AUTHOR=Cai Qin-Yu , Liu Shang Jing , Zhi Xing-Qi , Tang Wei-Zhen , Wang Ying-Xiong , Lan Xia , Wen Li , Luo Shu-Juan , Wang Lan , Sheng Jie , Liu Tai-Hang 

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

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1546013

DOI=10.3389/fmed.2025.1546013

ISSN=2296-858X

ABSTRACT=BackgroundThe 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.MethodsA 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.ResultsDuring 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.ConclusionCOVID-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.