# Three-year impact of COVID-19 pandemic on hospitalized twin pregnancies: evaluation of characteristics and changes in antibiotic prescribing

## TL;DR

The study found that the COVID-19 pandemic increased hospital admissions and changed antibiotic use in twin pregnancies, with more complications and longer hospital stays.

## Contribution

This study reveals new insights into how the pandemic affected twin pregnancies and antibiotic prescribing patterns over three years.

## Key findings

- Twin pregnancy admissions increased by 24.19% during the pandemic.
- Neonates had higher pneumonia rates and NICU admissions during the pandemic.
- Antibiotic prescriptions increased for older patients, higher BMI, and premature deliveries.

## Abstract

The COVID-19 pandemic has significantly impacted healthcare systems worldwide, including obstetric care. However, the long-term effects on twin pregnancies remain unclear. This study investigates the impact of COVID-19 on the clinical characteristics and antibiotic prescribing patterns in hospitalized twin pregnancies.

A retrospective cohort study was conducted at Women and Children’s Hospital of Chongqing Medical University, Chongqing, China, involving 3,827 twin pregnancies with live deliveries between 1 January 2017 and 31 December 2022. The pre-pandemic group included 1,707 patients, and the pandemic group included 2,120. Sociodemographic and clinical data were analyzed using general linear models with SPSS and R software.

During the pandemic, twin pregnancy admissions increased by 24.19%. Patients in the pandemic group have less gestational weight gain (17.00 vs. 16.08 kg, P < 0.001), had higher rates of assisted reproductive technology use (73.2% vs. 68.7%, P = 0.002), and experienced more complications. Neonates showed higher rates of pneumonia (5.7% vs. 3.8%, P < 0.001) and NICU admissions (43.7% vs. 13.9%, P < 0.001). Longer hospital stays were observed in the pandemic group (P = 0.004). Antibiotic prescriptions, especially non-repeat prescriptions, increased for older patients, those with higher BMI, and premature deliveries. The rate of repeated antibiotic prescriptions for bacterial vaginosis increased 1.68 times.

COVID-19 influenced twin pregnancy admissions, clinical characteristics, and antibiotic use. The study highlights the need for rational antibiotic use and improved healthcare resource management in future crises.