Changes in Antenatal Obstetric Hospitalizations During the COVID-19 Pandemic in Western Sydney, Australia: A Population-Based Study.

BACKGROUND

Information regarding the prevalence of antenatal obstetric hospitalizations (AOHs) before and during the COVID-19 pandemic is limited.

AIMS: To examine changes in AOH prevalence, severity, emergency status, emergency department use, length of stay, causes, and associated maternal characteristics.

METHODS

Routinely collected data from a tertiary referral hospital were analysed for January 2018-February 2020 (pre-pandemic) and from March 2020-April 2022 (during the pandemic).

FINDINGS: AOHs decreased from 1,721/10,359 births (16.6%) pre-pandemic to 1,393/9,714 births (14.3%) during the pandemic (odds ratio [OR] = 0.84; 95% confidence interval [CI] = 0.78-0.91). Reductions were observed in overnight stays (- 2.6%), emergency admissions (- 2.2%), and emergency department involvement (- 1.4%). Mean length of stay decreased by 0.5 days. Pre-pandemic, women aged 35 and older, Indigenous women and women from Sub-Saharan Africa had higher rates of AOH, whereas women from Southern Asia had lower rates. During the pandemic, women aged 24 and younger and those from North Africa and the Middle East had higher rates, whereas women from Southern and Northeast Asia, those requiring an interpreter, and those living in less disadvantaged areas had lower rates. Smokers had higher rates both before and during the pandemic.

CONCLUSIONS

AOH rates declined during the COVID-19 pandemic alongside reduced hospital utilization. These changes may reflect shifts in care-seeking and service delivery, including public health restrictions and telehealth use. Variation across population groups suggests differences in access to and use of care. Ongoing monitoring is needed to ensure reduced utilization does not reflect unmet need.