Buu-Hac Nguyen
Research Mentor(s): Alex Peahl
Research Mentor School/College/Department: Department of Obstetrics and Gynecology, University of Michigan
Presentation Date: 08/03/2022
Presentation Type: Poster
Poster Number: 13
Session: Session I: 12:30 – 1:20pm
Room: League Ballroom
Authors: Buu-Hac Nguyen, Mark Turrentine, MD, Alex Friedman Peahl, MD MSc,
Abstract
Prenatal care is one of the most common preventive services in the United States—over 98% of the almost 4 million patients who give birth each year receive at least some prenatal care. Until the COVID-19 pandemic, prenatal care delivery had remained largely unchanged since 1930. National guidelines recommend a uniform 12- to 14-visit schedule for all patients to deliver evidence-based services. Catalyzed by changes in prenatal care delivery launched during the COVID-19 pandemic, the American College of Obstetricians and Gynecologists (ACOG), in collaboration with the University of Michigan, convened a panel to redesign prenatal care delivery recommendations. The resulting Plan for Appropriate Tailored Healthcare in pregnancy (PATH) is a paradigm shift in prenatal care delivery, providing a more individualized and flexible approach to prenatal care that matches recommended services to patients’ medical needs. The panel identified for low-risk prenatal care delivery a flexible schedule of visits every 6 weeks until 28 weeks, every 4 weeks until 36 weeks, every 2 weeks until delivery. All in-person prenatal care services can be streamlined to 4 visits: the first prenatal visit, 28 weeks, 36 weeks, and 39 weeks. For other visits, telemedicine would be an option for prenatal care delivery if preferred by the patient. We anticipate that outcome research will be necessary to compare this new prenatal method to the traditional delivery of prenatal care. A core outcome set for evaluating evidence for the best frequency and method of delivery (in-person versus audio/video visits) as well as other innovative models of care, including group prenatal care, pregnancy medical homes or wrap around digital support (e.g. OB Nest model) is necessary. Our objective is to develop a clinically relevant core outcome set to standardize outcome selection, collection and reporting across future randomized or observational studies on the frequency of prenatal visits and method of delivery of prenatal care. We will use eDelphi survey methods to query key stakeholders’ perspectives of critical core outcomes for prenatal care frequency to inform a final core outcome set, to be finalized in a virtual consensus meeting.
