Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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.

PubMed Disclaimer

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

References

    1. Arora KS, Mauch JT, Gibson KS. Labor and delivery visitor policies during the COVID-19 pandemic: balancing risks and benefits. JAMA. (2020) 323:2468–9. 10.1001/jama.2020.7563 - DOI - PMC - PubMed
    1. Aziz A, Fuchs K, Nhan-Chang CL, Zork N, Friedman AM, Simpson LL. Adaptation of prenatal care and ultrasound. Semin Perinatol. (2020) 44(7):151278. 10.1016/J.SEMPERI.2020.151278 - DOI - PMC - PubMed
    1. Peahl AF, Smith RD, Moniz MH. Prenatal care redesign: creating flexible maternity care models through virtual care. Am J Obstet Gynecol. (2020) 223:389.e1–e10. 10.1016/j.ajog.2020.05.029 - DOI - PMC - PubMed
    1. Peahl AF, Powell A, Berlin H, Smith RD, Krans E, Waljee J, et al. Patient and provider perspectives of a new prenatal care model introduced in response to the coronavirus disease 2019 pandemic. Am J Obstet Gynecol. (2021) 224:384.e1–e11. 10.1016/j.ajog.2020.10.008 - DOI - PMC - PubMed
    1. Reddy UM, Abuhamad AZ, Levine D, Saade GR. Fetal imaging: executive summary of a joint Eunice Kennedy Shriver national institute of child health and human development, society for maternal-fetal medicine, American institute of ultrasound in medicine, American college of obstetricians and gynecologists, American college of radiology, society for pediatric radiology, and society of radiologists in ultrasound fetal imaging workshop. Obstet Gynecol. (2014) 123:1070–82. 10.1097/AOG.0000000000000245 - DOI - PubMed

LinkOut - more resources