(826) Telehealth since the COVID-19 Pandemic: Can it Improve Prenatal Care and Birth Outcomes?

Many clinics modified prenatal care to include telehealth visits in response to the COVID-19 pandemic, enabling the opportunity to investigate its impact on patient outcomes. We hypothesized that use of prenatal telehealth visits would increase the number of prenatal visits, decrease the frequency of urgent triage/emergency department (ED) visits, and improve birth outcomes. 

Study Design:

Retrospective cohort study of patients from a federally qualified health center (FQHC) in central Texas. Patients with a singleton pregnancy who delivered after 32 weeks between May 2020-December 2020 were included. Patients who experienced the modified prenatal visit schedule (in-person and telehealth visits) were compared to those who received the traditional care model (in-person visits only). Multiple linear and logistic regression were used to estimate differences in the number of prenatal visits, urgent visits and birth outcomes between the two groups. Analyses were conducted using SAS 9.4.

Results:

723 patients who received modified prenatal care and 67 patients who received traditional care, during the pandemic, were compared. Women who received modified care (M=9.68, SD=2.79) had more prenatal visits (M=7.78, SD=4.92); (p=0.0001); were less likely to require an urgent visit; (aOR=0 0.449, 95% CI:0.223 - 0.904, p=0.0249) and were also more likely to have a term delivery (aOR=2.87, 95% CI:1.34 – 6.13, p=0.0065). No differences were seen regarding birth weight (p=0.1657) or preeclampsia diagnosis (p=0.8464).

Conclusion:

Individuals who received telehealth prenatal care had, on average, two more prenatal visits than those who received traditional care. Those who received telehealth also required less urgent visits and were more likely to give birth at term. Additionally, these differences did not seem to result in under diagnosis of preeclampsia, but larger samples will be needed to confirm our findings. These data emphasizes the importance of continuing to explore telemedicine as part of prenatal care and the potentials to improve patient outcomes.