{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T16:50:42Z","timestamp":1771692642746,"version":"3.50.1"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>\n            Objective\u2003The primary objective of this study was to evaluate coronavirus 2019 (COVID-19) pandemic\u2013related changes in the antenatal utilization of high-risk obstetric services. Our secondary objective was to characterize change in stillbirth rate during the pandemic.<\/jats:p><jats:p>\n            Study Design\u2003This 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.<\/jats:p><jats:p>\n            Results\u2003While 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\u2009&lt;\u20090.001). The stillbirth rate during the pandemic epoch was not significantly different when compared with the prepandemic period and accounting for both week (p\u2009=\u20090.286) and year (p\u2009=\u20090.643) effect.<\/jats:p><jats:p>\n            Conclusion\u2003The 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.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1740212","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T23:59:31Z","timestamp":1638489571000},"page":"830-835","source":"Crossref","is-referenced-by-count":4,"title":["Changes in the Antenatal Utilization of High-Risk Obstetric Services and Stillbirth Rate during the COVID-19 Pandemic"],"prefix":"10.1055","volume":"39","author":[{"given":"Megan C.","family":"Oakes","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lori","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Women & Infants Center, Barnes-Jewish Hospital, St. Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bree","family":"Porcelli","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebony B.","family":"Carter","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nandini","family":"Raghuraman","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeannie C.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University, in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,12,2]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1002\/uog.22029","article-title":"ISUOG Consensus Statement on organization of routine and specialist obstetric ultrasound services in context of COVID-19","volume":"55","author":"R S Abu-Rustum","year":"2020","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"151278","DOI":"10.1016\/j.semperi.2020.151278","article-title":"Adaptation of prenatal care and ultrasound","volume":"44","author":"A Aziz","year":"2020","journal-title":"Semin Perinatol"},{"issue":"08","key":"ref3","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":"08","key":"ref4","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1055\/s-0040-1710538","article-title":"A proposed plan for prenatal care to minimize risks of COVID-19 to patients and providers: focus on hypertensive disorders of pregnancy","volume":"37","author":"J R Barton","year":"2020","journal-title":"Am J Perinatol"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"100106","DOI":"10.1016\/j.ajogmf.2020.100106","article-title":"MFM guidance for COVID-19","volume":"2","author":"R C Boelig","year":"2020","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"389.e1","DOI":"10.1016\/j.ajog.2020.05.029","article-title":"Prenatal care redesign: creating flexible maternity care models through virtual care","volume":"223","author":"A F Peahl","year":"2020","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1136\/archdischild-2020-320682","article-title":"Increase of stillbirth and decrease of late preterm infants during the COVID-19 pandemic lockdown","volume":"106","author":"M De Curtis","year":"2021","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.ejogrb.2020.09.006","article-title":"Effects of SARS Cov-2 epidemic on the obstetrical and gynecological emergency service accesses. 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The impact of the COVID-19 pandemic on obstetric and gynecologic procedures and consults at a New York City hospital","volume":"28","author":"E E Spurlin","year":"2021","journal-title":"J Minim Invasive Gynecol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ejogrb.2021.01.054","article-title":"Increase rate of ruptured tubal ectopic pregnancy during the COVID-19 pandemic","volume":"259","author":"S Dvash","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"384.e1","DOI":"10.1016\/j.ajog.2020.10.008","article-title":"Patient and provider perspectives of a new prenatal care model introduced in response to the coronavirus disease 2019 pandemic","volume":"224","author":"A F Peahl","year":"2021","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref23","doi-asserted-by":"crossref","first-page":"100233","DOI":"10.1016\/j.ajogmf.2020.100233","article-title":"Adherence and acceptability of telehealth appointments for high-risk obstetrical patients during the coronavirus disease 2019 pandemic","volume":"2","author":"S Jeganathan","year":"2020","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"15","key":"ref24","doi-asserted-by":"crossref","first-page":"e25435","DOI":"10.1097\/MD.0000000000025435","article-title":"The efficacy of reduced-visit prenatal care model during the coronavirus disease 2019 pandemic: a protocol for systematic review and meta-analysis","volume":"100","author":"X Wang","year":"2021","journal-title":"Medicine (Baltimore)"},{"issue":"01","key":"ref27","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1001\/jama.2020.20991","article-title":"Changes in preterm birth phenotypes and stillbirth at 2 Philadelphia hospitals during the SARS-CoV-2 pandemic, March-June 2020","volume":"325","author":"S C Handley","year":"2021","journal-title":"JAMA"},{"issue":"02","key":"ref29","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1111\/1471-0528.15509","article-title":"Risk of stillbirth in low-risk singleton term pregnancies following fertility treatment: a national cohort study","volume":"126","author":"B Bay","year":"2019","journal-title":"BJOG"},{"issue":"05","key":"ref30","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1093\/humrep\/deq023","article-title":"IVF and stillbirth: a prospective follow-up study","volume":"25","author":"K Wisborg","year":"2010","journal-title":"Hum Reprod"},{"issue":"04","key":"ref31","first-page":"819","article-title":"Decrease in trauma admissions with COVID-19 pandemic","volume":"21","author":"T H Kamine","year":"2020","journal-title":"West J Emerg Med"},{"issue":"04","key":"ref32","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1097\/TA.0000000000003061","article-title":"\u201cSafer at home\u201d: the effect of the COVID-19 lockdown on epidemiology, resource utilization, and outcomes at a large urban trauma center","volume":"90","author":"H Chiba","year":"2021","journal-title":"J Trauma Acute Care Surg"},{"issue":"01","key":"ref33","doi-asserted-by":"crossref","first-page":"e000642","DOI":"10.1136\/tsaco-2020-000642","article-title":"Decreased adult trauma admission volumes and changing injury patterns during the COVID-19 pandemic at 85 trauma centers in a multistate healthcare system","volume":"6","author":"G M Berg","year":"2021","journal-title":"Trauma Surg Acute Care Open"},{"issue":"02","key":"ref34","doi-asserted-by":"crossref","first-page":"103","DOI":"10.3390\/ijgi10020103","article-title":"Escaping from cities during the COVID-19 crisis: Using mobile phone data to trace mobility in Finland","volume":"10","author":"E Willberg","year":"2021","journal-title":"ISPRS Int. 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