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Poster Session 3

Category: Clinical Obstetrics

Poster Session 3

(845) Prenatal Care Utilization in a Novel Hybrid Prenatal Care Model: Implications in Chronic Disease

Thursday, February 12, 2026

10:30 AM - 12:00 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:
The American College of Obstetricians and Gynecologists “Tailored Prenatal Care Delivery for Pregnant Individuals ” recommends personalized prenatal care. Yet, evidence for tailored care focuses on low-risk patients. This project assessed the effect of tailored prenatal care on patients with chronic conditions.

Study Design:
Retrospective cohort study of electronic health record data from three academic hospitals that implemented tailored prenatal care during the COVID-19 pandemic: two sustained changes (“intervention”), and one did not (“control”). Chronic conditions (CC) included asthma, type 2 diabetes mellitus, substance use disorder, and chronic hypertension. Primary outcomes were planned (prenatal visits) and unplanned (ED/triage) utilization. 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). The difference in difference in difference (DDD) coefficient was reported for all outcomes.

Results:
In the study cohort, chronic conditions were common (50% control, 27% intervention, n=49,264). Post intervention, both groups experienced a similar decrease in planned utilization (no CC: -1.49, CC: -1.31; DDD=0.18, p=0.57). The increase in unplanned utilization was not statistically significant, and was equivalent between groups (no CC: 0.51, CC: 0.66; DDD=0.151, p=0.348). Patients with chronic conditions had lower completion of services after the intervention (no CC: 0.15, CC: -0.15; DDD: -0.301, p=0.35). Both groups had an increase in timely completion of services, but the increase was smaller for those with CC (no CC: 0.621, CC: 0.147; DDD: -0.475, p=0.35).

Conclusion:
For patients with CC, implementation of tailored prenatal care reduced planned care utilization, but did not increase in unplanned utilization. Patients with CC did not see the same benefit for timely completion of services. More work is needed to understand how tailored care models affect maternal and neonatal outcomes.