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. 2022 Nov 9:10:1064039.
doi: 10.3389/fped.2022.1064039. eCollection 2022.

Changes in prenatal testing during the COVID-19 pandemic

Sara C Handley  1   2   3 , Rachel Ledyard  1 , Lisbet S Lundsberg  4 , Molly Passarella  1 , Nancy Yang  1 , Moeun Son  4 , Kathryn McKenney  5 , Jay Greenspan  6   7 , Kevin Dysart  6   7 , Jennifer F Culhane  5 , Heather H Burris  1   2   3
Affiliations

Changes in prenatal testing during the COVID-19 pandemic

Sara C Handley et al. Front Pediatr. .

Abstract

Objective: The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare delivery, including prenatal care. The study objective was to assess if timing of routine prenatal testing changed during the COVID-19 pandemic.

Methods: Retrospective observational cohort study using claims data from a regional insurer (Highmark) and electronic health record data from two academic health systems (Penn Medicine and Yale New Haven) to compare prenatal testing timing in the pre-pandemic (03/10/2018-12/31/2018 and 03/10/2019-12/31/2019) and early COVID-19 pandemic (03/10/2020-12/31/2020) periods. Primary outcomes were second trimester fetal anatomy ultrasounds and gestational diabetes (GDM) testing. A secondary analysis examined first trimester ultrasounds.

Results: The three datasets included 31,474 pregnant patients. Mean gestational age for second trimester anatomy ultrasounds increased from the pre-pandemic to COVID-19 period (Highmark 19.4 vs. 19.6 weeks; Penn: 20.1 vs. 20.4 weeks; Yale: 18.8 vs. 19.2 weeks, all p < 0.001). There was a detectable decrease in the proportion of patients who completed the anatomy survey <20 weeks' gestation across datasets, which did not persist at <23 weeks' gestation. There were no consistent changes in timing of GDM screening. There were significant reductions in the proportion of patients with first trimester ultrasounds in the academic institutions (Penn: 57.7% vs. 40.6% and Yale: 78.7% vs. 65.5%, both p < 0.001) but not Highmark. Findings were similar with multivariable adjustment.

Conclusion: While some prenatal testing happened later in pregnancy during the pandemic, pregnant patients continued to receive appropriately timed testing. Despite disruptions in care delivery, prenatal screening remained a priority for patients and providers during the COVID-19 pandemic.

Keywords: COVID-19; access to care; gestational diabetes; glucose tolerance test; pregnancy; prenatal care; ultrasound.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Distribution of completion of second trimester testing with an ultrasound to assess fetal anatomy (panel A) and gestational diabetes (panel B) across the three data sources.
Figure 2
Figure 2
Distribution of completion of first trimester ultrasound across the three data sources.
See this image and copyright information in PMC

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