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. 2025 Jun 18:12:1546013.
doi: 10.3389/fmed.2025.1546013. eCollection 2025.

Three-year impact of COVID-19 pandemic on hospitalized twin pregnancies: evaluation of characteristics and changes in antibiotic prescribing

Qin-Yu Cai #  1   2 , Shang Jing Liu #  1   3 , Xing-Qi Zhi  4 , Wei-Zhen Tang  1   3 , Ying-Xiong Wang  1   3 , Xia Lan  2 , Li Wen  2 , Shu-Juan Luo  2 , Lan Wang  2 , Jie Sheng  1   3 , Tai-Hang Liu  1   3
Affiliations

Three-year impact of COVID-19 pandemic on hospitalized twin pregnancies: evaluation of characteristics and changes in antibiotic prescribing

Qin-Yu Cai et al. Front Med (Lausanne). .

Abstract

Background: The COVID-19 pandemic has significantly impacted healthcare systems worldwide, including obstetric care. However, the long-term effects on twin pregnancies remain unclear. This study investigates the impact of COVID-19 on the clinical characteristics and antibiotic prescribing patterns in hospitalized twin pregnancies.

Methods: A retrospective cohort study was conducted at Women and Children's Hospital of Chongqing Medical University, Chongqing, China, involving 3,827 twin pregnancies with live deliveries between 1 January 2017 and 31 December 2022. The pre-pandemic group included 1,707 patients, and the pandemic group included 2,120. Sociodemographic and clinical data were analyzed using general linear models with SPSS and R software.

Results: During the pandemic, twin pregnancy admissions increased by 24.19%. Patients in the pandemic group have less gestational weight gain (17.00 vs. 16.08 kg, P < 0.001), had higher rates of assisted reproductive technology use (73.2% vs. 68.7%, P = 0.002), and experienced more complications. Neonates showed higher rates of pneumonia (5.7% vs. 3.8%, P < 0.001) and NICU admissions (43.7% vs. 13.9%, P < 0.001). Longer hospital stays were observed in the pandemic group (P = 0.004). Antibiotic prescriptions, especially non-repeat prescriptions, increased for older patients, those with higher BMI, and premature deliveries. The rate of repeated antibiotic prescriptions for bacterial vaginosis increased 1.68 times.

Conclusion: COVID-19 influenced twin pregnancy admissions, clinical characteristics, and antibiotic use. The study highlights the need for rational antibiotic use and improved healthcare resource management in future crises.

Keywords: COVID-19 pandemic; antibiotic prescribing; clinical characteristics; retrospective cohort study; twin pregnancies.

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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
Overview of the study.
FIGURE 2
FIGURE 2
Number of monthly hospitalizations for twin pregnancies from 1 January 2017 to 31 December 2022.
FIGURE 3
FIGURE 3
Comparison of monthly antibiotic prescribing patterns (repeat and non-repeat) for twin pregnancy inpatients in pre-pandemic and pandemic cohorts. (A) Percentage of monthly twin pregnancy inpatients prescribed antibiotics before the COVID-19 pandemic. (B) Percentage of monthly twin pregnancy inpatients prescribed antibiotics during the COVID-19 pandemic. (C) Change in the antibiotic prescribing rate of monthly twin pregnancy inpatients in pre-pandemic and pandemic cohorts.
FIGURE 4
FIGURE 4
Changes in the rate of antibiotic prescribing (repeat and non-repeat) among patients in the pandemic versus pre-pandemic cohorts, categorized by the following demographic characteristics: age, BMI before pregnancy and gestational age.
FIGURE 5
FIGURE 5
Comparison of antibiotic prescribing patterns (repeat and non-repeat) for the most common infections in twin pregnancy inpatients in pre-pandemic and pandemic cohorts. (A) Relative frequency of repeat and non-repeat antibiotic use in pre-pandemic and pandemic cohorts. (B) Fold change in the rate of repeat and non-repeat antibiotic use in pre-pandemic and pandemic cohorts.
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References

    1. Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed. (2020) 91:157–60. 10.23750/abm.v91i1.9397 - DOI - PMC - PubMed
    1. Buch-Vicente B, Acosta-Rodriguez JM, Sanchez-Sanchez ME, González-García N, Garcia-Ullan L, de la Iglesia-Larrad JI, et al. Coping strategies used by health-care workers during the SARS-COV2 crisis. A real-world analysis. Psychiatry Res. (2022) 317:114915. 10.1016/j.psychres.2022.114915 - DOI - PMC - PubMed
    1. Misra-Hebert A, Jehi L, Ji X, Nowacki A, Gordon S, Terpeluk P, et al. Impact of the COVID-19 pandemic on healthcare workers’ risk of infection and outcomes in a large, integrated health system. J Gen Intern Med. (2020) 35:3293–301. 10.1007/s11606-020-06171-9 - DOI - PMC - PubMed
    1. Chmielewska B, Barratt I, Townsend R, Kalafat E, van der Meulen J, Gurol-Urganci I, et al. Effects of the COVID-19 pandemic on maternal and perinatal outcomes: A systematic review and meta-analysis. Lancet Glob Health. (2021) 9:e759–72. 10.1016/S2214-109X(21)00079-6 - DOI - PMC - PubMed
    1. Spiegelman J, Bertozzi-Villa C, D’Alton M, Aubey J, Fuchs K, Goffman D, et al. Obstetric inpatient and ultrasound clinical personnel absences during the COVID-19 pandemic in New York City. Am J Perinatol. (2022) 39:714–6. 10.1055/s-0041-1740008 - DOI - PubMed

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