Changes in the Antenatal Utilization of High-Risk Obstetric Services and Stillbirth Rate during the COVID-19 Pandemic

Megan C. Oakes; Fan Zhang; Lori Stevenson; Bree Porcelli; Ebony B. Carter; Nandini Raghuraman; Jeannie C. Kelly

doi:10.1055/s-0041-1740212

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2022; 39(08): 830-835
DOI: 10.1055/s-0041-1740212

Original Article

Changes in the Antenatal Utilization of High-Risk Obstetric Services and Stillbirth Rate during the COVID-19 Pandemic

Megan C. Oakes

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri

,

Fan Zhang

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri

,

Lori Stevenson

²Women & Infants Center, Barnes-Jewish Hospital, St. Louis, Missouri

,

Bree Porcelli

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri

,

Ebony B. Carter

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri

,

Nandini Raghuraman

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri

,

Jeannie C. Kelly

¹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri

› Institutsangaben

Abstract

Objective The primary objective of this study was to evaluate coronavirus 2019 (COVID-19) pandemic–related changes in the antenatal utilization of high-risk obstetric services. Our secondary objective was to characterize change in stillbirth rate during the pandemic.

Study Design This is a retrospective, observational study performed at a single, tertiary care center. Maternal-Fetal Medicine (MFM) visits, ultrasounds, and antenatal tests of fetal well-being during the pandemic epoch (2020), which spans the first 12 weeks of the year to include pandemic onset and implementation of mitigation efforts, were compared with the same epoch of the three preceding years visually and using general linear models to account for week and year effect. An analysis of stillbirth rate comparing the pandemic time period to prepandemic was also performed.

Results While there were decreased MFM visits and antenatal tests of fetal well-being during the pandemic epoch compared with prepandemic epochs, only the decrease in MFM visits by year was statistically significant (p < 0.001). The stillbirth rate during the pandemic epoch was not significantly different when compared with the prepandemic period and accounting for both week (p = 0.286) and year (p = 0.643) effect.

Conclusion The COVID-19 pandemic resulted in a significant decrease in MFM visits, whereas obstetric ultrasounds and antenatal tests of fetal well-being remained unchanged. While we observed no change in the stillbirth rate compared with the prepandemic epoch, our study design and sample size preclude us from making assumptions of association. Our findings may support future work investigating how changes in prenatal care for high-risk obstetric patients influence perinatal outcomes.

Key Points

MFM visits significantly decreased during the COVID-19 pandemic epoch.
The overall stillbirth rate during the COVID-19 pandemic epoch was not significantly changed.
Larger studies are needed to capitalize on these changes to evaluate rare outcomes such as stillbirth.

Keywords

COVID-19 - SARS-CoV-2 - SARS - coronavirus - high-risk pregnancy - maternal-fetal medicine - antenatal - ultrasound

Volltext

Referenzen

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