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Am J Perinatol
DOI: 10.1055/a-2325-9213
SMFM Fellowship Series Article

The Impact of Telehealth on Obstetrical Outcomes during the COVID-19 Pandemic

Alexander M. Saucedo 
1   Department of Women's Health, University of Texas at Austin, Dell Medical School, Austin, Texas
,
Mamaram Ceesay
1   Department of Women's Health, University of Texas at Austin, Dell Medical School, Austin, Texas
,
Sanjana Ravi
1   Department of Women's Health, University of Texas at Austin, Dell Medical School, Austin, Texas
,
Kelsey Mumford
1   Department of Women's Health, University of Texas at Austin, Dell Medical School, Austin, Texas
,
Miriam Alvarez
1   Department of Women's Health, University of Texas at Austin, Dell Medical School, Austin, Texas
,
Jeny Ghartey
1   Department of Women's Health, University of Texas at Austin, Dell Medical School, Austin, Texas
,
Lorie M. Harper 
1   Department of Women's Health, University of Texas at Austin, Dell Medical School, Austin, Texas
,
Alison G. Cahill
1   Department of Women's Health, University of Texas at Austin, Dell Medical School, Austin, Texas
› Author Affiliations Funding None.
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Abstract

Objective Nationwide, obstetric clinics modified prenatal care to include telehealth visits in response to the coronavirus disease 2019 (COVID-19) pandemic, enabling the opportunity to investigate its impact on patient outcomes. We hypothesized that use of prenatal telehealth visits would increase the number of prenatal visits, decrease the frequency of urgent triage/emergency department (ED) visits, and improve perinatal outcomes. This study aimed to determine the impact of telehealth on number of obstetric prenatal visits and urgent triage/ED visits amidst the COVID-19 pandemic.

Study Design This is a retrospective cohort of patients from a federally qualified health center in central Texas. Patients with a singleton gestation who delivered after 32 weeks were included. Comparison groups were made between those patients who delivered between May 2020 and December 2020 (presumed modified prenatal visit schedule with in-person and telehealth) and those patients delivering between June 2019 and February 2020 (the traditional care model with in-person visits only). Multivariable linear and logistic regression models were used to estimate differences in the number of prenatal visits and unscheduled triage/ED visits.

Results A total of 1,654 patients were identified with 801 (48.4%) patients undergoing modified prenatal care and 853 (51.6%) patients receiving traditional care during the study period. No significant differences were seen in overall prenatal attendance or triage/ED presentations. However, when stratified by parity, multiparous patients undergoing modified prenatal care were less likely to experience an urgent triage/ED presentation (8.7 vs. 12.7%; odds ratio, 1.69; 95% confidence interval, 1.10–2.61).

Conclusion When compared with a traditional prenatal visitation cohort prepandemic, patients who received modified telehealth prenatal care during the COVID-19 pandemic had similar prenatal attendance and unscheduled emergency presentations. However, multiparous patients experienced a decreased rate of unscheduled emergency presentations. Supplementing prenatal care with telehealth may provide overall comparable prenatal care delivery.

Key Points

  • Use of telehealth has the potential to improve prenatal care.

  • The COVID-19 pandemic allowed for comparison to traditional prenatal care.

  • Multiparous patients had a decreased frequency of ED visits.

  • Similar prenatal attendance was seen between both prenatal models.

Keywords

telehealth - COVID-19 pandemic - virtual - prenatal visits - triage visits - emergency visits - perinatal outcomes

Note

This study was presented as a poster at the 43rd Annual Meeting of the Society for Maternal-Fetal Medicine, San Francisco, CA, on February 10, 2023.


Authors' Contributions

All authors take responsibility for the accuracy and completeness of reporting and for the fidelity of the report to the study protocol.


Study concept and design: All authors.


Data collection: M.C. and M.A.


Analysis and interpretation of data: All authors.


Drafting of manuscript: A.M.S.


Critical revision of the manuscript: All authors.




Publication History

Received: 23 April 2024

Accepted: 12 May 2024

Accepted Manuscript online:
14 May 2024

Article published online:
10 June 2024

© 2024. Thieme. All rights reserved.

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