The COVID-19 Pandemic and Routine Prenatal Care: Use of Online Visits.

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% CI1.04, 1.56, p < 0.001), lower odds for initiation of prenatal care which was inadequate according to widely used criteria (OR0.39, 95% CI0.34, 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 (OR1.27, 95% CI 1.10, 1.48, p = 0.001), quadrivalent screening (OR1.30, 95% CI1.15, 1.48, p < 0.001), and anatomy sonogram (OR2.30, 95% CI2.04, 2.59, p < 0.001) but decreased odds for glucose challenge test screening (OR0.81, 95% CI0.72, 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.