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使用OB Teleflex(一种混合式产前远程医疗项目)的患者的围产期结局

Perinatal Outcomes Among Patients Using OB Teleflex, A Hybrid Prenatal Telemedicine Program.

作者信息

Lekshmi Devika, Nader Sophie, Roberts-Barry Jennifer, Baecher Lind Laura E, Charles Alysa St, Werner Erika F, Ramos Sebastian Z

机构信息

Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, MA.

Tufts University, Doctor of Medicine (MD), Boston, MA.

出版信息

J Obstet Gynaecol Can. 2025 Jun;47(6):102911. doi: 10.1016/j.jogc.2025.102911. Epub 2025 Apr 18.

Abstract

OBJECTIVES

To assess obstetric outcomes among participants of the OB Teleflex program, in which roughly half of prenatal care was virtual, compared to those who were eligible, but elected traditional prenatal care.

METHODS

This retrospective cohort study of patients who delivered between October 1, 2021, and September 30, 2022, compared OB Teleflex participation to routine prenatal care. Low-risk patients with a singleton, viable, non-anomalous fetus, and without hypertension requiring medication, were eligible for OB Teleflex and included in the study. Inverse-probability weighting was used to obtain unbiased estimates of the program effect on a composite of adverse outcomes that included primary cesarean delivery, neonatal intensive care unit admission, preterm birth, insufficient gestational weight gain, and hypertensive disorders of pregnancy.

RESULTS

Out of 674 patients who delivered at our centre during the study period, 347 were eligible for OB Teleflex and met the study criteria. Of the 347 patients eligible for OB Teleflex, 63 (18%) chose to participate in the program. Those who elected OB Teleflex compared to those who did not, differed by race, parity, and history of cesarean deliveries. In both adjusted and unadjusted analyses of the composite of adverse outcomes, there was no difference between OB Teleflex participants and those receiving standard care.

CONCLUSIONS

Hybrid prenatal telemedicine did not differ from standard prenatal care in the rate of adverse maternal and perinatal outcomes. Programs like OB Teleflex may help to remove barriers from care without worsening birth outcomes. Larger studies are needed to investigate whether hybrid prenatal care can improve outcomes.

摘要

目的

评估OB Teleflex项目参与者的产科结局,该项目约一半的产前护理为虚拟护理,将其与符合条件但选择传统产前护理的人群进行比较。

方法

这项对2021年10月1日至2022年9月30日期间分娩患者的回顾性队列研究,将参与OB Teleflex项目与常规产前护理进行比较。单胎、存活、无异常胎儿且无需要药物治疗的高血压的低风险患者有资格参与OB Teleflex项目并纳入研究。采用逆概率加权法,以获得该项目对包括初次剖宫产、新生儿重症监护病房入院、早产、孕期体重增加不足和妊娠高血压疾病在内的不良结局综合指标影响的无偏估计。

结果

在研究期间于我们中心分娩的674例患者中,347例有资格参与OB Teleflex项目并符合研究标准。在347例有资格参与OB Teleflex项目的患者中,63例(18%)选择参与该项目。选择OB Teleflex项目的患者与未选择的患者在种族、产次和剖宫产史方面存在差异。在对不良结局综合指标的调整分析和未调整分析中,OB Teleflex项目参与者与接受标准护理的患者之间均无差异。

结论

混合式产前远程医疗在孕产妇和围产期不良结局发生率方面与标准产前护理并无差异。像OB Teleflex这样的项目可能有助于消除护理障碍,而不会使分娩结局恶化。需要开展更大规模的研究来调查混合式产前护理是否能改善结局。

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