The impact on postpartum care by telehealth: a retrospective cohort study

Arias, Dr Maria Paula; Wang, Dr Eileen; Leitner, Dr Kristin; Sannah, Ms Tasneem; Keegan, Ms Morgan; Delferro, Mr Joseph; Iluore, Ms Charissa; Arimoro, Ms Faith; Streaty, Ms Taylor; Hamm, Dr Rebecca F

doi:10.1016/j.ajogmf.2022.100611

Cited by 20 publications

(21 citation statements)

References 19 publications

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“…1). We screened 589 full-text articles and included 64 studies (80 articles, 17–96 ) in the current systematic review. Follow-up in the earliest study began in 1989 and in the last study ended in 2021.…”

Section: Resultsmentioning

confidence: 99%

“…Dodge et al 32,40 reported that participants randomized to home visits from nurses and those randomized to usual care had comparable attendance. However, Arias et al 20 reported that virtual visits during the COVID-19 pandemic were associated with greater visit attendance than before (adjusted odds ratio [aOR] 1.90, 95% CI 1.47–2.46). The RCT (Dodge et al 32,40 ) reported that participants randomized to home visits from nurses had more emergency room visits than participants randomized to usual care (mean difference 0.21, 95% CI 0.01–0.40); however, the numbers of hospitalizations per participant were comparable (Appendix 8, http://links.lww.com/AOG/D279).…”

Section: Resultsmentioning

confidence: 99%

“…The RCT (Dodge et al 32,40 ) reported that participants randomized to home visits from nurses had more emergency room visits than participants randomized to usual care (mean difference 0.21, 95% CI 0.01–0.40); however, the numbers of hospitalizations per participant were comparable (Appendix 8, http://links.lww.com/AOG/D279). The nonrandomized comparative study (Arias et al 20 ) reported that compared with before the COVID-19 pandemic, virtual visits during the pandemic were associated with higher depression screening rates (aOR 4.61, 95% CI 3.38–6.28) but comparable oral glucose tolerance testing (OGTT) rates (Appendix 12, http://links.lww.com/AOG/D279).…”

Section: Resultsmentioning

confidence: 99%

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Delivery Strategies for Postpartum Care

Saldanha,

Adam,

Kanaan

et al. 2023

Obstetrics &Amp; Gynecology

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OBJECTIVE: To systematically review the effects of postpartum health care–delivery strategies on health care utilization and maternal outcomes. DATA SOURCES: We searched Medline, EMBASE, CENTRAL, CINAHL, and ClinicalTrials.gov for studies in the United States or Canada from inception to November 16, 2022. METHODS OF STUDY SELECTION: We used duplicate screening for studies comparing health care–delivery strategies for routine postpartum care on health care utilization and maternal outcomes. We selected health care utilization, clinical, and harm outcomes prioritized by stakeholder panels. TABULATION, INTEGRATION, AND RESULTS: We found 64 eligible studies (50 randomized controlled trials, 14 nonrandomized comparative studies; N=543,480). For general postpartum care, care location (clinic, at home, by telephone) did not affect depression or anxiety symptoms (low strength of evidence), and care integration (by multiple types of health care professionals) did not affect depression symptoms or substance use (low strength of evidence). Providing contraceptive care earlier (compared with later) was associated with greater implant use at 6 months (summary effect size 1.36, 95% CI 1.13–1.64) (moderate strength of evidence). Location of breastfeeding care did not affect hospitalization, other unplanned care utilization, or mental health symptoms (all low strength of evidence). Peer support was associated with higher rates of any or exclusive breastfeeding at 1 month and any breastfeeding at 3–6 months (summary effect size 1.10–1.22) but not other breastfeeding measures (all moderate strength of evidence). Care by a lactation consultant was associated with higher breastfeeding rates at 6 months (summary effect size 1.43, 95% CI 1.07–1.91) but not exclusive breastfeeding (all moderate strength of evidence). Use and nonuse of information technology for breastfeeding care were associated with comparable rates of breastfeeding (moderate strength of evidence). Testing reminders for screening or preventive care were associated with greater adherence to oral glucose tolerance testing but not random glucose or hemoglobin A1c testing (moderate strength of evidence). CONCLUSION: Various strategies have been shown to improve some aspects of postpartum care, but future research is needed on the most effective care delivery strategies to improve postpartum health. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42022309756.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Delivery Strategies for Postpartum Care

Saldanha,

Adam,

Kanaan

et al. 2023

Obstetrics &Amp; Gynecology

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“…As a result, the healthcare community implemented telemedicine into everyday practice. A retrospective study revealed the use of telehealth increased the odds ratio of postpartum visit attendance by 90% and increased PPD screening rates by approximately 20% from prepandemic numbers [12]. A rapid review of telehealth services for maternal healthcare concluded that telehealth interventions (e.g., therapy services, anti-depressant dose monitoring) were as effective, and sometimes more than in-person visits for treatment of PPD [7].…”

Section: Editorialmentioning

confidence: 99%

“…A rapid review of telehealth services for maternal healthcare concluded that telehealth interventions (e.g., therapy services, anti-depressant dose monitoring) were as effective, and sometimes more than in-person visits for treatment of PPD [7]. Thus, telemedicine strategies have the potential to address certain well-known barriers to care, including limited transportation, a need for childcare services, and managing an appointment during a period of lifestyle adjustment [7,12]. Technology resources can be implemented to increase monitoring of PPD symptoms such as health portals sending automated surveys to patients via email or text message and certified nurse phone calls to check in with higher-risk patients [7].…”

Section: Editorialmentioning

confidence: 99%

The Impact of COVID-19 on Postpartum Depression and the Responsibility of the Healthcare System

DiGregory¹,

Githere²,

Crites³

et al. 2022

Cureus

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Peripartum depression is a common complication of pregnancy with the potential for dangerous consequences to maternal and infant health if left untreated. The disorder was previously classified as a global public health issue due to the high prevalence of the disorder and the mismatch between available treatment options and successful completion of those options. The coronavirus disease 2019 (COVID-19) pandemic increased the incidence of mental health disorders globally, with an even greater effect on peripartum mothers. A preliminary study on fetal implications suggests the resulting increased maternal stress and depressive mood symptoms correlates to worsened fetal brain development. The pandemic highlighted existing barriers to the treatment of peripartum mood disorders. The drastic increase in the use of telemedicine as a modality of treatment in response to the public health crisis has the potential to address some of these barriers. Future global disasters are inevitable with peripartum mothers highly susceptible to worsened mental health outcomes. We are thus highlighting the responsibility of clinicians, professional organizations, and policymakers to support, identify, and facilitate the treatment of postpartum depression for this vulnerable population to prevent short-term and long-term repercussions.

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Telemedicine and Digital Health Solutions in Intrapartum and Postpartum Care

Stone,

Hirshberg

2024

Curr Obstet Gynecol Rep

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Purpose of Review Telemedicine and digital health platforms are now integral to the way patients and clinicians interact with the health system. Application of these technologies in the antepartum context is well studied and accepted. The purpose of this review is to outline the state of telemedicine and digital health solutions in the intrapartum and postpartum period, understanding applications for labor and the months following delivery. Recent Findings Telemedicine can be used in the intrapartum period to assist with staffing shortages, remote assessment of intrapartum fetal heart tracings, and doula support. Application in the postpartum period includes but is not limited to remote blood pressure monitoring, lactation support, mental health screening and treatment, and substance use disorder. Summary Both telemedicine and digital health solutions aim to augment, not replace, care relationship during pregnancy, delivery, and postpartum. Whether these tools advance intrapartum and postpartum care remains subject to the same contingencies present in other specialties and care contexts. Ongoing investment into the application and evaluation of telemedicine and digital health solutions throughout pregnancy should be prioritized.

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The impact on postpartum care by telehealth: a retrospective cohort study

Cited by 20 publications

References 19 publications

Delivery Strategies for Postpartum Care

Delivery Strategies for Postpartum Care

The Impact of COVID-19 on Postpartum Depression and the Responsibility of the Healthcare System

Telemedicine and Digital Health Solutions in Intrapartum and Postpartum Care

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