330 - Impact of Telehealth on Utilization of Fetal Center Services and Family Care Coordination Conferences During COVID-19 Pandemic

Poster Number: 330
Publication Number: 330.1138

Background: At COVID-19 pandemic onset in March 2020, telemedicine represented a major healthcare practice change. Rush Fetal Neonatal Medicine Center (FNMC) adopted telemedicine to continue providing family complex care coordination conferences (FC) for pregnant mothers with suspected fetal anomalies while minimizing COVID-19 exposures. The impact of the Covid-19 pandemic and video telehealth visits on FNMC service utilization is currently unknown.

Objective: Evaluate FNMC service utilization in Pre-Covid and Covid-19 Era pregnant mothers with suspected fetal anomalies. Evaluate whether social determinants of health (SDoH) correlate with FC attendance.

Design/Methods: A retrospective convenience sample of pregnant mothers with fetal anomalies referred to FNMC between Jan 2014-Dec 2019 (Pre-Covid Era) and June 2020-May 2023 (Covid-19 Era) were included by searching an existing quality improvement (QI) database. Data including healthcare utilization, maternal sociodemographic information, pregnancy and birth outcomes were extracted from the electronic medical record. Data analysis included t-tests, Mann-Whitney U tests, and Chi-square tests based on appropriate distribution of variables. Mothers' Area Deprivation Index (ADI) deciles were calculated using an interactive map which publishes state ADI deciles online using 2018 United States Census Bureau data. The Institutional Review Board approved the study.

Results: Table 1 reports cohort characteristics, Table 2 reports FNMC service utilization, and Figure 1 reports ADI deciles. 139 mother-infant dyads (75 Pre-Covid Era & 64 Covid-19 Era) were included. Maternal fetal medicine consults, genetic counseling visits, ultrasound, and fetal magnetic resonance imaging utilization were similar between eras. Fetal echo utilization decreased during Covid-19 Era. FC offered and accepted decreased during Covid-19 Era, with trend towards decreased attendance. FC participants decreased during Covid-19 Era. Involved co-parent was identified less often in Covid-19 Era. Data collection is ongoing for analysis (goal 200 Pre-Covid Era & 100 Covid-19 Era mothers).

Conclusion(s): FC utilization by pregnant mothers with suspected fetal anomalies decreased during the Covid-19 Era despite the transition to telehealth video visits. Co-parents were identified less frequently, and fewer supporting adults participated in complex care coordination conferences during Covid-19 Era pregnancies. Understanding barriers to healthcare utilization in mothers whose pregnancy is affected by a fetal anomaly can help improve accessibility to care for this vulnerable population.