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
. 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.

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
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.
See this image and copyright information in PMC

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

LinkOut - more resources