Perinatal Health and Healthcare Utilisation During the COVID-19 Pandemic: A Nationwide Interrupted Time Series Analysis.

IF 2.7 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Paediatric and perinatal epidemiology Pub Date : 2025-05-01 Epub Date: 2025-03-12 DOI:10.1111/ppe.70000

Deborah Karasek, Daniel F Collin, Rita Hamad, Kaitlyn Jackson, Alison Gemmill

{"title":"Perinatal Health and Healthcare Utilisation During the COVID-19 Pandemic: A Nationwide Interrupted Time Series Analysis.","authors":"Deborah Karasek, Daniel F Collin, Rita Hamad, Kaitlyn Jackson, Alison Gemmill","doi":"10.1111/ppe.70000","DOIUrl":null,"url":null,"abstract":"Background: Perinatal health was profoundly affected as a result of the socioeconomic hardships and public health measures during the COVID-19 pandemic. Few studies have evaluated changes and disparities in perinatal health using population-based data and rigorous methods.Objective: To examine changes related to the COVID-19 pandemic in perinatal health and healthcare utilisation.Methods: Using population-based data from the 2016-2021 Pregnancy Risk Assessment Monitoring System (N = 116,170), we employed a Bayesian structural time-series approach to examine deviations in perinatal health and healthcare utilisation outcomes from predicted trends following the onset of the COVID-19 pandemic in March 2020, adjusting for covariates.Results: The onset of the COVID-19 pandemic was associated with delayed prenatal care initiation (1.1%, 95% confidence interval [CI] 0.2, 2.0), reduced prenatal care (-2.8%, 95% CI -3.6, -1.7), reduced postpartum visits (-1.0%, 95% CI -1.5, -0.4), and increased gestational hypertension (11.1%, 95% CI 5.4, 16.7), gestational diabetes mellitus (GDM), (17.6%, 95% CI 10.1, 26.2), and prenatal depression (7.3%, 95% CI 1.9, 13.0). Stratified models showed that Black participants experienced earlier prenatal care initiation; Native American participants experienced lower prenatal care visits and greater increases in gestational hypertension and GDM; Asian/Pacific Islander participants experienced delayed prenatal care initiation and heightened prenatal depression and postnatal depressive symptoms; and Hispanic participants experienced higher GWG and reduced postpartum visits.Conclusions: As perinatal health imparts enduring impacts for pregnant people and infants, this study provides insight into the pandemic's potentially long-lasting population health effects. Future work should examine longer-term trends and how pandemic-related policies contributed to disparate impacts.","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"373-384"},"PeriodicalIF":2.7000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121338/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Paediatric and perinatal epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/ppe.70000","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/12 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Perinatal health was profoundly affected as a result of the socioeconomic hardships and public health measures during the COVID-19 pandemic. Few studies have evaluated changes and disparities in perinatal health using population-based data and rigorous methods.

Objective: To examine changes related to the COVID-19 pandemic in perinatal health and healthcare utilisation.

Methods: Using population-based data from the 2016-2021 Pregnancy Risk Assessment Monitoring System (N = 116,170), we employed a Bayesian structural time-series approach to examine deviations in perinatal health and healthcare utilisation outcomes from predicted trends following the onset of the COVID-19 pandemic in March 2020, adjusting for covariates.

Results: The onset of the COVID-19 pandemic was associated with delayed prenatal care initiation (1.1%, 95% confidence interval [CI] 0.2, 2.0), reduced prenatal care (-2.8%, 95% CI -3.6, -1.7), reduced postpartum visits (-1.0%, 95% CI -1.5, -0.4), and increased gestational hypertension (11.1%, 95% CI 5.4, 16.7), gestational diabetes mellitus (GDM), (17.6%, 95% CI 10.1, 26.2), and prenatal depression (7.3%, 95% CI 1.9, 13.0). Stratified models showed that Black participants experienced earlier prenatal care initiation; Native American participants experienced lower prenatal care visits and greater increases in gestational hypertension and GDM; Asian/Pacific Islander participants experienced delayed prenatal care initiation and heightened prenatal depression and postnatal depressive symptoms; and Hispanic participants experienced higher GWG and reduced postpartum visits.

Conclusions: As perinatal health imparts enduring impacts for pregnant people and infants, this study provides insight into the pandemic's potentially long-lasting population health effects. Future work should examine longer-term trends and how pandemic-related policies contributed to disparate impacts.

查看原文本刊更多论文

COVID-19大流行期间围产期健康和医疗保健利用：全国中断时间序列分析

背景：COVID-19大流行期间，社会经济困难和公共卫生措施对围产期健康产生了深刻影响。很少有研究使用基于人群的数据和严格的方法评估围产期健康的变化和差异。目的：探讨与新冠肺炎大流行相关的围产期健康和保健利用的变化。方法：使用来自2016-2021年妊娠风险评估监测系统（N = 116,170）的基于人群的数据，我们采用贝叶斯结构时间序列方法来检验2020年3月COVID-19大流行爆发后围产期健康和医疗保健利用结果与预测趋势的偏差，并对协变量进行调整。结果：COVID-19大流行的发生与产前护理开始延迟（1.1%，95%可信区间[CI] 0.2, 2.0）、产前护理减少（-2.8%,95% CI -3.6, -1.7）、产后就诊减少（-1.0%,95% CI -1.5, -0.4）、妊娠高血压（11.1%,95% CI 5.4, 16.7）、妊娠糖尿病（17.6%,95% CI 10.1, 26.2）和产前抑郁（7.3%,95% CI 1.9, 13.0）增加相关。分层模型显示黑人参与者经历了更早的产前护理开始；美洲原住民参与者的产前检查次数较少，妊娠期高血压和GDM增加较多；亚洲/太平洋岛民参与者的产前护理开始延迟，产前抑郁和产后抑郁症状加重；西班牙裔参与者的GWG更高，产后就诊次数减少。结论：由于围产期健康对孕妇和婴儿具有持久的影响，本研究提供了对大流行潜在的长期人口健康影响的见解。今后的工作应审查长期趋势以及与大流行有关的政策如何造成不同的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Paediatric and perinatal epidemiology 医学-妇产科学

CiteScore

5.40

自引率

7.10%

发文量

审稿时长

1 months

期刊介绍： Paediatric and Perinatal Epidemiology crosses the boundaries between the epidemiologist and the paediatrician, obstetrician or specialist in child health, ensuring that important paediatric and perinatal studies reach those clinicians for whom the results are especially relevant. In addition to original research articles, the Journal also includes commentaries, book reviews and annotations.