COVID-19 and Recurrent Pregnancy Loss Management: Trends in Clinical Care From a Tertiary Centre

To investigate the impact of the COVID-19 pandemic on the care received by patients with recurrent pregnancy loss (RPL) in British Columbia, Canada. To explore the differential impact of socioeconomic status on health care utilization outcomes during the COVID-19 pandemic for patients with RPL.

This is a retrospective cohort study of patients from an RPL clinic located within a tertiary referral centre. Patients were divided into 2 groups based on the date of their initial visit to the clinic: (1) pre-pandemic group (March 1, 2018-February 28, 2020) and (2) pandemic group (March 1, 2020-February 28, 2022). Data were sourced from the RPL Clinic Database and Population Data BC. Outcomes assessed included visit trends, immediate pandemic impact, and socioeconomic effects.

Demographic and clinical characteristics were not significantly different between study groups, except for increased referral rates to fertility clinics by the RPL clinic during the COVID-19 pandemic (4.90% vs. 9.50%). The mean number of visits per patient was comparable between pre-pandemic (3.50 ± 2.00) and during the pandemic (3.40 ± 3.40). However, monthly initial visits were lower during the pandemic (12.50 ± 3.10) compared with pre-pandemic (14.40 ± 4.83). Telehealth was rare in the pre-pandemic period and increased dramatically during the pandemic, with virtual visits reaching up to 64% of total and 94% of initial visits. The pandemic's onset caused immediate drops in total (38.80%) and initial visits (51.70%). Health care utilization was higher among those with less material deprivation, whereas contrasting effects were observed in those with less social deprivation.

The COVID-19 pandemic impacted the care received by patients with RPL within a tertiary care centre. There was a shift in how services were provided to patients, uniquely impacting specific populations within the community.