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BOSTON — The COVID-19 pandemic has caused unprecedented stressors in the U. S. physical health care formula. This resulted in decreased access to in-person prenatal care regimen and reproductive health services, less follow-up of pregnancy-related headaches, and avoidance of care through patients and physicians seeking to restrict exposure to COVID-19. It is unknown how the pandemic has affected pregnancy outcomes, especially among other low-income people and other people from racial and ethnic minority groups, and few empirical studies read about the impact of the pregnancy pandemic. COVID-19 on obstetric outcomes nationwide.
In an article published in JAMA Network Open, medical researchers from Beth Israel Deaconess Medical Center (BIDMC) and the T. H. School of Public HealthHarvard’s Chan assessed how pregnancy-related headaches and obstetric outcomes have replaced the COVID-19 pandemic compared to the pre-pandemic period. By examining relative adjustments in mode of delivery, preterm birth rates, and mortality outcomes before the pandemic, the team found an increased threat of hospitalization for maternal death during childbirth, cardiovascular disorders, and obstetric bleeding during the pandemic.
“We found a small but statistically significant increase in maternal mortality, hospitalization for childbirth, and pregnancy-related headaches during the pandemic, which is alarming,” said first writer Rose L. Molina, MD, MPH, obstetrician-gynecologist and director of OBGYN Diversity. , Committee on Inclusion and Advocacy at BIDMC. ” Our paintings show how the global disruptions of the COVID-19 pandemic are affecting the fitness of pregnant women. “
Molina and his colleagues analyzed the knowledge of more than 1. 6 million pregnant patients who gave birth at 463 U. S. hospitals. In the 14 months prior to the advent of COVID-19 and in the first 14 months of the pandemic. There were no statistically significant differences in the demographics characteristic of the two groups, adding age, race and ethnicity, for sure, and comorbidities.
According to reports from the U. S. Census Bureau. In the U. S. , the team found 5. 2% relief in the total number of live births during the pandemic during the pandemic. Pandemic to 8. 69 deaths according to 100,000 pregnant patients from the pandemic, a small but statistically significant accumulation. that the COVID-19 pandemic has had a negative effect on obstetric care and pregnancy-related outcomes.
“While inpatient obstetric care has remained an indispensable service during the COVID-19 pandemic, prenatal care for outpatients has experienced significant disruptions and much of the regimen’s prenatal care has been provided virtually,” said Molina, who is also an assistant professor of obstetrics. gynecology and reproductive health biology at Harvard Medical School. “It is conceivable that these interruptions and limitations in follow-up through telehealth contributed to the slight worsening of pregnancy-related hypertension. In addition, the accumulation in rates of hypertensive disorders is possibly due to the increasing tension caused by the pandemic.
The study team also found shorter hospital stays, especially after cesarean deliveries during the pandemic, as obstetric groups and patients tried to minimize the spread of infection. and masking due to COVID-19. Molina and colleagues additionally observed that preterm (or preterm) birth rates and delivery patterns (vaginal, cesarean section, or forceps/vacuum) remained stable. Well-documented racial and ethnic disparities in obstetric outcomes persisted. it did not worsen the pandemic in this dataset.
“As obstetric operations mobilized to adapt to changing clinical orientations and offer essential services, the fun of care was radically different, especially when it came to restrictive visitation policies that limited social assistance during an anxiety-provoking hospitalization. “Molina said, “As the country continues to face ongoing outbreaks, it will be vital to mitigate additional pandemic-related disruptions in obstetric care and pregnancy outcomes. “
Co-authors Thomas C. Tsai, MD, MPH, E. John Orav, PhD and Jose F. Figueroa, MD, MPH, du Brigham and Women’s Hospital; Dannie Dai of T. H. Harvard School of Public Health; and Ning Rosenthal, MD, MPH, PhD pf PINC AI Applied Sciences, Premier Inc.
This study was funded through a scholarship from the Commonwealth Fund.
Molina reports any potential conflicts of interest. For a complete list of disclosures, see the publication.
Beth Israel Deaconess Medical Center is a patient care, teaching and arm of Harvard Medical School and consistently ranks among the national leaders among independent hospitals funded through the National Institutes of Health. BIDMC is the official hospital of the Boston Red Sox.
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