Examining Outcomes for Nulliparous, at Term, Singleton and Vertex Deliveries During the First Wave of the COVID-19 Pandemic in Rhode Island.

Background: During the initial wave of the COVID-19, there was uncertainty related to whether the pandemic would affect pregnancy delivery outcomes. We sought to identify whether changes in hospital policies and provider practices, driven by COVID-19, would influence delivery outcomes in nulliparous, term, singleton, vertex (NTSV) pregnancies in Rhode Island.
Objective: We compare the delivery outcomes and associated factors for NTSV deliveries during the first wave of the COVID-19 pandemic in Rhode Island compared to patients who delivered the year prior.
Study Design: This is a retrospective cohort study of patients who presented to Women & Infants Hospital for NTSV deliveries during April 2019, pre-COVID-19, and April 2020, during COVID-19.
Results: During COVID-19, patients were more likely to have abnormal electronic fetal monitoring (AEFM) as an indication for cesarean section (p<.02) and less likely to have an elective cesarean delivery (p<.01). Patients during COVID-19 were more likely to have a midwife involved in their care compared to pre-COVID-19 (p<.001). The cesarean section rate was not statistically different between the two time periods.
Conclusion: Those delivering during the pandemic were more likely to have AEFM as an indication for cesarean delivery and less likely to have elective cesareans. They were more likely to have a midwife involved in their care. Further investigation into factors associated with changes in NTSV cesarean rates is warranted.