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Poster Session 4

Category: Clinical Obstetrics

Poster Session 4

(1152) Prenatal Care Utilization in a Novel Hybrid Prenatal Care Model: Mental Health Conditions

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Laura Peyton Ellis, MD (she/her/hers)

Resident Physician
UConn Health Obstetrics and Gynecology
Farmington, Connecticut, United States

Coauthor(s)

EK

Elizabeth Krans, MD, MSc

Associate Professor, Department of Obstetrics, Gynecology & Reproductive Sciences
UPMC Magee-Womens Pregnancy and Women's Recovery Center
Pittsburgh, Pennsylvania, United States
DH

David M. Haas, MD

Robert A. Munsick Professor of Obstetrics & Gynecology
Indiana University
Indiannapolis, Indiana, United States
TN

Thuy Nguyen, MPPA, PhD

Searle Assistant Professor, Health Management and Policy
University of Michigan School of Public Health
Ann Arbor, Michigan, United States
BI

Basil Issac

PhD Candidate
University of Michigan School of Economics
Ann Arbor, Michigan, United States
CQ

Chloe Qi, BA, MS

PhD Candidate
University of Michigan School of Public Health
Ann Arbor, Michigan, United States
AJ

Amy Jiao, BA, MPPA, MS

PhD Candidate
University of Michigan School of Public Health
Ann Arbor, Michigan, United States
Alex Peahl, MD, MSc (she/her/hers)

Assistant Professor of Obstetrics and Gynecology
University of Michigan Department of Obstetrics & Gynecology
Ann Arbor, Michigan, United States

Objective:
An increasing number of pregnancies are affected by mental health conditions. Evidence is lacking, however, on how to best provide high-quality, patient-centered prenatal care. This work evaluated the effect of the new tailored prenatal care model as described in Clinical Consensus Number 8 “Tailored Prenatal Care Delivery for Pregnant Individuals” in patients with mental health conditions.

Study Design:
This retrospective cohort study used electronic health records from three academic hospitals that implemented tailored prenatal care during the COVID-19 pandemic, two of which sustained changes (“intervention”), and one that did not (“control”). Mental health conditions (MH) were defined as generalized anxiety disorder and major depressive disorder diagnoses. The primary outcomes were planned (prenatal visits) and unplanned (ED/triage) utilization. The secondary outcomes were completion of recommended prenatal tests and timeliness of test completion. Difference-in-difference analysis compared pregnancies from pre-COVID Jan '17 to Feb '20 to post-COVID Jun '20 to Dec '23 excluding a washout period (Mar to May '20). Difference in difference in difference (DDD) coefficients were reported.

Results:
Overall, 49,264 pregnancies were included. Anxiety and depression were common in both groups (21% intervention, 30% control). There was a similar decrease in overall visit number for both groups (no MH: -1.554, MH: -1.785; DDD: -0.232, p=0.96) and similar increases in unplanned utilization (no MH=0.462, MH=0.438; DDD: -0.24, p=0.27). The completion of tests (no MH: 0.168, MH: 0.61, DDD: -0.107, p=0.333) and timely completion of tests (no MH: 0.631, MH: 0.19, DDD: -0.612, p=.002) increased in both groups, but increased less for those with MH conditions. The difference was only significant for the timely completion.

Conclusion:
Patients with mental health conditions face challenges in accessing prenatal care. Results suggest that patients with mental health conditions may not experience the same benefits of tailored prenatal care. Future work is needed to understand the patient experience of this new model.