Telehealth for Prenatal Care Peaked Early in COVID-19 Pandemic

April 13, 2023 - Published in JAMA Network Open, new research indicates that the COVID-19 pandemic led to increases in telehealth use for prenatal care, with April 2020 having the highest share of pregnancies observed virtually and deliveries in November 2020 having the highest telehealth visits rates throughout pregnancy.

Following the implementation of in-person care restrictions due to the COVID-19 pandemic, telehealth became widely used within various specialties, including reproductive healthcare. But, the researchers noted that although virtual care can help enable follow-up visits, it is generally not considered useful for laboratory tests and ultrasounds.

Thus, in this study, researchers aimed to gather information regarding the evolution of telehealth use in treating prenatal needs. They conducted a cross-sectional study using IQVIA PharMetrics Plus for Academics data, a health insurance claims database covering commercially insured patients in the US.

Focusing on the period between September 2018 and October 2021, researchers gathered data regarding deliveries from patients aged 15 to 50. They defined the 40 weeks before delivery as the baseline period, and those deliveries involving a patient 35 years or older were considered high-risk. Researchers also mentioned that in order to be deemed to have engaged in telehealth, a pregnancy needed to include one prenatal virtual visit that took place during the 40-week period.

Additionally, researchers used place of service, procedure codes, specialty, and pregnancy supervision diagnosis codes to categorize and identify prenatal telehealth visits throughout the baseline period. While performing trend analyses where pregnancies, prenatal telehealth, and insurance coverage were assessed on a month-by-month basis, researchers noted that active pregnancies were considered the denominator and pregnancies that included prenatal telehealth visits were considered the numerator. 

In total, researchers identified 45,203 pregnancies, 26,485 (58.6 percent) of which were high-risk. Of the total population, the mean age was 31.5 years, and 12.3 percent had gestational diabetes.

From September 2018 to October 2021, the use of telehealth for prenatal care varied by month. For deliveries in September 2018, prenatal telehealth use during pregnancy was 1.3 percent, followed by 1.1 percent for those occurring in January 2020, 17.3 percent for those in November 2020, and 9.9 percent for those in October 2021.

Telehealth use rates for active pregnancies also varied by month, with 0.1 percent in September 2018, 0.1 percent in January 2020, 2.8 percent in April 2020, and 0.5 percent in October 2021.

Additionally, they found that patients under Medicaid coverage and those with depression or anxiety used telehealth more.

These statistics provided researchers with sufficient evidence to conclude that the use of telehealth for prenatal care peaked early in the COVID-19 pandemic.

Many recent efforts have aimed to improve maternal health management by providing options for virtual care.

For instance, in March, MedArrive began a partnership with Ouma Health to increase access to maternal-fetal healthcare among Medicaid beneficiaries.

MedArrive provides patients with in-home care through a group of field providers and telehealth. Its partnership with Ouma Health aims to provide Medicaid beneficiaries with access to virtual maternal-fetal health services such as prenatal care, behavioral health screenings, chronic care management, and remote patient monitoring.