Table 4.

Results of the quantitative synthesis.

Outcomes	Studies	Pre-pandemic	Post-pandemic	Pooled estimate †(95% CI)	P	I[2]
Number of antenatal care appointments per week	Holcomb [29]	2409	1888	IRR 0•614 (0•486 – 0•776)	<0•0001	54•6%
	Jeganathan [70]	79	42
	Abdela [37]	86	60
	Madden [66]	417	378
	Peahl [42]	805	430
	Sarkar [58]	321	99
	Soffer [47]	1156	594
Number of virtual or over the phone visits per week	Holcomb [29]	0	399	IRR 46•56 (7•762 – 279•4)	<0•0001	90•6%
	Jeganathan [70]	0	21
	Madden [66]	4	187
	Peahl [42]	97	332
	Soffer [47]	0	251
Number of unscheduled care visits per week	Dell'Utri [24]	403	260	IRR 0•741 (0•602 – 0•911)	0•0046	0•0%
	Khalil [31]	119	96
	Kugelman [71]	136	99
	Meyer [39]	483	462
	Salsi [68]	90	57
	Abel [23]	778	554
	Facco [36]	22	18
Number of prenatal diagnosis procedures per year	Baptiste [32]	464	377	IRR 0•880 (0•645 – 1•199)	0•41	0•0%
	Ozalp [54]	88	56
	Monni [53]	772	793
Hospital admissions amongst unscheduled care visits	Salsi [68]	55•7% (223/400)	64•6% (164/254)	RR 1•214 (1•118 – 1•319)	<0•0001	0•0%
	Kugelman [71]	51•3% (279/544)	64•6% (257/398)
General anaesthesia for ELCS	Bhatia [48]	2•6% (28/1059)	1•3% (14/1083)	RR 0•831 (0•205 – 3•356)	0•79	61•8%
	Patkar-Kamminati [49]	1•1% (2/186)	2•3% (4/172)
General anaesthesia for EMCS	Bhatia [48]	24•3% (118/486)	12•9% (61/472)	RR 0•529 (0•407 – 0•690)	<0•0001	0•0%
	Patkar-Kamminati [49]	26•9% (18/67)	13•8% (8/58)
Epidural use	Hui [30]	12•9% (461/3577)	13•2% (126/954)	RR 1•044 (0•993 – 1•098)	0•0896	37•4%
	Justman [50]	77•1% (572/742)	83•1% (507/610)

*Individual patient data quantitative synthesis using generalised Poisson regression with random intercepts for studies reporting events per week. Mantel-Haenszel random effects meta-analysis for outcomes reported given a number of dependant events.

IRR: incidence rate ratio, RR: risk ratio, CI: confidence interval.