ABSTRACT
INTRODUCTION: To determine differences in cesarean postpartum length of stay (pLOS) before and during the COVID-19 pandemic as a function of social determinants of health. METHODS: Cesarean birth pLOS data between January 1 and June 30, 2020, were reviewed. Births after March 10, 2020, were considered pandemic births. Primary outcome was early discharge <5,760 minutes (96 hours). Rates of early discharge were analyzed by social determinants of health, with socially vulnerable patients defined as Black or Hispanic, publicly insured, or non-English-speaking. We compared rates of early discharge before and during the pandemic overall and then among socially vulnerable patients using probit regression analysis. RESULTS: There were 1,885 eligible deliveries: 694 before the start of the pandemic and 1,171 after. Median pLOS pre-pandemic was 5,696 (IQR, 4,686-6,060) minutes versus 4,655 (IQR, 3,897- 5,860) minutes during the pandemic. Of the eligible deliveries, 54% had early discharges pre-pandemic compared to 71% afterwards (P<.01). Overall, we found these variables predictive of early discharge pLOS: socially vulnerable (P<.01), payer type (P<.01), English ability (P<.01), and multiparity (P<.01). Race as a variable alone was not found to be significantly predictive of early discharge. CONCLUSION: Socially vulnerable patients are more likely to leave the hospital earlier than their counterparts both before and during the COVID-19 pandemic. Our findings suggest that increased early discharges fall disproportionately on socially vulnerable patients. Further research is needed to determine whether these results are due to provider bias or patient driven.
ABSTRACT
Objective: The Society for Maternal-Fetal Medicine (SMFM) uses social media to increase awareness of the Society, its members, and its key programs (e.g. Annual Meeting and advocacy efforts). Primary audiences include SMFM members;fellow OB clinicians and organizations;policy makers;members of the media;and pregnant individuals and their families. Our objectives were: 1) to compare recent growth in followers of the SMFM Twitter and Facebook accounts, and 2) to identify content areas with the highest reach. Study Design: This is a retrospective study of Twitter Analytics and Facebook Insights data for the SMFM accounts (@MySMFM for Twitter and @SocietyforMaternalFetalMedicine for Facebook) both created in 2009. Available follower growth data (Aug 2019 through Jun 2021) were collected. We collated the top 10 posts on Twitter and Facebook between Jan 2019 and June 2021, defined by the posts with the most impressions or people reached to identify topic areas of high public interest. Results: While the overall number of followers gained since Aug 2019 was similar, follower growth was 50% (6448/12777) for Twitter vs. 30% (6653/22168) for Facebook (Fig. 1). Follower growth for Facebook was greater than for Twitter from Aug 2019 - Jun 2020 (4299 vs. 3103, respectively);however, Facebook growth was surpassed by Twitter during the period from Jul 2020 - Jun 2021 (2354 vs. 3385). When comparing the top 10 posts for each account, there was no difference in median impressions/reach of Twitter vs. Facebook: 35,084 (IQR 24,634-48,145) vs. 28,875 (IQR 24,819-44,361;Table 1, p=ns). The 10 most popular Tweets were shared more recently than the most popular Facebook posts. The topics that had the highest reach between the 2 platforms were: COVID vaccine (n=7), COVID (n=6), vaccines - non-COVID (n=3), disparities/racism (n=2), and research/other (n=2). Conclusion: Trends in SMFM social media growth suggest that Twitter has become more popular in recent years. Unsurprisingly, posts on COVID-19 and COVID vaccines had the furthest reach, although non-COVID vaccine-related Facebook posts were also popular prior to the pandemic. [Formula presented] [Formula presented]