Accepted for/Published in: JMIR Pediatrics and Parenting
Date Submitted: Feb 5, 2021
Date Accepted: Aug 24, 2021
Date Submitted to PubMed: Sep 12, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Delivery Outcomes During the COVID-19 Pandemic as Reported in a Pregnancy Mobile Application: A Retrospective Cohort Study
ABSTRACT
Background:
The COVID-19 pandemic has presented obstacles for providers and patients in the maternal healthcare setting, causing changes to many pregnant women’s birth plans, as well as abrupt changes in hospital labor and delivery policies and procedures. Few data exist on the effects of the COVID-19 pandemic on the maternal healthcare landscape.
Objective:
To assess the incidence of key obstetrics outcomes (preterm delivery, Cesarean sections, home births, and length of hospital stay) during the COVID-19 pandemic.
Methods:
We conducted a retrospective cohort study of women in the US who delivered between October 1, 2019 and September 30, 2020, had singleton deliveries, and completed a birth report in the Ovia Health pregnancy mobile application. Women were assigned to the before-pandemic cohort if they delivered between October and March, and the during-pandemic cohort if they delivered between April and September. Gestational age at delivery, delivery method, delivery facility type, and length of hospital stay were compared.
Results:
A total of 415,125 birth reports were collected with 213,541 (51%) in the before-pandemic cohort and 201,584 (49%) in the during-pandemic cohort. Compared to the before-pandemic cohort, principal findings indicate a 5% decrease in preterm deliveries in the during-pandemic cohort (P<.001; OR = 0.95, 95% CI 0.93-0.97), a 28% increase in home birth rates (P<.001; OR = 1.29, 95% CI 1.22-1.35), and a 7.6% decrease in the average hospital length of stay post-delivery (mean 2.53 (SD 1.4)).
Conclusions:
Results suggest a need for continuous monitoring of maternal health trends as the COVID-19 pandemic progresses, and the important role of digital data collection, particularly during the pandemic.
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