UAMS study finds pregnancy telehealth visits spiked during COVID

A University of Arkansas for Medical Sciences study found that digital health services for prenatal care spiked during the COVID pandemic in 2020 and, while declining from the peak, remained significantly higher than before the pandemic in 2021.

The UAMS study of a national database, published in JAMA Network Open, found that the use of at least one telehealth visit during a 40-week pregnancy increased from 1.1% of deliveries in January 2020 to 17.3% in November 2020. By October 2021, it was 9.9%.

Researchers based their findings off a health insurance claims database, the IQVIA PharMetrics Plus for Academics, that provided de-identified information on 45,203 pregnancies.

“The findings could be used to design telehealth-integrated prenatal care models, but we would first need to determine the best combination of digital health and in-person visits,” said the study’s first author, Mahip Acharya, Ph.D., a senior data analyst for the Rural Telehealth Evaluation Center at the UAMS Institute for Digital Health & Innovation, in a UAMS press release.

The study’s principal investigator was Hari Eswaran, Ph.D., professor and vice chair for research in the College of Medicine Department of Obstetrics and Gynecology, and director of research at the institute.

Of the 45,203 pregnancies, 26,485 were considered to be high-risk, meaning the maternal age at delivery was older than 35 or that other clinical characteristics were met. Those women tended to have prenatal telehealth visits at higher rates than women who did not have high-risk pregnancies.

Of the 45,203 pregnancies identified, the mean age for delivery was 31.5, while 5,549 women, or 12.3%, had gestational diabetes.

The study also found that pregnant women with Medicaid used digital health appointments more than those with commercial insurance. The authors suggest that the reason is because of policy changes regarding coverage and reimbursement made at the state level. But the authors acknowledge the study’s sample size consisted of “almost exclusively commercially insured patients.”

Women with anxiety and depression were more likely to use digital health services. The authors said that finding is consistent with telehealth use overall during the pandemic.

The study was supported by a grant from the U.S. Department of Health and Human Services’ Office for the Advancement of Telehealth. The grant was made to the Rural Telehealth Evaluation Center at the UAMS Institute for Digital Health & Innovation.

The research was also supported by the UAMS Translational Research Institute, which supports the IQVIA PharMetrics Plus for Academics database.