Abstract
OBJECTIVE: To examine telehealth care utilization during pregnancy and in the 6 months postpartum during the COVID-19 pandemic. RESEARCH DESIGN: We used a repeated cross-sectional design to assess aggregated and standardized electronic health records (EHR) from 28 participating US health systems in the PCORnet®, National Patient-Centered Clinical Research Network. SUBJECTS: We studied women aged 18-55 years with delivery records from 2018 to 2019 (prepandemic), 2020-2021 (early pandemic), and 2022-2023 (late/postpandemic). Women with hypertension in pregnancy (HTN-PREG) were identified as those with documented hypertension 1 year prepregnancy or during pregnancy (40 wk predelivery). MEASURES: We used the International Classification of Disease Clinical Modification/Procedure Classification codes, a normalized naming system for drug names (RXnorm), and the Current Procedural Terminology/Healthcare Common Procedure Coding System to identify deliveries, hypertension, and telehealth visits. RESULTS: We examined 1,028,426 deliveries, of which 108,606 had HTN-PREG. The proportion of women with 1+ pregnancy telehealth use was higher in the early pandemic (15.8%) and late/postpandemic (16.4%) periods compared with prepandemic (0.2%). Telehealth use among HTN-PREG women was higher than among all women (0.24% prepandemic, 24.9% early pandemic, 26.8% late/postpandemic).. Among HTN-PREG women, telehealth use was lower among Hispanic women (19.2% and 23.2%) compared with NH Black (26.5% and 29.3%) or NH White (24.5% and 26.1%) women during the early and late/postpandemic periods, respectively. We observed similar patterns postpartum. All P values for comparisons were <0.001. CONCLUSIONS: These findings underscore the value of aggregate PCORnet® data infrastructure and other standardized electronic health records in analyzing health care utilization trends and racial and ethnic differences among pregnant women.