Evidence mapPaperPMID 41214625Full record

ArticleBMC medicine2025

The impact of the COVID-19 pandemic on the rate of maternal postnatal healthcare examinations in England: an OpenSAFELY interrupted time series analysis providing evidence of disparity in care access.

Dexter J L Hayes, Andrea L Schaffer, Amir Mehrkar, Sebastian C J Bacon, Ben Goldacre, Brian MacKenna, Alexander E P Heazell, Tjeerd van Staa, Victoria Palin

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Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Dexter J L HayesMaternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, The University of Manchester, Manchester, M13 9WL, UK.
Andrea L SchafferBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, The University of Oxford, Oxford, OX26GG, UK.
Amir MehrkarBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, The University of Oxford, Oxford, OX26GG, UK.
Sebastian C J BaconBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, The University of Oxford, Oxford, OX26GG, UK.
Ben GoldacreBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, The University of Oxford, Oxford, OX26GG, UK.
Brian MacKennaBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, The University of Oxford, Oxford, OX26GG, UK.ORCID http://orcid.org/0000-0002-3786-9063
Alexander E P HeazellMaternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, The University of Manchester, Manchester, M13 9WL, UK.
Tjeerd van StaaCentre for Health Informatics, School of Health Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester, M13 9PL, UK.ORCID http://orcid.org/0000-0001-9363-742X
Victoria PalinMaternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, The University of Manchester, Manchester, M13 9WL, UK. victoria.palin@manchester.ac.uk.ORCID http://orcid.org/0000-0002-0851-8619

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical guidance in England currently recommends that women undergo a postnatal health and wellbeing examination with a general practitioner 6-8 weeks after giving birth. The current study aimed to describe the impact of the COVID-19 pandemic on the rate of maternal postnatal examinations in England over time and its predictors, including socioeconomic deprivation and ethnicity.

methodsWith the approval of NHS England, the OpenSAFELY platform was used to access the TPP SystmOne electronic health record (EHR) system for primary care. All records for registered female patients aged 14 to 49 years with a recorded birth coded between January 2019 and August 2023. Monthly rates of postnatal examinations were estimated based on the number of patients with a postnatal-related code within 6, 8 or 12 weeks of birth. Interrupted time-series analysis modelled the impact of the COVID-19 pandemic on the rate of examinations. Characteristics that may influence the likelihood of not having a postnatal examination were estimated using logistic regression.

resultsFor 626,180 patients with births coded, the rate of postnatal examinations increased with length of time after birth. Rates within 8 weeks fell from 368 to 279 per 1000 (↓24.1%) between January and March 2020, recovering to 402 per 1000 by January 2023. The incident rate ratio for the first national lockdown was 0.87 (95%CI 0.81-0.91) for 6 weeks, 0.84 (0.81-0.87) for 8 and 1.06 (1.04-1.08) for 12 weeks. The odds of no examination were affected by ethnicity (Asian or Asian British (OR 1.11, 1.09-1.14)), region (North East (1.39, 1.28-1.37) and West Midlands (1.33, 1.27-1.39)) and deprivation (most deprived (1.43, 1.31-1.37)).

conclusionsMaternal postnatal examinations within the recommended time were negatively affected by the onset of the pandemic. Despite rates improving over time, most failed to occur within the recommended 6-8 weeks. Significant variation in rates exists across NHS regions: rates were lower in ethnic minority groups and in more deprived populations. Addressing these disparities will require a combination of policy changes, financial incentives and targeted, culturally appropriate interventions to ensure equitable access to care for all mothers and infants.

Indexed as

COVID-19Healthcare DisparitiesHealth Services AccessibilityPostnatal CareAdolescentAdultEnglandFemaleHumansInterrupted Time Series AnalysisMiddle AgedPregnancySARS-CoV-2Young AdultCoronavirusCOVID-19Maternal healthPostnatal healthcarePregnancySix-week check

Identifiers

PMID41214625
PMCPMC12599107

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.