Effect of Policies Aiming to Restrict Ultrasound Use [ID: 1375832]

Abstract

INTRODUCTION: During the early months of the COVID-19 pandemic, policies were implemented that sought to reduce in-person prenatal visits and ultrasounds. We sought to evaluate the effect of those policies on the rate of diagnosed fetal growth restriction and infant low birth weight. METHODS: We performed a cohort study of patients delivered at an academic center. Participants who received prenatal care during the time period of restricted visits were matched in a 1:1 ratio to patients receiving care during an equivalent time period when there were no such restrictions (group I: July 1, 2019, to December 31, 2019; and group II: March 23, 2020, to September 23, 2020). Medical records were reviewed for clinical and demographic characteristics. Neonatal morbidity was defined as any of the following: stillbirth, neonatal death, preterm birth, neonatal intensive care unit admission, low birth weight. Data were analyzed using chi-square and Mann-Whitney U test where appropriate. P<.05 was significant. RESULTS: Our cohort included 580 patients. Overall, the group had a 13% preterm birth rate, 8.2% were diagnosed with fetal growth restriction, and 26% had the composite neonatal morbidity. All patients in the cohort had at least one ultrasound. Compared to group I, group II had more individuals who had only one ultrasound during the pregnancy (3.1 versus 0%, P=.004), but overall the group had more total ultrasounds performed (1.5 [1–3] versus 1 [1–2], P=.02) and had more patients who required fetal surveillance for maternal and fetal conditions (56 versus 44, P=.014). Group II was more likely to have a neonatal demise (1.4 versus 0.3%, P<.01), but there was no difference in the rate of prenatal diagnosis of fetal growth restriction or low birth weight. CONCLUSION: Policies to reduce prenatal ultrasounds were not effective in reducing ultrasounds performed, and there was no difference in the diagnosis of fetal growth restriction despite an increase in comorbidity.