Leveraging the Massachusetts perinatal quality collaborative to address the COVID-19 pandemic among diverse populations

Katherine Sullivan; Mandy B Belfort; Patrice Melvin; Asimenia Angelidou; Aviel Peaceman; Jessica E Shui; Ruben Vaidya; Rachana Singh; Ruby Bartolome; Silvia Patrizi; Neha Chaudhary; Ilona Telefus Goldfarb; Ivana Culic; Diana Yanni; Munish Gupta; Mark Hudak; Margaret G Parker

doi:10.1038/s41372-021-01136-0

Leveraging the Massachusetts perinatal quality collaborative to address the COVID-19 pandemic among diverse populations

J Perinatol. 2021 Nov;41(11):2674-2683. doi: 10.1038/s41372-021-01136-0. Epub 2021 Jul 5.

Authors

Katherine Sullivan¹, Mandy B Belfort², Patrice Melvin³, Asimenia Angelidou^{4

5}, Aviel Peaceman⁶, Jessica E Shui⁷, Ruben Vaidya⁸, Rachana Singh^{8

9}, Ruby Bartolome⁶, Silvia Patrizi², Neha Chaudhary^{4

10}, Ilona Telefus Goldfarb¹¹, Ivana Culic⁴, Diana Yanni⁴, Munish Gupta⁴, Mark Hudak¹², Margaret G Parker⁶

Affiliations

¹ Department of Pediatrics, UMass Memorial Health Center, UMass Memorial Medical School, Worcester, MA, USA. [email protected].
² Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
³ Center for Applied Pediatric Quality Analytics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
⁴ Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
⁵ Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, USA.
⁶ Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
⁷ Department of Pediatrics, Division of Neonatology and Newborn Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁸ Department of Pediatrics, University of Massachusetts Medical Center-Baystate, Springfield, MA, USA.
⁹ Department of Pediatrics, Tufts Children's Hospital, Boston, MA, USA.
¹⁰ Department of Pediatrics, Cambridge Health Alliance, Cambridge, MA, USA.
¹¹ Deparatment of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
¹² Department of Pediatrics, University of Florida Health, University of Florida College of Medicine, Jacksonville, FL, USA.

Abstract

Objective: We leveraged the Massachusetts perinatal quality collaborative (PQC) to address the COVID-19 pandemic. Our goals were to: (1) implement perinatal practices thought to reduce mother-to-infant SARS-CoV-2 transmission while limiting disruption of health-promoting practices and (2) do so without inequities attributable to race/ethnicity, language status, and social vulnerability.

Methods: Main outcomes were cesarean and preterm delivery, rooming-in, and breastfeeding. We examined changes over time overall and according to race/ethnicity, language status, and social vulnerability from 03/20-07/20 at 11 hospitals.

Results: Of 255 mothers with SARS-CoV-2, 67% were black or Hispanic and 47% were non-English speaking. Cesarean decreased (49% to 35%), while rooming-in (55% to 86%) and breastfeeding (53% to 72%) increased. These changes did not differ by race/ethnicity, language, or social vulnerability.

Conclusions: Leveraging the Massachusetts PQC led to rapid changes in perinatal care during the COVID-19 crisis in a short time, representing a novel use of statewide PQC structures.

MeSH terms

COVID-19*
Female
Humans
Infant
Infant, Newborn
Infectious Disease Transmission, Vertical
Pandemics
Pregnancy
SARS-CoV-2
Social Vulnerability