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

Abstract

Nationwide, obstetric clinics modified prenatal care to include telehealth visits in response to the 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. To determine the impact of telehealth on number of obstetric prenatal visits and urgent triage/ED visits amidst the COVID-19 pandemic. This is a retrospective cohort of patients from a federally qualified health center (FQHC) 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 to December 2020 (presumed modified prenatal visit schedule with in-person and telehealth) and those patients delivering between June 2019 to 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. A total of 1654 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). When compared to a traditional prenatal visitation cohort pre-pandemic, 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.