Impact of COVID-related restrictions on maternal and infant health

The rapid implementation of COVID-related policies and procedures across Canada were designed to reduce the spread of disease; but had far-reaching implications on maternal and child health. Prenatal, postpartum, and well-baby visits were transitioned from in-person to virtual visits (or cancelled outright by providers and patients as they tried to minimize exposure risk), universal forms of screening for gestational diabetes changed to a targeted screening model, infant immunization appointments (which traditionally had been used as broad health checks for the infant and their mother) transitioned to brief vaccine-only appointments, and length of stay in hospital for childbirth was reduced. As active case counts decline, and vaccine coverage increases, we are hopeful that we have now entered a recovery stage following the peak of the pandemic. This entails both a catch-up on missed services, but also a need to evaluate what policies and procedures had a beneficial impact and what should remain in place. In this study we will 1) describe the magnitude of missed screening and preventative health visits during pregnancy and the first year postpartum for pregnant persons and their infants; 2) assess how missed opportunities for preventative care differ by system factors (i.e., geography), community factors (i.e., area-level SES, ethnic concentration), family characteristics (i.e., presence of other children in the home, medical risk factors), and COVID-status in individuals (i.e., active infection during pregnancy) and the community (i.e., daily case count, type of restrictions); and 3) using an integrated KT approach, actively reach out to families who would benefit from enhanced follow-up.