19 on mothers and newborns in low-and middle-income countries. Heal Policy Plus. http://www.healthpolicyplus. com/covid-mnh-impacts.cfm. 2020
  • 5. World Health Organization (WHO). Pulse survey on continuity of essential health services during the COVID-19 pandemic. İnterim Report. 2020a.
  • 6. Hall KS, Samari G, Garbers S, Casey SE, Diallo DD, Orcutt M, et al. Centring sexual and reproductive health and justice in the global COVID-19 response. Lancet. 2020;395(10231):1175-7.
  • 7. Kingsley JP, Vijay PK, Kumaresan J, Sathiakumar N. The Changing Aspects of Motherhood in Face of the COVID-19 Pandemic in Low-and Middle-Income Countries. Matern Child Health J. 2021;25(1):15-21.
  • 8. World Health Organization (WHO). Rapid assessment of service delivery for NCDs during the COVID-19 pandemic. Geneva. 2020b.
  • 9. Kotlar B, Gerson E, Petrillo S, Langer A, Tiemeier H. The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review. Reprod Health. 2021;18(1):1-39.
  • 10. World Health Organization (WHO). Trends in maternal mortality: 1990-2015: estimates from WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. 2015.
  • 11. Riley T, Sully E, Ahmed Z, Biddlecom A. Estimates of the potential impact of the COVID-19 pandemic on sexual and reproductive health in low-and middle-income countries. Int Perspect Sex Reprod Health. 2020;46:73-6.
  • 12. Dashraath P, Wong JLJ, Lim MXK, Lim LM, Li S, Biswas A, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222(6):521-31.
  • 13. Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus disease 2019 (COVID-19) and pregnancy: what obstetricians need to know. Am J Obstet Gynecol. 2020;222(5):415-26.
  • 14. Rasmussen SA, Kissin DM, Yeung LF, MacFarlane K, Chu SY, Turcios-Ruiz RM, et al. Preparing for influenza after 2009 H1N1: special considerations for pregnant women and newborns. Am J Obstet Gynecol. 2011;204(6):S13-S20.
  • 15. Dang D, Wang L, Zhang C, Li Z, Wu H. Potential effects of SARS-CoV-2 infection during pregnancy on fetuses and newborns are worthy of attention. J Obstet Gynaecol Res. 2020;46(10):1951-7.
  • 16. Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: a systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 2020;99(7):823-9.
  • 17. Lam CM, Wong SF, Leung TN, Chow KM, Yu WC, Wong TY, et al. A case-controlled study comparing clinical course and outcomes of pregnant and non- pregnant women with severe acute respiratory syndrome. BJOG. 2004;111(8):771-4.
  • 18. Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol. 2004;191(1):292-7.
  • 19. hen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395(10226):809-15.
  • 20. Ellington S, Strid P, Tong VT, Woodworth K, Galang RR, Zambrano LD, et al. Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status— United States, January 22–June 7, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(25):769.
  • 21. Poon LC, Yang H, Kapur A, Melamed N, Dao B, Divakar H, et al. Global interim guidance on coronavirus disease 2019 (COVID-19) during pregnancy and puerperium from FIGO and allied partners: Information for healthcare professionals. I Int J Gynaecol Obstet. 2020;149(3):273-86.
  • 22. Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 2020;2(2):100107.
  • 23. Botto LD, Panichello JD, Browne ML, Krikov S, Feldkamp ML, Lammer E, et al. Congenital heart defects after maternal fever. Am J Obstet Gynecol. 2014;210(4):359. e1-. e11.
  • 24. Edwards MJ. Hyperthermia and fever during pregnancy. Birth Defects Res A Clin Mol Teratol. 2006;76(7):507-16.
  • 25. Zhang L, Dong L, Ming L, Wei M, Li J, Hu R, et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during late pregnancy: a report of 18 patients from Wuhan, China. BMC Pregnancy Childbirth. 2020;20(1):1-7.
  • 26. Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr. 2020;9(1):51.
  • 27. Della Gatta A, Rizzo R, Pilu G, Simonazzi G. COVID19 du-ring pregnancy: a systematic review of reported cases. Am J Obstet Gynecol. 2020.
  • 28. World Health Organization (WHO). Preventing unsafe abortion. https://www.who.int/news- room/fact-sheets/detail/preventing-unsafe- abortion. 2020c
  • 29. Aly J, Haeger KO, Christy AY, Johnson AM. Contraception access during the COVID-19 pandemic. Contracept Reprod Med. 2020;5(17):1-9
  • 30. Nanda K, Lebetkin E, Steiner MJ, Yacobson I, Dorflinger LJ. Contraception in the Era of COVID-19. Glob Health Sci Pract. 2020;8(2):166-8.
  • 31. Vora KS, Saiyed S, Natesan S. Impact of COVID-19 on family planning services in India. Sex Reprod Health Matters. 2020;28(1):1785378.