Background/Objectives: The COVID-19 pandemic period from 2020 to 2022 had a significant impact on maternal infant health with mothers impacted more than their infants. We questioned whether there have been any lingering effects from the pandemic. Methods: We examined intermediate and long-term pandemic effects on maternal and neonatal outcomes before, during, and after the COVID-19 pandemic period. We reviewed mother–infant pairs from the following three epochs: (1) the pre–COVID-19 period, (2) the COVID-19 pandemic period, and (3) the post-pandemic period. The Case Mix Index (CMI) for the neonates from all three epochs were detailed. Results: Post-pandemic, we noted a rising trend of LGA infants (10%) and an increase in SGA infants (13%). For women in 2023, we noted an increase in hypertension, preeclampsia, diabetes, and a higher BMI than in the pre-pandemic period. There have also been more congenital anomalies (9%), and neonatal CMI increased in the post-pandemic period. Conclusions: Well after the pandemic period, maternal–infant health continues to be affected. For women, the increase in hypertension and diabetes during pregnancy is concerning. For infants, being LGA or SGA may have long-term consequences. The post-pandemic increase in infants with congenital anomalies compared to the pre-pandemic era is an area that needs ongoing review.

The COVID-19 pandemic period, from 2020 - 2022 had a significant impact on maternal infant health with mothers impacted more than their infants. We questioned whether there have been any lingering effects from the pandemic. We examined intermediate and long-term pandemic effects of maternal and neonatal outcomes before, during and after the COVID-19 pandemic period. We reviewed mother-infant pairs from three epochs: 1) the pre-COVID-19 period, 2) the COVID-19 pandemic period, and 3) the post-pandemic period. The Case Mix Index (CMI) for the neonates from all 3 epochs were detailed. Post-pandemic we noted a rising trend of LGA infants (10%), and an increase in SGA infants (13%). For women in 2023 we noted an increase in hypertension, preeclampsia, diabetes, and a higher BMI than the pre- pandemic period. There have also been more congenital anomalies (9%), and neonatal CMI increased in the post-pandemic period. Well after the pandemic period, maternal-infant health continues to be affected. For women, increase in hypertension and diabetes during pregnancy is concerning. For the infants, being LGA or SGA may have long-term consequences. The post-pandemic increase in infants with congenital anomalies compared to the pre-pandemic era is an area that needs ongoing review.

Background/Objectives: Infants exposed to opioids in utero are at risk of neonatal opioid withdrawal syndrome (NOWS). We compared clinical, family-related, and classification-derived resource outcomes before and after implementation of Eat, Sleep, Console (ESC) in an Appalachian hospital. Methods: This single-center retrospective cohort study compared outcomes of opioid-exposed neonates assessed with Finnegan Scoring system (FNASS) (Epoch 1, N = 252) versus the Eat, Sleep, Console (ESC) method (Epoch 2, N = 100). Multivariable logistic regression and gamma generalized linear models with log links evaluated outcomes after adjustment for gestational age and maternal tobacco, fentanyl, and methamphetamine exposure. Results: ESC was associated with lower adjusted odds of NOWS classification (adjusted odds ratio (aOR) 0.32, 95% Confidence Interval (CI) 0.19–0.54), rescue morphine (aOR 0.36, 95% CI 0.17–0.75), and morphine taper (aOR 0.32, 95% CI 0.12–0.85). Adjusted mean length of stay was lower (ratio 0.66, 95% CI 0.54–0.79). Adjusted associations with foster care discharge (aOR 0.97, 95% CI 0.49–1.93) and parental involvement (aOR 1.24, 95% CI 0.66–2.32) were not statistically significant. Conclusions: ESC implementation was associated with shorter hospitalization and less pharmacological treatment after adjustment for measured differences between epochs. Unadjusted differences in foster care discharge and parental involvement did not persist after adjustment. The observational, sequential-epoch design precludes causal attribution.