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哥伦比亚西南部 COVID-19 大流行期间实施远程医疗的混合产前保健模式的母婴围产期结局。

Maternal and perinatal outcomes in mixed antenatal care modality implementing telemedicine in the southwestern region of Colombia during the COVID-19 pandemic.

机构信息

High Complexity Obstetric Unit, Department of Obstetrics and Gynecology, Fundación Valle del Lili, Cra 98 Nro.18-49, 7600.2, Cali, Colombia.

Department of Obstetrics and Gynecology, School of Medicine, Universidad Icesi, Cali, Colombia.

出版信息

BMC Health Serv Res. 2023 Mar 16;23(1):259. doi: 10.1186/s12913-023-09255-4.

Abstract

INTRODUCTION

Contingency measures due to the COVID-19 pandemic limited access to routine prenatal care for pregnant women, increasing the risk of pregnancy complications due to poor prenatal follow-up, especially in those patients at high obstetric risk. This prompted the implementation and adaptation of telemedicine.

OBJECTIVE

We aim to evaluate the maternal and perinatal outcomes of patients who received prenatal care in-person and by telemedicine.

METHODS

We conducted a retrospective observational cohort study of pregnant women who received exclusive in-person and alternate (telemedicine and in-person) care from March to December 20,202, determining each group's maternal and neonatal outcomes.

RESULTS

A total of 1078 patients were included, 156 in the mixed group and 922 in the in-person group. The patients in the mixed group had a higher number of prenatal controls (8 (6-9) vs 6 (4-8) p < 0.001), with an earlier gestational age at onset (7.1 (6-8.5) vs 9.3 (6.6-20.3), p < 0.001), however, they required a longer hospital stay (26 (16,67%) vs 86 (9,33%), p = 0.002) compared to those attended in-person; there were no significant differences in the development of obstetric emergencies, maternal death or neonatal complications.

DISCUSSION

Incorporating telemedicine mixed with in-person care could be considered as an alternative for antenatal follow-up of pregnant women in low- and middle-income countries with barriers to timely and quality health care access.

摘要

简介

由于 COVID-19 大流行,常规产前保健的可及性受到限制,这增加了因产前随访不佳而导致妊娠并发症的风险,尤其是在那些高产科风险的患者中。这促使了远程医疗的实施和适应。

目的

我们旨在评估接受面对面和远程医疗产前护理的患者的母婴围产期结局。

方法

我们对 2020 年 3 月至 12 月期间仅接受面对面和交替(远程医疗和面对面)护理的孕妇进行了回顾性观察队列研究,确定了每个组的母婴结局。

结果

共纳入 1078 名患者,混合组 156 名,面对面组 922 名。混合组的产前检查次数更多(8(6-9)次 vs 6(4-8)次,p<0.001),起始孕周更早(7.1(6-8.5)周 vs 9.3(6.6-20.3)周,p<0.001),但住院时间更长(26(16-67%)天 vs 86(9-93%)天,p=0.002);在产科急症、孕产妇死亡或新生儿并发症的发生方面无显著差异。

讨论

在中低收入国家,远程医疗与面对面医疗相结合,可以作为及时获得高质量医疗保健存在障碍的孕妇进行产前随访的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c366/10018960/1bc82f13adec/12913_2023_9255_Fig1_HTML.jpg

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