Telehealth Utilization in High-Risk Pregnancies During COVID-19

Area of Science:

• Obstetrics and Gynecology
• Digital Health
• Public Health

Background:

• The COVID-19 pandemic necessitated rapid adoption of telehealth in healthcare.
• High-risk obstetrics patients require continuous monitoring and specialized care.
• Understanding telehealth's impact on this population is crucial for evolving healthcare delivery models.

Purpose of the Study:

• To evaluate the influence of telehealth on pregnancy outcomes in high-risk obstetrics patients during the COVID-19 pandemic.
• To identify patient characteristics and conditions associated with telehealth utilization in maternal-fetal medicine.

Main Methods:

• Retrospective chart review of 419 high-risk obstetrics patients from March 2020 to October 2021.
• Analysis of telehealth vs. in-person visits, including patient demographics, insurance status, and medical conditions.
• Logistic regression models (univariate and multivariable) to assess associations with telehealth use and impact on pregnancy outcomes.

Main Results:

• Telehealth use was not associated with race, BMI, or maternal age.
• Patients with private insurance, anxiety, asthma, or depression were more likely to use telehealth.
• No statistically significant differences in delivery mode or key pregnancy outcomes (fetal demise, preterm delivery) were observed between telehealth and in-person groups.
• Multivariable analysis linked anxiety, maternal obesity, and twin pregnancy to higher telehealth utilization.

Conclusions:

• Certain pregnancy complications and patient demographics (e.g., private insurance) correlate with increased telehealth adoption.
• Telehealth appears to be a safe and viable option for managing high-risk obstetrics patients, showing no adverse effects on pregnancy outcomes.
• Integrating telehealth into routine care may offer benefits for specific patient groups, even post-pandemic, warranting further investigation.