Cargando…

Impact of the COVID-19 Pandemic on Obstetric Interventions at a Public Hospital

INTRODUCTION: In response to the COVID-19 pandemic, health systems quickly implemented changes in care delivery with a goal of balancing patient-focused obstetric care with the need to protect pregnant persons and health care providers from infection. Yet, there is no consensus within the scientific...

Descripción completa

Detalles Bibliográficos
Autores principales: Johnson, Tatyana A., Jamieson, Denise J., Geary, Franklyn H., Stanhope, Kaitlyn K., Boulet, Sheree L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jacobs Institute of Women's Health, George Washington University. Published by Elsevier Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381428/
https://www.ncbi.nlm.nih.gov/pubmed/36117075
http://dx.doi.org/10.1016/j.whi.2022.08.003
_version_ 1784769076737867776
author Johnson, Tatyana A.
Jamieson, Denise J.
Geary, Franklyn H.
Stanhope, Kaitlyn K.
Boulet, Sheree L.
author_facet Johnson, Tatyana A.
Jamieson, Denise J.
Geary, Franklyn H.
Stanhope, Kaitlyn K.
Boulet, Sheree L.
author_sort Johnson, Tatyana A.
collection PubMed
description INTRODUCTION: In response to the COVID-19 pandemic, health systems quickly implemented changes in care delivery with a goal of balancing patient-focused obstetric care with the need to protect pregnant persons and health care providers from infection. Yet, there is no consensus within the scientific community on the impact these measures have on obstetric outcomes in vulnerable populations. We aimed to assess the impact of the COVID-19 pandemic on rates of obstetric procedures and severe maternal morbidity (SMM) among births at an urban safety net institution. METHODS: We used an interrupted time series design to calculate risk ratios (RRs) and 95% confidence intervals (CIs) comparing monthly rates of labor induction, cesarean births (overall and among nulliparous, term, singleton, vertex births), operative vaginal births, and SMM among births occurring at a public hospital before (March 1, 2016, to February 29, 2020) and during (March 1, 2020, to May 31, 2021) the COVID-19 pandemic. RESULTS: There were 10,714 and 2,736 births in the prepandemic and postpandemic periods, respectively. Overall, the rates of obstetric interventions and SMM were constant over the two time periods. There were no significant differences in rates of labor induction (42% during prepandemic period vs. 45% during pandemic period; RR, 1.12; 95% CI, 0.93–1.34), operative vaginal births (5% vs. 6%; RR, 1.24; 95% CI, 0.88–1.76), cesarean births (28% vs. 33%; RR, 1.10; 95% CI, 0.94–1.28), or nulliparous, term, singleton, vertex cesarean births (24% vs. 31%; RR, 1.27; 95% CI, 0.92–1.74). Rates of SMM (7% vs. 8%; RR, 1.19; 95% CI, 0.86–1.65) were also unchanged. CONCLUSIONS: Our findings indicate that the rapid implementation of measures to reduce viral transmission in the labor and delivery setting did not materially affect routine clinical management or rates of serious maternal complications.
format Online
Article
Text
id pubmed-9381428
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Jacobs Institute of Women's Health, George Washington University. Published by Elsevier Inc.
record_format MEDLINE/PubMed
spelling pubmed-93814282022-08-17 Impact of the COVID-19 Pandemic on Obstetric Interventions at a Public Hospital Johnson, Tatyana A. Jamieson, Denise J. Geary, Franklyn H. Stanhope, Kaitlyn K. Boulet, Sheree L. Womens Health Issues Covid-19 INTRODUCTION: In response to the COVID-19 pandemic, health systems quickly implemented changes in care delivery with a goal of balancing patient-focused obstetric care with the need to protect pregnant persons and health care providers from infection. Yet, there is no consensus within the scientific community on the impact these measures have on obstetric outcomes in vulnerable populations. We aimed to assess the impact of the COVID-19 pandemic on rates of obstetric procedures and severe maternal morbidity (SMM) among births at an urban safety net institution. METHODS: We used an interrupted time series design to calculate risk ratios (RRs) and 95% confidence intervals (CIs) comparing monthly rates of labor induction, cesarean births (overall and among nulliparous, term, singleton, vertex births), operative vaginal births, and SMM among births occurring at a public hospital before (March 1, 2016, to February 29, 2020) and during (March 1, 2020, to May 31, 2021) the COVID-19 pandemic. RESULTS: There were 10,714 and 2,736 births in the prepandemic and postpandemic periods, respectively. Overall, the rates of obstetric interventions and SMM were constant over the two time periods. There were no significant differences in rates of labor induction (42% during prepandemic period vs. 45% during pandemic period; RR, 1.12; 95% CI, 0.93–1.34), operative vaginal births (5% vs. 6%; RR, 1.24; 95% CI, 0.88–1.76), cesarean births (28% vs. 33%; RR, 1.10; 95% CI, 0.94–1.28), or nulliparous, term, singleton, vertex cesarean births (24% vs. 31%; RR, 1.27; 95% CI, 0.92–1.74). Rates of SMM (7% vs. 8%; RR, 1.19; 95% CI, 0.86–1.65) were also unchanged. CONCLUSIONS: Our findings indicate that the rapid implementation of measures to reduce viral transmission in the labor and delivery setting did not materially affect routine clinical management or rates of serious maternal complications. Jacobs Institute of Women's Health, George Washington University. Published by Elsevier Inc. 2023 2022-08-17 /pmc/articles/PMC9381428/ /pubmed/36117075 http://dx.doi.org/10.1016/j.whi.2022.08.003 Text en © 2022 Jacobs Institute of Women's Health, George Washington University. Published by Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Covid-19
Johnson, Tatyana A.
Jamieson, Denise J.
Geary, Franklyn H.
Stanhope, Kaitlyn K.
Boulet, Sheree L.
Impact of the COVID-19 Pandemic on Obstetric Interventions at a Public Hospital
title Impact of the COVID-19 Pandemic on Obstetric Interventions at a Public Hospital
title_full Impact of the COVID-19 Pandemic on Obstetric Interventions at a Public Hospital
title_fullStr Impact of the COVID-19 Pandemic on Obstetric Interventions at a Public Hospital
title_full_unstemmed Impact of the COVID-19 Pandemic on Obstetric Interventions at a Public Hospital
title_short Impact of the COVID-19 Pandemic on Obstetric Interventions at a Public Hospital
title_sort impact of the covid-19 pandemic on obstetric interventions at a public hospital
topic Covid-19
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381428/
https://www.ncbi.nlm.nih.gov/pubmed/36117075
http://dx.doi.org/10.1016/j.whi.2022.08.003
work_keys_str_mv AT johnsontatyanaa impactofthecovid19pandemiconobstetricinterventionsatapublichospital
AT jamiesondenisej impactofthecovid19pandemiconobstetricinterventionsatapublichospital
AT gearyfranklynh impactofthecovid19pandemiconobstetricinterventionsatapublichospital
AT stanhopekaitlynk impactofthecovid19pandemiconobstetricinterventionsatapublichospital
AT bouletshereel impactofthecovid19pandemiconobstetricinterventionsatapublichospital