Impact of Telehealth and Social Drivers of Health on Utilization of Fetal Center Services

Background: Data is limited regarding the impact of social drivers of health (SDOH) on fetal center (FNMC) service utilization. Objectives: The objectives of this study were to (1) compare FNMC utilization by era (pre-telehealth era vs. COVID-19 telehealth era) and (2) examine associations between maternal sociodemographics and FNMC service utilization. Study Design: A retrospective study of 300 high-risk pregnant individuals with suspected fetal anomalies was conducted, analyzing utilization vs. SDOH (deprivation (ADI), preferred language, race/ethnicity, insurance, employment) comparing pre-telehealth (n = 200) and COVID-19 telehealth (n = 100) cohorts. Results: Race/ethnicity was associated with differences in fetal echo utilization and family complex care coordination conference (FC) attendance in the univariate analysis. The ADI decile and era predicted FC attendance in the logistic regression, while race/ethnicity, preferred language, and employment were not significant. The ADI and insurance were significant predictors of co-parent attendance, whereas era, employment, preferred language, and race were not. Conclusions: FC attendance was lower in the COVID-19 era despite telehealth expansion. Higher neighborhood deprivation predicted higher maternal attendance but lower co-parent attendance. Co-parent FC attendance was lower for mothers with Medicaid.