(534) COVID Pandemic Effect on Prenatal Care Utilization in Women with OUD

Objective: To compare prenatal care aspects of opioid exposed pregnancies before and during the COVID-19 pandemic.

Study Design: This retrospective, single center, cohort study identified patients with opioid use disorder (active or in remission on maintenance therapy) presenting for delivery from January 2017 through July 2022. The cohort was divided based on the start of SARS-Cov-2 pandemic in March 2020. Pregnancy information and newborn outcomes were obtained. Maternal prenatal care utilization included type of provider, start of prenatal care, MOUD on discharge, and pediatric consultation. Pediatric consultation involved the pediatric team counseling pregnant or postpartum patients about newborn care and NAS. Statistical analysis included Chi square and student t tests with significance levels of p < 0.05.

Results: There were 396 pregnant persons with 256 (65%) delivering before COVID and 140 (35%) delivering during the pandemic. Maternal age, insurance type, GA at delivery, PTD rate, mode of delivery, birth weight, and NICU admission were similar between the groups. Before the COVID pandemic, prenatal care was more often initiated in the second (27.8%) or third trimester (4.8%) and occur in private (27.6%) or resident clinics (13.8%). During the COVID pandemic, more patients started care in the first trimester (63.3%) and had care in a specialized MOMS clinic (72.4%). Pediatric consultations were more often obtained prenatally (16.7%) prior to the pandemic, whereas during the pandemic pediatric consult occurred after delivery (76.4%). (Table 1)

Conclusion: During COVID more patients had care in a specialized prenatal clinic and were more likely to be seen in the first trimester. Pediatric consultation was obtained more often but occurred after delivery.