Many perinatal services to manage chronic diseases transitioned to telehealth following the onset of the coronavirus disease 2019 (COVID-19) pandemic. This study was conducted to review the literature and summarize the effectiveness of telehealth for diabetes, hypertensive disorders of pregnancy (HDP), mental health (anxiety and depression), and opioid use disorder (OUD) management during the perinatal period postonset of COVID-19.
Methods:
PubMed, CINAHL, Web of Science, and IEEE Xplore databases were searched for articles published between 2020 and 2023 using keywords (COVID-19) and (maternal, maternity, obstetrics, perinatal, pregnancy) and (telemedicine, telehealth). Inclusion criteria were: intervention or change in practice with clinical results, postonset of COVID-19, English language, and addressed disease management (i.e., diabetes, hypertension, mental health, OUD) during pregnancy or postpartum. Exclusion criteria were: commentary, guideline, protocol, or review articles and perspectives.
Results:
The review included 24 articles, including 7 randomized controlled trials. Articles evaluated diabetes (N = 9), HDP (N = 4), mental health (N = 10), and OUD (N = 1). One-half (N = 12) were conducted in the United States and telehealth interventions (e.g., app, videoconferencing, audio visits) and clinical effectiveness varied by disease state. Most studies reported at least one positive outcome of telehealth (N = 19, 79.2%); however, some also reported negative outcomes (N = 8, 33.3%). Glycemic control was adequately achieved in most studies (N = 8, 88.9%), and the majority of studies (N = 3, 75%) reported positive or neutral results for the management of HDP. Various telehealth interventions resulted in lower anxiety and depression symptoms. Only one study examined OUD and reported negative outcomes.
Conclusions:
Telehealth offered effective management of diabetes, hypertension, anxiety, and depression in perinatal women and often improved patient outcomes during COVID-19. Therefore, telehealth should continue to be offered to perinatal women with these chronic conditions as appropriate for individual and clinical situations. More research is needed to evaluate the effectiveness of telehealth interventions for OUD management.
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