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- Title
Evaluating Standard of Care and Obstetrical Outcomes in a Reduced Contact Prenatal Care Model in the COVID-19 Pandemic.
- Authors
Mei, Jenny Y.; Bernstein, Megan E.; Patton, Eden; Duong, Hai-Lang; Negi, Masaru
- Abstract
Introduction: We aimed to investigate the impact of reduced contact prenatal care necessitated by the COVID-19 pandemic on meeting standards of care and perinatal outcomes. Methods: This was a retrospective case-control study of patients in low-risk obstetrics clinic at a tertiary care county facility serving solely publicly insured patients comparing reduced in-person prenatal care (R) over 12 weeks with a control group (C) receiving traditional prenatal care who delivered prior. Results: Total 90 patients in reduced contact (R) cohort were matched with controls (C). There were similar rates of standard prenatal care metrics between groups. Gestational age (GA) of anatomy ultrasound was later in R (p = 0.017). Triage visits and missed appointments were similar, though total number of visits (in-person and telehealth) was higher in R (p = 0.043). R group had higher GA at delivery (p = 0.001). Composite neonatal morbidity and length of stay were lower in R (p = 0.017, p = 0.048). Maternal and neonatal outcomes did not otherwise differ between groups. Using Kotelchuck Adequacy of Prenatal Care Utilization index, R had higher rates of adequate prenatal care (45.6% R vs. 24.4% C, p = 0.005). Discussion: Our study demonstrates the non-inferiority of a hybrid, reduced schedule prenatal schedule to traditional prenatal scheduling. In a reduced contact prenatal care model, more patients met criteria for adequate prenatal care, likely due to higher attendance of telehealth visits. These findings raise the question of revising the prenatal care model to mitigate disparities in disadvantaged populations. Significance: Recent studies have explored the impact of reduced prenatal care models on obstetrical outcomes with overall mixed findings. We aimed to investigate the impact of a reduced contact prenatal care model necessitated by the COVID-19 pandemic on meeting standards of care and obstetric outcomes. We found that in a reduced contact prenatal care model, more patients obtained adequate prenatal care, standards of care were met, and obstetrical outcomes were similar to that of controls. These findings raise the question of raising the question of pursuing a revised prenatal care model in the future.
- Subjects
MEDICAL quality control; MATERNAL health services; LENGTH of stay in hospitals; MEDICAL triage; ANALYSIS of variance; RETROSPECTIVE studies; CASE-control method; TERTIARY care; GESTATIONAL age; DISEASES; PREGNANCY outcomes; T-test (Statistics); HEALTH insurance; AUTONOMY (Psychology); DESCRIPTIVE statistics; CHI-squared test; PRENATAL care; MEDICAL appointments; DATA analysis software; TELEMEDICINE; COVID-19 pandemic; LONGITUDINAL method
- Publication
Maternal & Child Health Journal, 2024, Vol 28, Issue 2, p287
- ISSN
1092-7875
- Publication type
Article
- DOI
10.1007/s10995-023-03812-3