Hussaini Khaleel S, Li Rui, Miles Jennifer, Dizon Maridelle, Hoffman Mathew K
US Department of Health and Human Services, Centers for Disease Control and Prevention, Division of Reproductive Health, Field Support Branch, Atlanta, GA; Delaware Department of Health and Social Services, Division of Public Health.
U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, Office of Epidemiology and Research, Division of Research.
Dela J Public Health. 2022 Aug 31;8(3):108-112. doi: 10.32481/djph.2022.08.018. eCollection 2022 Aug.
We examined statewide perinatal quality indicators: nulliparous singleton term vertex cesarean births (NTSV) or low risk cesarean births, and non-medically indicated early term delivery (NMETD) rates during COVID-19 pandemic pre-lockdown (1/1/2019 to 3/23/2020) and post-lockdown (after 3/23/2020). Interrupted time-series analyses were used to examine the effects of the COVID-19 pandemic on these indicators. We observed a statistically significant increase in NTSV cesarean rates, 4.4% (95%CI: 1.3,7.4) immediately after lockdown, and a decrease in NMETD rate, 1.6% (95%CI: -2.5,-0.7). We observed an increase (0.3%; 95%CI: 0.0,0.6) in the slope (i.e., trend change) of NTSV rates post-lockdown and a decrease (-0.2%; 95%CI: -0.3,-0.1) in the slope of NMETD rates. Results suggest that the COVID-19 pandemic had an immediate effect on perinatal quality indicators in Delaware, with gradual return to pre-pandemic rates as the pandemic continued. In addition to emergency preparedness planning, hospital monitoring of perinatal quality indicators might improve obstetrical care during public health emergencies.
初产妇单胎足月头位剖宫产（NTSV）或低风险剖宫产，以及新冠疫情封锁前（2019年1月1日至2020年3月23日）和封锁后（2020年3月23日之后）的非医学指征早产（NMETD）率。采用中断时间序列分析来研究新冠疫情对这些指标的影响。我们观察到，封锁后立即出现NTSV剖宫产率有统计学意义的上升，为4.4%（95%可信区间：1.3,7.4），而NMETD率下降，为1.6%（95%可信区间：-2.5,-0.7）。我们观察到封锁后NTSV率的斜率（即趋势变化）上升（0.3%；95%可信区间：0.0,0.6），而NMETD率的斜率下降（-0.2%；95%可信区间：-0.3,-0.1）。结果表明，新冠疫情对特拉华州的围产期质量指标有即时影响，随着疫情持续，逐渐恢复到疫情前的水平。除了应急准备规划外，医院对围产期质量指标的监测可能会改善公共卫生紧急情况期间的产科护理。
