Post-pandemic for maternity care for local, regional, and national maternity systems across the four nations

We aim to find out how pregnant women and babies have been affected by maternity care changes due to COVID-19.

Questions include:

Were any changes useful? Were any unwelcome or damaging?
How were different groups affected?
Can lessons be learned to reduce inequalities in maternity care in the future?

We ask whether the overall consequences of the pandemic for pregnant women were magnified or diminished for minority ethnic groups, and those women living with social or medical problems.

BACKGROUND

During the pandemic, pregnant and post-birth women often had ‘virtual’ care (by phone or online), rather than in clinic. Some monitored their blood pressure or blood sugar at home and sent readings to care-providers via apps. Now women must decide whether to accept COVID vaccination when offered. Yet, there is little information about how well COVID vaccines in pregnancy or post -birth work, their safety, and whether women will accept them when offered. This is important, as pregnant women who contract COVID-19 are more likely to develop severe illness, particularly women from minority ethnic groups, who may also more often decline vaccination.

WHAT CAN WE LEARN?

The effects of maternity care changes on some women may have been greater, such as those experiencing racial discrimination, lone parenthood or domestic abuse, or affected by deprivation or ill-health. We will investigate this possibility for women and babies known to have poorer health and pregnancy outcomes before COVID – those: from minority ethnic groups, with prior health conditions, current pregnancy complications, or living with social difficulties. We will explore associated care costs.

In more detail, the 2-year project (Nov/21-Oct/23) will have 3 work packages (WPs):

WP1 will use existing maternity and mental health records, collected as part of care in south London.

These are accessible via a secure database, the early-LIfe data cross-LInkage in Research (eLIXIR) platform. They include some details of how maternity care changed in the pandemic, such as virtual care, self-monitoring (eg, blood pressure), and acceptance of COVID-19 vaccination. This WP will compare care and the consequences for different groups.

WP2 will collect information across the UK in two ways.

First, interviews with minority ethnic group women, those living with complex social or medical needs, and health service leaders and policymakers, will gather views on care changes that have occurred and their effects.

Second, women who are planning pregnancy, pregnant, or post-birth and using the King’s College London COVID Symptom Study app (ZOE Global Ltd.) will be invited to join the COVID Symptom Study Biobank and share their views on COVID-19 vaccination, pregnancy outcomes, mental health, and early-life parenting.

In WP3, we will hold ‘listening events’ in the four UK nations, and a national ‘Policy Lab’ workshop, to engage maternity service users, health care staff, and health policymakers. We will present the study results and ‘imagine our best future’, then work together to agree recommendations for future policy and action.

A patient and public involvement and engagement advisory group will work with us throughout. We will share our findings locally, regionally, and nationally across the four nations, through webinars, social media, online, and plain-language reports. Our impact will be on women, NHS maternity staff, the NHS Long Term Plan, and wider society.

People

Dr Abigail Easter

Reader in Perinatal Mental Health

Dr Hiten Mistry

Honorary Senior Research Fellow

Sergio A. Silverio

Research Fellow in Social Science of Women’s Health

Publications

COVID-related publications from our co-investigator group members:

2021:

Schmidt P, Nelson EC, Kearney G, Kraft S, Oliver BJ. International, national and local trends in the spread of COVID-19: a geographic view of COVID-19 spread and the role to be played by coproduction. International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care. 2021 Nov;33(Supplement_2):ii71-ii77. DOI: 10.1093/intqhc/mzab074. PMID: 34850905.

Oliver BJ, Schmidt P, Tomlin S, Kraft SA, Fisher E, Nelson EC. A 'COVID Compass' for navigating the pandemic. Int J Qual Health Care. 2021 Nov 29;33(Supplement_2):ii78-ii80. doi: 10.1093/intqhc/mzab053. PMID: 34849969.

Jackson L, De Pascalis L, Harrold JA, Fallon V, Silverio SA. Postpartum women's experiences of social and healthcare professional support during the COVID-19 pandemic: A recurrent cross-sectional thematic analysis. Women Birth. 2021 Oct 11:S1871-5192(21)00174-8. doi: 10.1016/j.wombi.2021.10.002. Epub ahead of print. PMID: 34756734; PMCID: PMC8553649.

Fallon V, Davies SM, Silverio SA, Jackson L, De Pascalis L, Harrold JA. Psychosocial experiences of postnatal women during the COVID-19 pandemic. A UK-wide study of prevalence rates and risk factors for clinically relevant depression and anxiety. J Psychiatr Res. 2021 Apr;136:157-166. doi: 10.1016/j.jpsychires.2021.01.048. Epub 2021 Feb 2. PMID: 33596462; PMCID: PMC8635302.

Fernandez Turienzo, C., Newburn, M., Agyepong, A., Buabeng, R., Dignam, A., Abe, C., Bedward, L., RaymentJones, H., Silverio, S. A., Easter, A., Carson, L., Howard, L., Sandall, J., & on behalf of the NIHR ARC South London Maternity and Perinatal Mental Health Research and Advisory Teams (Jan 2021). Addressing inequities in maternal health among women living in communities of social disadvantage and ethnic diversity. BMC Public Health, 21(1), 1-5. [176]. https://doi.org/10.1186/s12889-021-10182-4

Jackson L, De Pascalis L, Harrold JA, Fallon V, Silverio SA. Postpartum women's psychological experiences during the COVID-19 pandemic: a modified recurrent cross-sectional thematic analysis. BMC Pregnancy Childbirth. 2021 Sep 17;21(1):625. doi: 10.1186/s12884-021-04071-2. PMID: 34530772; PMCID: PMC8445650.

Sergio A. Silverio, Kaat De Backer, Abigail Easter, Peter von Dadelszen, Laura A. Magee, Jane Sandall,Women's experiences of maternity service reconfiguration during the COVID-19 pandemic: A qualitative investigation, Midwifery, Volume 102, 2021, 103116, ISSN 0266-6138, https://doi.org/10.1016/j.midw.2021.103116.(https://www.sciencedirect.com/science/article/pii/S0266613821001960)

Silverio, S.A., Davies, S.M., Christiansen, P. et al. A validation of the Postpartum Specific Anxiety Scale 12-item research short-form for use during global crises with five translations. BMC Pregnancy Childbirth 21, 112 (2021). https://doi.org/10.1186/s12884-021-03597-9

Silverio, S.A., Easter, A., Storey, C. et al. Preliminary findings on the experiences of care for parents who suffered perinatal bereavement during the COVID-19 pandemic. BMC Pregnancy Childbirth 21, 840 (2021). https://doi.org/10.1186/s12884-021-04292-5

Afuwape I, Parsons J, Bick D, Dale J, Hillman SC. Vaccines and Pregnancy. InnoVAIT. Official Journal of the Royal College of General Practitioners. 2021. November. https://doi.org/10.1177/17557380211051765

Murray B, Kerfoot E, Chen L, Deng J, Graham MS, Sudre CH, Molteni E, Canas LS, Antonelli M, Klaser K, Visconti A, Hammers A, Chan AT, Franks PW, Davies R, Wolf J, Spector TD, Steves CJ, Modat M, Ourselin S. Accessible data curation and analytics for international-scale citizen science datasets. Sci Data. 2021 Nov 22;8(1):297. doi: 10.1038/s41597-021-01071-x. PMID: 34811392.

Laura A. Magee; Peter von Dadelszen; Erkan Kalafat; Emma L Duncan; Pat O’Brien; Edward Morris; Paul Heath; Asma Khalil. “COVID-19 vaccination in pregnancy: number needed to vaccinate to avoid harm.” The Lancet Infectious Diseases, published on line 2 November 2021 (https://doi.org/10.1016/S1473-3099(21)00691-5).

Liane S. Canas, Marc F. Österdahl, Jie Deng, Joan Capdevila Pujol, Erika Molteni, Benjamin Murray, Liyuan Chen, Eric Kerfoot, Kerstin Klaser, Michela Antonelli, Alexander Hammers, Tim Spector, Sebastien Ourselin, Claire Steves, Carole H. Sudre, Marc Modat, Emma L. Duncan. “Disentangling post-vaccination symptoms from early COVID-19.” Preprinted MedRxiv (https://medrxiv.org/cgi/content/short/2021.07.21.21260906v1). Accepted, eClinicalMedicine, October 2021.

Antonelli M, Penfold RS, Merino J, Sudre CH, Molteni E, Berry S, Canas LS, Graham MS, Klaser K, Modat M, Murray B, Kerfoot E, Chen L, Deng J, Österdahl MF, Cheetham NJ, Drew DA, Nguyen LH, Pujol JC, Hu C, Selvachandran S, Polidori L, May A, Wolf J, Chan AT, Hammers A, Duncan EL, Spector TD, Ourselin S, Steves CJ. Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: a prospective, community-based, nested, case-control study. Lancet Infect Dis. 2021 Sep 1:S1473-3099(21)00460-6. doi: 10.1016/S1473-3099(21)00460-6. Epub ahead of print. PMID: 34480857; PMCID: PMC8409907.

Canas LS, Sudre CH, Capdevila Pujol J, Polidori L, Murray B, Molteni E, Graham MS, Klaser K, Antonelli M, Berry S, Davies R, Nguyen LH, Drew DA, Wolf J, Chan AT, Spector T, Steves CJ, Ourselin S, Modat M. Early detection of COVID-19 in the UK using self-reported symptoms: a large-scale, prospective, epidemiological surveillance study. Lancet Digit Health. 2021 Sep;3(9):e587-e598. doi: 10.1016/S2589-7500(21)00131-X. Epub 2021 Jul 29. PMID: 34334333; PMCID: PMC8321433.

Klaser K, Thompson EJ, Nguyen LH, Sudre CH, Antonelli M, Murray B, Canas LS, Molteni E, Graham MS, Kerfoot E, Chen L, Deng J, May A, Hu C, Guest A, Selvachandran S, Drew DA, Modat M, Chan AT, Wolf J, Spector TD, Hammers A, Duncan EL, Ourselin S, Steves CJ. Anxiety and depression symptoms after COVID-19 infection: results from the COVID Symptom Study app. J Neurol Neurosurg Psychiatry. 2021 Dec;92(12):1254-1258. doi: 10.1136/jnnp-2021-327565. Epub 2021 Sep 28. PMID: 34583944; PMCID: PMC8599635.

Kerstin Kläser,Ellen J. Thompson, Long H. Nguyen, Carole H. Sudre, Michela Antonelli, Benjamin Murray, Liane S. Canas, Erika Molteni^,, Mark S. Graham, Anna May, Christina Hu, Andy Guest, Somesh Selvachandran, David A Drew, Marc Modat, Andrew T. Chan, Jonathan Wolf, Tim D. Spector, Alexander Hammers,^, Emma L. Duncan, Sebastien Ourselin^,, Claire J. Steves. “Anxiety and depression symptoms after COVID-19 infection: results from the COVID Symptom Study app”. Preprint in MedRxiv (https://www.medrxiv.org/content/10.1101/2021.07.07.21260137v1); Published on line, JNND, 28 Sept 2021 (https://jnnp.bmj.com/content/early/2021/09/27/jnnp-2021-327565).

Michela Antonelli, Rose S Penfold, Jordi Merino, Carole H Sudre, Erika Molteni, Sarah Berry, Liane S Canas, Mark S Graham, Kerstin Klaser, Marc Modat, Benjamin Murray, Marc F Österdahl, Nathan J Cheetham, David Drew, Long Nguyen, Joan Capdeila Pujol, Christina Hu, Somesh Selvachandran, Lorenzo Polidori, Anna May, Jonathan Wolf, Andrew T Chan, Alexander Hammers, Emma L Duncan, Tim D Spector, Sebastien Ourselin, Claire J Steves. “Post-vaccination SARS-CoV-2 infection: risk factors and illness in a prospective, observational community-based case-control study.” Preprint in MedRxiv (https://doi.org/10.1101/2021.05.24.21257738) May 2021; published online ahead of print, Lancet Infect Dis. 2021 Sep 1: S1473-3099(21)00460-6. doi: 10.1016/S1473-3099(21)00460-6.

Erika Molteni, Carole H. Sudre, Liane S. Canas, Sunil S. Bhopal, Robert C. Hughes, Michela Antonelli, Benjamin Murray, Kerstin Kläser, Eric Kerfoot, Liyuan Chen, Jie Deng, Christina Hu, Somesh Selvachandran, Kenneth Read, Joan Capdevila Pujol, Alexander Hammers, Tim D. Spector, Sebastien Ourselin, Claire J. Steves, Marc Modat, Michael Absoud, Emma L. Duncan. “Illness duration and symptom profile in a large cohort of symptomatic UK school-aged children tested for SARS-CoV-2”. Pre-print, medRxiv, https://medrxiv.org/cgi/content/short/2021.05.05.21256649v1; Published online ahead of print, Lancet Child and Adolescent Health, Aug 3:S2352-4642(21)00198-X. doi: 10.1016/S2352-4642(21)00198-X.

Molteni E, Sudre CH, Canas LS, Bhopal SS, Hughes RC, Antonelli M, Murray B, Kläser K, Kerfoot E, Chen L, Deng J, Hu C, Selvachandran S, Read K, Capdevila Pujol J, Hammers A, Spector TD, Ourselin S, Steves CJ, Modat M, Absoud M, Duncan EL. Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2. Lancet Child Adolesc Health. 2021 Oct;5(10):708-718. doi: 10.1016/S2352-4642(21)00198-X. Epub 2021 Aug 3. Erratum in: Lancet Child Adolesc Health. 2021 Aug 31;: PMID: 34358472; PMCID: PMC8443448.

Sudre CH, Murray B, Varsavsky T, Graham, MS, Penfold RS, Bowyer RC, Pujol JC, Klaser K, Antonelli M, Canas LS, Molteni E, Modat M, Jorge Cardoso M, May A, Ganesh S, Davies R, Nguyen LH, Drew DA, Astley CM, Joshi AD, Merino J, Tsereteli N, Fall T, Gomez MF, Duncan EL, Menni C, Williams FMK, Frank, PW, Chan AT, Wolf J, Ourselin S, Spector T, and Steves CJ “Attributes and predictors of Long-COVID: analysis of COVID cases and their symptoms collected by the Covid Symptoms Study App”. Nat Medicine, published March 2021 (https://doi.org/10.1038/s41591-021-01292-y).

Molteni E, Sudre CH, Canas LS, Bhopal SS, Hughes RC, Chen L, Deng J, Murray B, Kerfoot E, Antonelli M, Graham M, Kläser K, May A, Hu C, Capdevila-Pujol J, Wolf J, Hammers A, Spector TD, Ourselin S, Modat M, Steves CJ, Absoud M, Duncan EL. Illness characteristics of COVID-19 in children infected with the SARS-CoV-2 Delta variant. medRxiv, 2021.10.06 doi:https://doi.org/10.1101/2021.10.06.21264467.

Sudre CH, Keshet A, Graham MS, Joshi AD, Shilo S, Rossman H, Murray B, Molteni E, Klaser K, Canas LD, Antonelli M, Nguyen LH, Drew DA, Modat M, Pujol JC, Ganesh S, Wolf J, Meir T, Chan AT, Steves CJ, Spector TD, Brownstein JS, Segal E, Ourselin S, Astley CM. Anosmia, ageusia, and other COVID-19-like symptoms in association with a positive SARS-CoV-2 test, across six national digital surveillance platforms: an observational study. Lancet Digit Health. 2021 Sep;3(9):e577-e586. doi: 10.1016/S2589-7500(21)00115-1. Epub 2021 Jul 22. Erratum in: Lancet Digit Health. 2021 Sep;3(9):e542. PMID: 34305035; PMCID: PMC8297994.

Menni C, Klaser K, May A, Polidori L, Capdevila J, Louca P, Sudre CH, Nguyen LH, Drew DA, Merino J, Hu C, Selvachandran S, Antonelli M, Murray B, Canas LS, Molteni E, Graham MS, Modat M, Joshi AD, Mangino M, Hammers A, Goodman AL, Chan AT, Wolf J, Steves CJ, Valdes AM, Ourselin S, Spector TD. Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID Symptom Study app in the UK: a prospective observational study. Lancet Infect Dis. 2021 Jul;21(7):939-949. doi: 10.1016/S1473-3099(21)00224-3. Epub 2021 Apr 27. PMID: 33930320; PMCID: PMC8078878.

Graham MS, Sudre CH, May A, Antonelli M, Murray B, Varsavsky T, Kläser K, Canas LS, Molteni E, Modat M, Drew DA, Nguyen LH, Polidori L, Selvachandran S, Hu C, Capdevila J; COVID-19 Genomics UK (COG-UK) Consortium, Hammers A, Chan AT, Wolf J, Spector TD, Steves CJ, Ourselin S. Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study. Lancet Public Health. 2021 May;6(5):e335-e345. doi: 10.1016/S2468-2667(21)00055-4. Epub 2021 Apr 12. PMID: 33857453; PMCID: PMC8041365.

Molteni E, Astley CM, Ma W, Sudre CH, Magee LA, Murray B, Fall T, Gomez MF, Tsereteli N, Franks PW, Brownstein JS, Davies R, Wolf J, Spector TD, Ourselin S, Steves CJ, Chan AT, Modat M. Symptoms and syndromes associated with SARS-CoV-2 infection and severity in pregnant women from two community cohorts. Sci Rep. 2021 Mar 25;11(1):6928. doi: 10.1038/s41598-021-86452-3. PMID: 33767292; PMCID: PMC7994587.

Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC, Pujol JC, Klaser K, Antonelli M, Canas LS, Molteni E, Modat M, Jorge Cardoso M, May A, Ganesh S, Davies R, Nguyen LH, Drew DA, Astley CM, Joshi AD, Merino J, Tsereteli N, Fall T, Gomez MF, Duncan EL, Menni C, Williams FMK, Franks PW, Chan AT, Wolf J, Ourselin S, Spector T, Steves CJ. Attributes and predictors of long COVID. Nat Med. 2021 Mar 10. doi: 10.1038/s41591-021-01292-y. Epub ahead of print. PMID: 33692530.

Antonelli M, Capdevila J, Chaudhari A, Granerod J, Canas LS, Graham MS, Klaser K, Modat M, Molteni E, Murray B, Sudre CH, Davies R, May A, Nguyen LH, Drew DA, Joshi A, Chan AT, Cramer JP, Spector T, Wolf J, Ourselin S, Steves CJ, Loeliger AE. Optimal symptom combinations to aid COVID-19 case identification: Analysis from a community-based, prospective, observational cohort. J Infect. 2021 Mar;82(3):384-390. doi: 10.1016/j.jinf.2021.02.015. Epub 2021 Feb 13. PMID: 33592254; PMCID: PMC7881291.

Relph S, Jardine J, Magee LA, von Dadelszen P, Morris E, Ross-Davie M, Draycott T, Khalil A. Authors’ reply re: Maternity services in the UK during the coronavirus disease 2019 pandemic: a national survey of modifications to standard care. BJOG 2021. doi:10.1111/1471-0528.16639

Kalafat E, O’Brien P, Heath PT, Le Doare K, von Dadelszen P, Magee L, Ladhani S, Khalil A. Benefits and potential harms of COVID-19 vaccination during pregnancy: evidence summary for patient counseling. UOG 2021 18 March. https://doi.org/10.1002/uog.23631

Chmielewska B, Barratt I, Townsend R, Kalafat E, van der Meulen J, Gurol-Urganci I, O'Brien P, Morris E, Draycott T, Thangaratinam S, Le Doare K, Ladhani S, von Dadelszen P, Magee L, Khalil A. Effects of the COVID-19 pandemic on maternal and perinatal outcomes: A systematic review and meta-analysis. Lancet Glob Health 2021 Jun; (6):e759-e772. doi: 10.1016/S2214-109X(21)00079-6. Epub 2021 Mar 31. PMID: 33811827

Townsend R, Chmielewska B, Barratt I, Kalafat E, van der Meulen J, Gurol-Urganci I, O’Brien P, Morris E, Draycott T, Thangaratinam S, Le Doare K, Ladhani S, von Dadelszen P. Magee LA, Khalil A. Global changes in maternity care provision during the COVID-19 pandemic: A systematic review and meta-analysis. EClinicalMedicine 2021 Jun 19;37:100947. doi: 10.1016/j.eclinm.2021.100947. eCollection 2021 Jul. PMID 34195576

Chmielewska B, Barratt I, Townsend R, Kalafat E, van der Meulen J, Gurol-Urganci I, O'Brien P, Morris E, Draycott T, Thangaratinam S, Le Doare K, Ladhani S, von Dadelszen P, Magee L, Khalil A. COVID-19 and maternal and perinatal outcomes - Authors' reply. Lancet Glob Health 2021 Aug;9(8):e1066. doi: 10.1016/S2214-109X(21)00293-X.PMID: 34297960

Blakeway H, Prasad S, Kalafat E, Health PT, Ladhani SN, Le Doare K, Magee LA, O’Brien P, Rezvani A, von Dadelszen P, Khalil A. COVID-19 vaccination during pregnancy: coverage and safety. AJOG 2021 Aug 0;S0002-9378(21)00873-5. doi: 10.1016/j.ajog.2021.08.007. PMID34389291

Silverio SA, De Backer K, Easter A, von Dadelszen P, Magee LA*, Sandall J* (joint senior authors). Women’s experiences of maternity service reconfiguration during the COVID-19 pandemic: A qualitative investigation. Midwifery 2021(102):103116

Kalafat E, Magee LA, von Dadelszen P, O’Brien P, Khalil A. SARS-CoV-2 immunisation for pregnant women in low-income countries – a unique opportunity for healthcare equity. Lancet 2021 11 Aug. https://doi.org/10.1016/S0140-6736(21)01756-6

Kalafat E, Prasad S, Birol P, Bilge A, Kunt A, Di Fabrizio C, Alatas C, Celik E, Bagci H, Binder J, Le Doare K, Magee LA, Ali-Mutlu M, Yassa M, Tug N, Sahin O, Drokos P, O’Brien P, von Dadelszen P, Palmrich P, Papaioannou G, Ayaz R, Ladhani SN, Kalantaridou S. Mihmanli V, Khalil A. An internally validated prediction model for critical COVID-19 infection and intensive care unit admission in symptomatic pregnant women. AJOG 2021 Sept 25;S0002-9378(21)01052-8. Online ahead of print. DOI: https://doi.org/10.1016/j.ajog.2021.09.024

Magee LA, von Dadelszen P, Kalafat E, Duncan EL, O’Brien P, Morris E, Heath P, Khalil A. COVID-19 vaccination in pregnancy: number needed to vaccinate to avoid harm. Lancet Infec Dis Dec 2021;12(1):1627 (online 2 Nov 2021). https://doi.org/10.1016/S1473-3099(21)00691-5

2020:

MacGregor R, Hillman S, Bick D. Falling through the cracks: the impact of COVID-19 on postnatal care in primary care. Br J Gen Pract. 2020 Nov 26;70(701):578-579. doi: 10.3399/bjgp20X713573.

Bick D, Cheyne H, Chang YS, Fisher J. Maternal postnatal health during the COVID-19 pandemic: Vigilance is needed.

Midwifery. 2020 Sep;88:102781. doi: 10.1016/j.midw.2020.102781.

Bick D. COVID-19: 2020 is the International Year of the Midwife. Midwifery. 2020 Jun;85:102719. doi: 10.1016/j.midw.2020.102719.

Magee LA, Khalil A, von Dadelszen P. Pregnancy hypertension diagnosis and care in COVID-19 era and beyond. Ultrasound Obstet Gynecol 2020 Jun 7;10.1002/uog.22115. doi: 10.1002/uog.22115. Online ahead of print. PMID: 32506723

von Dadelszen P, Khalil A, Wolfe I, Kametas NA, O’Brien P, Magee LA. Risks to children during covid-19 pandemic: “Women and children last” – effects of the covid-19 pandemic on reproductive, perinatal, and paediatric health. BMJ 2020 Jun 10; 369:m2287. https://doi.org/10.1136/bmj.m2287 PMID: 32522717

Khalil A, Kalafat E, Benlioglu Can, O'Brien P, Morris E, Draycott T, Thangaratinam S, Le Doare K, Heath Paul, Ladhani Shamez, von Dadelszen P, Magee LA. SARS-CoV-2 infection in pregnancy: a systematic review and meta-analysis of clinical features and pregnancy outcomes. eClinical Medicine 2020 Jul 3;doi.org/10.1016/j.eclinm.2020.100446

Khalil A, von Dadelszen P, Draycott T, Ugwumadu A, O’Brien P, Magee L. Change in the incidence of stillbirth and preterm delivery during the COVID-19 pandemic. JAMA 2020 Jul 10;324(7):705-6. doi: 10.1001/jama.2020.12746. Online ahead of print.

Magee LA, Khalil A, von Dadelszen P. UKOSS study in context. BMJ 2020 Jul 27;370:m2915. http://dx.doi.org/10.1136/bmj.m2915.

Jardine J, Relph S, Magee LA, von Dadelszen P, Morris E, Ross-Davie M, Draycott T, Khalil A. Maternity services in the UK during the COVID-19 pandemic: a national survey of modifications to standard care. BJOG 2020 29 Sept (online early, https://doi.org/10.1111/1471-0528.16547)

Etti M, Sekikubo M, Nankabirwa V, Sommerfelt H, Freyne B, Kawaza K, Gadama G, Jambo K, Sevene E, Temmerman M, Magee LA, von Dadelszen P, Khalil A, Doare KL, WHO/HRP Alliance author group. SARS-CoV-2 Infection in Pregnant Women and Their Newborns. Ann Global Health 2020; 86(1): 132, 1–3. DOI: https://doi.org/10.5334/aogh.3072

Khalil A, von Dadelszen P, Kalafat E, Sebghati M, Ladhani S, Ugwumadu A, Draycott T, O’Brien P, Magee LA, on behalf of the PregnaCOVID3 Study Group. Change in obstetric attendance and activities during the COVID-19 pandemic. Lancet Infec Dis 2020 (online October 5, 2020). https://doi.org/10.1016/S1473-3099(20)30779-9

Khalil AA, von Dadelszen P, Ugwumadu A, Draycott T, Magee LA. Effect of COVID-19 on maternal and neonatal services. Lancet Glob Health 2020 (online November 20, 2020). https://doi.org/10.1016/S2214-109X(20)30483-6

Magee LA, von Dadelszen P, Khalil A. COVID-19 and preterm birth. Lancet Glob Health 2021;9:e117 (online November 20, 2020). https://doi.org/10.1016/S2214-109X(20)30457-5

Molteni E, Astley CM, Ma W, Sudre CH, Magee LA, Murray B, Fall T, Gomez M, Tsereteli N, Franks PW, Brownstein JS, Davies R, Wolf J, Spector TD, Ourselin S, Steves CJ, Chan AT, Modat M. Symptoms and syndromes associated with SARS-CoV-2 infection and severity in pregnant women from two community cohorts. Sci Rep 2021 Mar 25;11(1):6928. doi: 10.1038/s41598-021-86452-3. (Version 2. medRxiv. Preprint. 2020 Aug 19 [revised 2020 Oct 14]. doi: 10.1101/2020.08.17.20161760)

COVID-19: 2020 is the International Year of the Midwife.COVID-19: 2020 is the International Year of the Midwife.

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https://doi.org/10.1038/s41591-021-01292-y