{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T01:57:04Z","timestamp":1773280624052,"version":"3.50.1"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","issue":"06","funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["T32- HD007440"],"award-info":[{"award-number":["T32- HD007440"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:p>\n            Objective\u2003Health care providers and health systems confronted new challenges to deliver timely, high-quality prenatal care during the coronavirus disease 2019 (COVID-19) pandemic as the pandemic raised concerns that care would be delayed or substantively changed. This study describes trends in prenatal care delivery in 2020 compared with 2018 to 2019 in a large, commercially insured population and investigates changes in obstetric care processes and outcomes.<\/jats:p><jats:p>\n            Study Design\u2003This retrospective cohort study uses de-identified administrative claims for commercially insured patients. Patients whose entire pregnancy took place from March 1 to December 31 in years 2018, 2019, and 2020 were included. Trends in prenatal care, including in-person, virtual, and emergency department visits, were evaluated, as were prenatal ultrasounds. The primary outcome was severe maternal morbidity (SMM). Secondary outcomes included preterm birth and stillbirth. To determine whether COVID-19 pandemic-related changes in prenatal care had an impact on maternal outcomes, we compared the outcome rates during the pandemic period in 2020 to equivalent periods in 2018 and 2019.<\/jats:p><jats:p>\n            Results\u2003In total, 35,112 patients were included in the study. There was a significant increase in the prevalence of telehealth visits, from 1.1 to 1.2% prior to the pandemic to 17.2% in 2020, as well as a significant decrease in patients who had at least one emergency department visit during 2020. Overall prenatal care and ultrasound utilization were unchanged. The rate of SMM across this period was stable (2.3\u20132.8%) with a statistically significant decrease in the preterm birth rate in 2020 (7.4%) compared with previous years (8.2\u20138.6%; p\u2009&lt;\u20090.05) and an unchanged stillbirth rate was observed.<\/jats:p><jats:p>\n            Conclusion\u2003At a time when many fields of health care were reshaped during the pandemic, these observations reveal considerable resiliency in both the processes and outcomes of obstetric care.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-1960-2682","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T22:56:46Z","timestamp":1665701806000},"page":"582-588","source":"Crossref","is-referenced-by-count":13,"title":["Patterns of Prenatal Care Delivery and Obstetric Outcomes before and during the COVID-19 Pandemic"],"prefix":"10.1055","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7932-1987","authenticated-orcid":false,"given":"Adina R.","family":"Kern-Goldberger","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0631-5834","authenticated-orcid":false,"given":"Natalie E.","family":"Sheils","sequence":"additional","affiliation":[{"name":"Optum Labs, Minnetonka, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Eloisa M.","family":"Ventura","sequence":"additional","affiliation":[{"name":"Optum Labs, Minnetonka, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Jane A.","family":"Paderanga","sequence":"additional","affiliation":[{"name":"Optum Labs, Minnetonka, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciara D.","family":"Janer","sequence":"additional","affiliation":[{"name":"Optum Labs, Minnetonka, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia Rose B.","family":"Donato","sequence":"additional","affiliation":[{"name":"Optum Labs, Minnetonka, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Asch","sequence":"additional","affiliation":[{"name":"Department of Medicine, Penn Medicine Center for Health Care Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sindhu K.","family":"Srinivas","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,1,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1056\/CAT.20.0170","article-title":"Rapid development and implementation of a Covid-19 telehealth clinic for obstetric patients","author":"J Spiegelman","year":"2020","journal-title":"NEJM Catal"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"E380","DOI":"10.3390\/healthcare8040380","article-title":"The impact of COVID-19 on telemedicine utilization across multiple service lines in the United States","volume":"8","author":"J A Betancourt","year":"2020","journal-title":"Healthcare (Basel)"},{"issue":"09","key":"ref3","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1007\/s10995-020-02967-7","article-title":"Implementation of obstetric telehealth during COVID-19 and beyond","volume":"24","author":"K Fryer","year":"2020","journal-title":"Matern Child Health J"},{"issue":"08","key":"ref4","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1055\/s-0040-1712121","article-title":"Telehealth for high-risk pregnancies in the setting of the COVID-19 pandemic","volume":"37","author":"A Aziz","year":"2020","journal-title":"Am J Perinatol"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"e045343","DOI":"10.1136\/bmjopen-2020-045343","article-title":"Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review","volume":"11","author":"R Moynihan","year":"2021","journal-title":"BMJ Open"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.annemergmed.2021.01.011","article-title":"Emergency department utilization for emergency conditions during COVID-19","volume":"78","author":"A K Venkatesh","year":"2021","journal-title":"Ann Emerg 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Gynecol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.ejogrb.2022.05.007","article-title":"The impact of mitigation measures on perinatal outcomes during the first nine months of the COVID-19 pandemic: a systematic review with meta-analysis","volume":"274","author":"S Hawco","year":"2022","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"11","key":"ref12","doi-asserted-by":"crossref","first-page":"e604","DOI":"10.1016\/S2468-2667(20)30223-1","article-title":"Impact of COVID-19 mitigation measures on the incidence of preterm birth: a national quasi-experimental study","volume":"5","author":"J V Been","year":"2020","journal-title":"Lancet Public Health"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1097\/AOG.0000000000004022","article-title":"An expanded obstetric comorbidity scoring system for predicting severe maternal morbidity","volume":"136","author":"S A Leonard","year":"2020","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"e212618","DOI":"10.1001\/jamanetworkopen.2021.2618","article-title":"In-person and telehealth ambulatory contacts and costs in a large US insured cohort before and during the COVID-19 pandemic","volume":"4","author":"J P Weiner","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1001\/jamainternmed.2020.5928","article-title":"Trends in outpatient care delivery and telemedicine during the COVID-19 pandemic in the US","volume":"181","author":"S Y Patel","year":"2021","journal-title":"JAMA Intern Med"},{"issue":"10","key":"ref16","doi-asserted-by":"crossref","first-page":"e2129973","DOI":"10.1001\/jamanetworkopen.2021.29973","article-title":"Changes in virtual and in-person health care utilization in a large health system during the COVID-19 pandemic","volume":"4","author":"K S Zachrison","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"06","key":"ref17","doi-asserted-by":"crossref","first-page":"151300","DOI":"10.1016\/j.semperi.2020.151300","article-title":"Conversion and optimization of telehealth in obstetric care during the COVID-19 pandemic","volume":"44","author":"N M Zork","year":"2020","journal-title":"Semin Perinatol"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1089\/tmj.2020.0553","article-title":"Models of incorporating telehealth into obstetric care during the COVID-19 pandemic, its benefits and barriers: a scoping review","volume":"28","author":"H Almuslim","year":"2022","journal-title":"Telemed J E Health"},{"issue":"10","key":"ref19","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1055\/s-0040-1712939","article-title":"Telehealth uptake into prenatal care and provider attitudes during the COVID-19 pandemic in New York City: a quantitative and qualitative 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2014)","volume":"223","author":"J Lauder","year":"2020","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref32","doi-asserted-by":"crossref","first-page":"100258","DOI":"10.1016\/j.ajogmf.2020.100258","article-title":"Decreased incidence of preterm birth during coronavirus disease 2019 pandemic","volume":"2","author":"V Berghella","year":"2020","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"04","key":"ref33","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1097\/AOG.0000000000004535","article-title":"A review of prenatal care delivery to inform the michigan plan for appropriate tailored healthcare in pregnancy panel","volume":"138","author":"C M Barrera","year":"2021","journal-title":"Obstet Gynecol"},{"issue":"05","key":"ref34","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1097\/AOG.0000000000003820","article-title":"Right-sizing prenatal care to meet patients' needs and improve maternity care value","volume":"135","author":"A F Peahl","year":"2020","journal-title":"Obstet Gynecol"},{"issue":"04","key":"ref35","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1097\/AOG.0000000000004531","article-title":"The Michigan plan for appropriate tailored healthcare in pregnancy prenatal care recommendations","volume":"138","author":"A F Peahl","year":"2021","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref36","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.ajog.2021.09.011","article-title":"Assessing access to obstetrical care via telehealth in the era of COVID-19","volume":"226","author":"O A Osarhiemen","year":"2022","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref37","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1097\/AOG.0000000000003933","article-title":"Examining inequities associated with changes in obstetric and gynecologic care delivery during the coronavirus disease 2019 (COVID-19) pandemic","volume":"136","author":"C Onwuzurike","year":"2020","journal-title":"Obstet Gynecol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1960-2682.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T12:57:02Z","timestamp":1681304222000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1960-2682"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,13]]},"references-count":36,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2023,4,3]]},"published-print":{"date-parts":[[2023,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1960-2682","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,10,13]]},"published":{"date-parts":[[2022,10,13]]}}}