Am J Perinatol
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
1  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri
,
Fan Zhang
1  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri
,
Lori Stevenson
2  Women & Infants Center, Barnes-Jewish Hospital, St. Louis, Missouri
,
Bree Porcelli
1  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri
,
Ebony B. Carter
1  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri
,
Nandini Raghuraman
1  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri
,
Jeannie C. Kelly
1  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri
› Author Affiliations

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.

Disclosure of Financial Support and Funding

Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1 TR002345. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.




Publication History

Received: 06 July 2021

Accepted: 03 October 2021

Publication Date:
02 December 2021 (online)

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