{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:08:27Z","timestamp":1786975707532,"version":"build-2736575974"},"reference-count":51,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Little is known about changes in obstetric outcomes during the COVID-19 pandemic.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess whether obstetric outcomes and pregnancy-related complications changed during the COVID-19 pandemic.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective cohort study included pregnant patients receiving care at 463 US hospitals whose information appeared in the PINC AI Healthcare Database. The relative differences in birth outcomes, pregnancy-related complications, and length of stay (LOS) during the pandemic period (March 1, 2020, to April 30, 2021) were compared with the prepandemic period (January 1, 2019, to February 28, 2020) using logistic and Poisson models, adjusting for patients\u2019 characteristics, and comorbidities and with month and hospital fixed effects.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n COVID-19 pandemic period.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The 3 primary outcomes were the relative change in preterm vs term births, mortality outcomes, and mode of delivery. Secondary outcomes included the relative change in pregnancy-related complications and LOS.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n There were 849\u202f544 and 805\u202f324 pregnant patients in the prepandemic and COVID-19 pandemic periods, respectively, and there were no significant differences in patient characteristics between periods, including age (\u226535 years: 153\u202f606 [18.1%] vs 148 274 [18.4%]), race and ethnicity (eg, Hispanic patients: 145\u202f475 [17.1%] vs 143\u202f905 [17.9%]; White patients: 456\u202f014 [53.7%] vs 433\u202f668 [53.9%]), insurance type (Medicaid: 366\u202f233 [43.1%] vs 346\u202f331 [43.0%]), and comorbidities (all standardized mean differences &amp;lt;0.10). There was a 5.2% decrease in live births during the pandemic. Maternal death during delivery hospitalization increased from 5.17 to 8.69 deaths per 100\u202f000 pregnant patients (odds ratio [OR], 1.75; 95% CI, 1.19-2.58). There were minimal changes in mode of delivery (vaginal: OR, 1.01; 95% CI, 0.996-1.02; primary cesarean: OR, 1.02; 95% CI, 1.01-1.04; vaginal birth after cesarean: OR, 0.98; 95% CI, 0.95-1.00; repeated cesarean: OR, 0.96; 95% CI, 0.95-0.97). LOS during delivery hospitalization decreased by 7% (rate ratio, 0.931; 95% CI, 0.928-0.933). Lastly, the adjusted odds of gestational hypertension (OR, 1.08; 95% CI, 1.06-1.11), obstetric hemorrhage (OR, 1.07; 95% CI, 1.04-1.10), preeclampsia (OR, 1.04; 95% CI, 1.02-1.06), and preexisting chronic hypertension (OR, 1.06; 95% CI, 1.03-1.09) increased. No significant changes in preexisting racial and ethnic disparities were observed.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n During the COVID-19 pandemic, there were increased odds of maternal death during delivery hospitalization, cardiovascular disorders, and obstetric hemorrhage. Further efforts are needed to ensure risks potentially associated with the COVID-19 pandemic do not persist beyond the current state of the pandemic.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.26531","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T12:06:48Z","timestamp":1660910808000},"page":"e2226531","source":"Crossref","is-referenced-by-count":82,"title":["Comparison of Pregnancy and Birth Outcomes Before vs During the COVID-19 Pandemic"],"prefix":"10.1001","volume":"5","author":[{"given":"Rose L.","family":"Molina","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas C.","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Surgery, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Center for Surgery and Public Health, Boston, Massachusetts"},{"name":"Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dannie","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Soto","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"PINC AI Applied Sciences, Premier Inc, Charlotte, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. John","family":"Orav","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Primary Care, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose F.","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Harvard T.H. 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