Abstract
Objective
To evaluate whether prenatal visits or screening/testing were fewer or occurred later during the initial phase of the COVID-19 pandemic in 2020 (CINT) as compared to the prior year (PreCINT).
Methods
A retrospective cohort study compared CINT (n = 2,195) to PreCINT (n = 2,395) at seven public hospitals in New York City. The primary outcome was total number of prenatal-care visits. Secondary outcomes were components of prenatal-care visits completion, timing of standard pregnancy screening tests, and adverse neonatal outcomes.
Results
CINT patients had more total prenatal-care visits (B = 1.30, 95% CI:1.04, 1.56, p < 0.001), lower odds for initiation of prenatal care which was inadequate according to widely used criteria (OR:0.39, 95% CI:0.34, 0.45, p < 0.001), and lower gestational age at initial visit (B=-4.51, 95% CI:-5.10, -3.93, p < 0.001) than PreCINT patients. In-person visits did not differ between the two groups. PreCINT patients had no televisits, while CINT patients had a median of one televisit (Median = 1, p < 0.001). CINT patients had increased odds for group B Streptococcus screening (OR:1.27, 95% CI: 1.10, 1.48, p = 0.001), quadrivalent screening (OR:1.30, 95% CI:1.15, 1.48, p < 0.001), and anatomy sonogram (OR:2.30, 95% CI:2.04, 2.59, p < 0.001) but decreased odds for glucose challenge test screening (OR:0.81, 95% CI:0.72, 0.91, p < 0.001). Adverse neonatal outcome did not differ between CINT and PreCINT pregnancies.
Conclusions for Practice
Despite the difficulties and perceived dangers of in-person visits during the COVID-19 pandemic, the COVID-19 pandemic had little negative impact upon the outpatient prenatal care received by patients in this hospital system.
Significance
There have been conflicting reports regarding the impact of the COVID-19 epidemic on prenatal care and on the role of telemedicine.
AbstractSection What this Study Adds?There was no decrease in the number and timing of in-person outpatient visits. There was comparable or greater completion of standard tests for patients pregnant during the COVID-19 pandemic as compared to the previous year. These safety net hospitals provided unbroken access to outpatient prenatal services, and patients availed themselves of these services, suggesting that pregnant patients understood the importance of prenatal care.
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Data Availability
All data was collected from the hospitals’ electronic health record. It is on file with the corresponding author and can be provided based upon a reasonable request.
Code Availability
SPSS Version 29 (©IBM) software was used in statistical analysis of the data.
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S.M.: Project design, preparation of protocol, data collection, data interpretation, writing the manuscript, approval of final manuscript. J.F.: Project design, preparation of protocol, data analysis, data interpretation, writing the manuscript, approval of final manuscript. K.H.: Data interpretation, writing the manuscript, approval of final manuscript. A.J.J.: Conceived of project, project design, preparation of protocol, data interpretation, writing the manuscript, approval of final manuscript.
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Mobeen, S., Fogel, J., Harishankar, K. et al. The COVID-19 Pandemic and Routine Prenatal Care: Use of Online Visits. Matern Child Health J (2024). https://doi.org/10.1007/s10995-024-03904-8
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DOI: https://doi.org/10.1007/s10995-024-03904-8