727 The impact of COVID-19 on intrauterine fetal demise: a single system’s experience

Abstract

Recent work shows an increase in intrauterine fetal demise (IUFD) during the COVID-19 pandemic. The objective is to compare IUFD rates before and during COVID-19 stratified by race. Retrospective cohort study, comparing the pandemic period (Mar-July 2020) and pre-pandemic period (Mar-July 2014-2019) in single hospital system in the American South. The primary outcome was IUFD rate per 1000 live births. Secondary outcomes include: IUFD rate by race and delivery location (tertiary care center vs. community hospital). Descriptive statistics and chi square testing was used to compare rates pre-pandemic to during the pandemic. Of 18624 included deliveries, 2678 were in the pandemic period, and 15,946 were prepandemic. The IUFD rate was not statistically different during the pandemic versus prepandemic period (8.7 vs 11.1, p=0.3). The rate of IUFD was lower in the community hospital versus tertiary care hospital in both the pre-pandemic (4.8 vs 15.32, p<0.001), and pandemic period (2.7 vs 12.91, p=0.005). Black women experienced higher rates of IUFD versus white women (17.0 vs 7.1 p=0.01) and Asian women (7.1, p=0.02). However, no statistically significant change in IUFD rate was noted in any subgroup analysis during the pandemic. In contrast to other reports, within our healthcare system, there was no increase in overall IUFD rates during the pandemic. Although not statistically significant, there is a concerning subjective trend in the tertiary care center: during the pandemic period, white women experienced a lower mean IUFD rate while Black women experienced a higher rate of IUFD. No similar subjective divergence was noted at the community hospital. This work emphasizes the need for culturally sensitive interventions to reduce IUFD rates, particularly for women with medically complex pregnancies who deliver at our tertiary care center.View Large Image Figure ViewerDownload Hi-res image Download (PPT)