Impact of COVID-19 on pregnancy-related healthcare utilisation: a prospective nationwide registry study
Objective To assess the impact of COVID-19 on pregnancy-related healthcare utilisation and differences across social groups.Design Nationwide longitudinal prospective registry-based study.Setting Norway.Participants Female residents aged 15–50 years (n=1 244 560).Main outcome measures Pregnancy-rela...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/10/e064118.full |
| _version_ | 1811230774581526528 |
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| author | Siri Eldevik Håberg Maria C Magnus Jonas Minet Kinge Laura Oakley Kjetil Telle Ferenc Macsali Carl Michael Baravelli |
| author_facet | Siri Eldevik Håberg Maria C Magnus Jonas Minet Kinge Laura Oakley Kjetil Telle Ferenc Macsali Carl Michael Baravelli |
| author_sort | Siri Eldevik Håberg |
| collection | DOAJ |
| description | Objective To assess the impact of COVID-19 on pregnancy-related healthcare utilisation and differences across social groups.Design Nationwide longitudinal prospective registry-based study.Setting Norway.Participants Female residents aged 15–50 years (n=1 244 560).Main outcome measures Pregnancy-related inpatient, outpatient and primary care healthcare utilisation before the COVID-19 pandemic (prepandemic: 1 January to 11 March 2020), during the initial lockdown (first wave: 12 March to 3 April 2020), during the summer months of low restrictions (summer period: 4 April to 31 August 2020) and during the second wave to the end of the year (second wave: 1 September to 31 December 2020). Rates were compared with the same time periods in 2019.Results There were 130 924 inpatient specialist care admissions, 266 015 outpatient specialist care consultations and 2 309 047 primary care consultations with pregnancy-related diagnostic codes during 2019 and 2020. After adjusting for time trends and cofactors, inpatient admissions were reduced by 9% (adjusted incidence rate ratio (aIRR)=0.91, 95% CI 0.87 to 0.95), outpatient consultations by 17% (aIRR=0.83, 95% CI 0.71 to 0.86) and primary care consultations by 10% (aIRR=0.90, 95% CI 0.89 to 0.91) during the first wave. Inpatient care remained 3%–4% below prepandemic levels throughout 2020. Reductions according to education, income and immigrant background were also observed. Notably, women born in Asia, Africa or Latin America had a greater reduction in inpatient (aIRR=0.87, 95% CI 0.77 to 0.97) and outpatient (aIRR 0.90, 95% CI 0.86 to 0.95) care during the first wave, compared with Norwegian-born women. We also observed that women with low education had a greater reduction in inpatient care during summer period (aIRR=0.88, 95% CI 0.83 to 0.92), compared with women with high educational attainment.Conclusion Following the introduction of COVID-19 mitigation measures in Norway in March 2020, there were substantial reductions in pregnancy-related healthcare utilisation, especially during the initial lockdown and among women with an immigrant background. |
| first_indexed | 2024-04-12T10:33:41Z |
| format | Article |
| id | doaj.art-6fb695a1504e4879976880f07c250256 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-12T10:33:41Z |
| publishDate | 2022-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-6fb695a1504e4879976880f07c2502562022-12-22T03:36:46ZengBMJ Publishing GroupBMJ Open2044-60552022-10-01121010.1136/bmjopen-2022-064118Impact of COVID-19 on pregnancy-related healthcare utilisation: a prospective nationwide registry studySiri Eldevik Håberg0Maria C Magnus1Jonas Minet Kinge2Laura Oakley3Kjetil Telle4Ferenc Macsali5Carl Michael Baravelli6Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, NorwayCentre for Fertility and Health, Norwegian Institute of Public Health, Oslo, NorwayDepartment of Disease Burden, Norwegian Institute of Public Health, Bergen, NorwayCentre for Fertility and Health, Norwegian Institute of Public Health, Oslo, NorwayHealth Services Research, Norwegian Institute of Public Health, Oslo, NorwayCentre for Fertility and Health, Norwegian Institute of Public Health, Oslo, NorwayDepartment of Disease Burden, Norwegian Institute of Public Health, Bergen, NorwayObjective To assess the impact of COVID-19 on pregnancy-related healthcare utilisation and differences across social groups.Design Nationwide longitudinal prospective registry-based study.Setting Norway.Participants Female residents aged 15–50 years (n=1 244 560).Main outcome measures Pregnancy-related inpatient, outpatient and primary care healthcare utilisation before the COVID-19 pandemic (prepandemic: 1 January to 11 March 2020), during the initial lockdown (first wave: 12 March to 3 April 2020), during the summer months of low restrictions (summer period: 4 April to 31 August 2020) and during the second wave to the end of the year (second wave: 1 September to 31 December 2020). Rates were compared with the same time periods in 2019.Results There were 130 924 inpatient specialist care admissions, 266 015 outpatient specialist care consultations and 2 309 047 primary care consultations with pregnancy-related diagnostic codes during 2019 and 2020. After adjusting for time trends and cofactors, inpatient admissions were reduced by 9% (adjusted incidence rate ratio (aIRR)=0.91, 95% CI 0.87 to 0.95), outpatient consultations by 17% (aIRR=0.83, 95% CI 0.71 to 0.86) and primary care consultations by 10% (aIRR=0.90, 95% CI 0.89 to 0.91) during the first wave. Inpatient care remained 3%–4% below prepandemic levels throughout 2020. Reductions according to education, income and immigrant background were also observed. Notably, women born in Asia, Africa or Latin America had a greater reduction in inpatient (aIRR=0.87, 95% CI 0.77 to 0.97) and outpatient (aIRR 0.90, 95% CI 0.86 to 0.95) care during the first wave, compared with Norwegian-born women. We also observed that women with low education had a greater reduction in inpatient care during summer period (aIRR=0.88, 95% CI 0.83 to 0.92), compared with women with high educational attainment.Conclusion Following the introduction of COVID-19 mitigation measures in Norway in March 2020, there were substantial reductions in pregnancy-related healthcare utilisation, especially during the initial lockdown and among women with an immigrant background.https://bmjopen.bmj.com/content/12/10/e064118.full |
| spellingShingle | Siri Eldevik Håberg Maria C Magnus Jonas Minet Kinge Laura Oakley Kjetil Telle Ferenc Macsali Carl Michael Baravelli Impact of COVID-19 on pregnancy-related healthcare utilisation: a prospective nationwide registry study BMJ Open |
| title | Impact of COVID-19 on pregnancy-related healthcare utilisation: a prospective nationwide registry study |
| title_full | Impact of COVID-19 on pregnancy-related healthcare utilisation: a prospective nationwide registry study |
| title_fullStr | Impact of COVID-19 on pregnancy-related healthcare utilisation: a prospective nationwide registry study |
| title_full_unstemmed | Impact of COVID-19 on pregnancy-related healthcare utilisation: a prospective nationwide registry study |
| title_short | Impact of COVID-19 on pregnancy-related healthcare utilisation: a prospective nationwide registry study |
| title_sort | impact of covid 19 on pregnancy related healthcare utilisation a prospective nationwide registry study |
| url | https://bmjopen.bmj.com/content/12/10/e064118.full |
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