O2205: Association of Duration of Virtual Maternity Care Engagement with Reduced Preterm Birth Risk: A Dose-Response Analysis

Background: Preterm birth affects approximately 1 in 10 births in the United States and represents a significant public health challenge, particularly among underserved populations who often face barriers to accessing comprehensive prenatal care. Virtual maternity care programs have emerged as a complement to traditional in-person prenatal care, offering pregnant individuals 24/7 access to maternal-child health specialists and comprehensive support services including personalized care plans, remote monitoring, and care coordination through smartphone-based platforms. However, evidence quantifying their impact on preterm birth rates remains limited. This study evaluated the association between duration of engagement with a comprehensive 24/7 virtual maternity and infant care program and preterm birth.

Methods: We conducted an inverse probability weighted analysis of deliveries between January and September 2024 among members claims data. The primary exposure was meaningful engagement with the maternity program during pregnancy, analyzed both as a binary variable and by duration of engagement (1+, 2+, or 3+ months). Inverse probability weighting was employed to balance treatment and control groups across demographic characteristics, pre-pregnancy healthcare utilization, medical conditions, and provider practice patterns. Double-robust regression methods were applied to account for any remaining differences between groups. The primary outcome was odds of preterm birth.

Results: 5,221 effective patients were included in the analysis across multiple plans. One month of engagement was associated with a 3.3% reduction in preterm birth odds, while two months of engagement showed a 24.9% reduction (p < 0.011). The strongest effect was observed among members engaged for three or more months, with a 36.9% reduction in preterm birth odds (p < 0.002). These findings remained significant after adjustment for potential confounders.

Conclusion: This analysis demonstrated a significant dose-response relationship between duration of engagement with the virtual maternity program and reduction in preterm birth odds, with greater benefits observed as duration of engagement increases. The substantial reduction in preterm birth odds among members engaged for several months suggests that virtual care programs may be an effective strategy for improving birth outcomes. Future research is needed to explore how pediatricians can best partner with virtual maternity care providers to improve birth outcomes.