{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:18Z","timestamp":1787016978933,"version":"build-2736575974"},"reference-count":20,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T00:00:00Z","timestamp":1665964800000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,9,29]]},"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the impact of COVID-19 on pregnancy-related healthcare utilisation and differences across social groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Nationwide longitudinal prospective registry-based study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Norway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Female residents aged 15\u201350 years (n=1 244 560).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Pregnancy-related inpatient, outpatient and primary care healthcare utilisation before the COVID-19 pandemic (prepandemic: 1 January to 11 March 2020), during the initial lockdown (first wave: 12 March to 3 April 2020), during the summer months of low restrictions (summer period: 4 April to 31 August 2020) and during the second wave to the end of the year (second wave: 1 September to 31 December 2020). Rates were compared with the same time periods in 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 130 924 inpatient specialist care admissions, 266 015 outpatient specialist care consultations and 2 309 047 primary care consultations with pregnancy-related diagnostic codes during 2019 and 2020. After adjusting for time trends and cofactors, inpatient admissions were reduced by 9% (adjusted incidence rate ratio (aIRR)=0.91, 95% CI 0.87 to 0.95), outpatient consultations by 17% (aIRR=0.83, 95% CI 0.71 to 0.86) and primary care consultations by 10% (aIRR=0.90, 95% CI 0.89 to 0.91) during the first wave. Inpatient care remained 3%\u20134% below prepandemic levels throughout 2020. Reductions according to education, income and immigrant background were also observed. Notably, women born in Asia, Africa or Latin America had a greater reduction in inpatient (aIRR=0.87, 95% CI 0.77 to 0.97) and outpatient (aIRR 0.90, 95% CI 0.86 to 0.95) care during the first wave, compared with Norwegian-born women. We also observed that women with low education had a greater reduction in inpatient care during summer period (aIRR=0.88, 95% CI 0.83 to 0.92), compared with women with high educational attainment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Following the introduction of COVID-19 mitigation measures in Norway in March 2020, there were substantial reductions in pregnancy-related healthcare utilisation, especially during the initial lockdown and among women with an immigrant background.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-064118","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T11:18:27Z","timestamp":1666005507000},"page":"e064118","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Impact of COVID-19 on pregnancy-related healthcare utilisation: a prospective nationwide registry study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7772-5315","authenticated-orcid":false,"given":"Carl Michael","family":"Baravelli","sequence":"first","affiliation":[{"name":"Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferenc","family":"Macsali","sequence":"additional","affiliation":[{"name":"Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway"},{"name":"Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7978-0825","authenticated-orcid":false,"given":"Kjetil","family":"Telle","sequence":"additional","affiliation":[{"name":"Health Services Research, Norwegian Institute of Public Health, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas Minet","family":"Kinge","sequence":"additional","affiliation":[{"name":"Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway"},{"name":"Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway"},{"name":"Health Services Research and Department of Health Management and Health Economics, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4697-4316","authenticated-orcid":false,"given":"Laura","family":"Oakley","sequence":"additional","affiliation":[{"name":"Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway"},{"name":"Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria C","family":"Magnus","sequence":"additional","affiliation":[{"name":"Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siri Eldevik","family":"H\u00e5berg","sequence":"additional","affiliation":[{"name":"Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,10,17]]},"reference":[{"key":"2025120518572319000_12.10.e064118.1","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1177\/14034948211000813","article-title":"Admissions to Norwegian hospitals during the COVID-19 pandemic","volume":"49","author":"Helgeland","year":"2021","journal-title":"Scand J Public Health"},{"key":"2025120518572319000_12.10.e064118.2","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/j.healthpol.2021.08.011","article-title":"Nordic responses to Covid-19: governance and policy measures in the early phases of the pandemic","volume":"126","author":"Saunes","year":"2022","journal-title":"Health Policy"},{"key":"2025120518572319000_12.10.e064118.3","first-page":"1440","article-title":"Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans","volume":"107","year":"2020","journal-title":"Br J Surg"},{"key":"2025120518572319000_12.10.e064118.4","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.hlpt.2020.08.004","article-title":"The COVID-19 pandemic in Norway: the dominance of social implications in framing the policy response","volume":"9","author":"Ursin","year":"2020","journal-title":"Health Policy Technol"},{"key":"2025120518572319000_12.10.e064118.5","unstructured":"Lunde ES , Otnes B , Ramm J . 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