Department of Health Services, Policy & Practice, School of Public Health, Brown University, Providence, Rhode Island.
Population Studies and Training Center, Brown University, Providence, Rhode Island.
Am J Prev Med. 2023 Mar;64(3):433-437. doi: 10.1016/j.amepre.2022.09.027. Epub 2022 Nov 7.
The COVID-19 public health emergency created unprecedented disruptions in the use of healthcare services, which could have affected long-standing racial‒ethnic disparities in maternal care use and outcomes. This study evaluates population-level changes in perinatal health services associated with the COVID-19 pandemic overall and by maternal race‒ethnicity.
In this analysis of all U.S. live births from 2016 to 2020, interrupted time-series analysis was used to estimate the change in the mean number of prenatal care visits and rates of hospital birth, labor induction, and cesarean delivery associated with the start of the pandemic (March 2020) overall and by maternal race‒ethnicity. Analyses were conducted in 2022.
The start of the pandemic was associated with overall decreases in the mean number of prenatal care visits, decreases in hospital birth rates, and increases in labor induction rates. The mean number of prenatal care visits decreased similarly for all racial‒ethnic groups, whereas reductions in hospital births were largest for non-Hispanic White individuals, and increases in labor induction were largest for non-Hispanic White and non-Hispanic Asian or Pacific Islander individuals.
Among all U.S. live births, the COVID-19 pandemic was associated with modest overall changes in perinatal care, with differential changes by maternal race‒ethnicity. Differential changes in perinatal services may have implications for racial-ethnic maternal health disparities.
COVID-19 公共卫生紧急事件对医疗服务的使用造成了前所未有的中断，这可能影响到长期存在的母婴护理使用和结果方面的种族和民族差异。本研究评估了与 COVID-19 大流行相关的整体和按产妇种族和民族分类的围产期保健服务的人群水平变化。
在这项对 2016 年至 2020 年所有美国活产儿的分析中，使用中断时间序列分析来估计与大流行开始（2020 年 3 月）相关的产前护理就诊次数和医院分娩、引产和剖宫产率的平均值变化。分析于 2022 年进行。
大流行的开始与产前护理就诊次数平均值的总体减少、医院分娩率的下降以及引产率的上升有关。所有种族和民族群体的产前护理就诊次数平均值下降相似，而非西班牙裔白人的医院分娩减少幅度最大，非西班牙裔白人和非西班牙裔亚洲或太平洋岛民的引产增加幅度最大。
在所有美国活产儿中，COVID-19 大流行与围产期护理的适度整体变化相关，产妇种族和民族的变化存在差异。围产期服务的差异变化可能对种族和民族产妇健康差异产生影响。
