Later Virtual Antenatal Care Linked to Increased Pregnancy Risks,Study Finds
A new study suggests that increased reliance on virtual antenatal care during the second and third trimesters may be associated with poorer pregnancy outcomes,including a higher risk of preterm birth and cesarean sections.
the shift towards virtual care, accelerated by the COVID-19 pandemic, has raised questions about its impact on maternal and infant health. Researchers at King’s College London, publishing their findings in the American Journal of Obstetrics and Gynecology on October 17, 2025, analyzed data from over 34,000 pregnancies in South London to assess the relationship between the proportion of virtual antenatal care received and subsequent pregnancy outcomes.
The study categorized women into four groups based on their engagement with virtual appointments: those with consistently low levels of virtual care, those with high engagement during the first trimester, those with high engagement during the second trimester, and those with high engagement during the third trimester. Data on pregnancy and birth outcomes were sourced from hospital records via the Early Life Cross-Linkage in Research,Born in South London (eLIXIR-BiSL) platform.
Analyses revealed a concerning trend. Women who received a high proportion of virtual antenatal care during their second trimester experienced a greater incidence of premature births (before 37 weeks), labor inductions, breech presentation, and bleeding after birth compared to those with consistently low levels of virtual care.
Furthermore, those with high virtual care engagement in the third trimester faced increased rates of premature births, elective or emergency cesarean sections, and neonatal intensive care unit (NICU) admissions. Interestingly, this group also exhibited lower rates of third- or fourth-degree vaginal tears, as well as reduced instances of early skin-to-skin contact with the newborn and breastfeeding as the first feed.
The rise in virtual antenatal care during the pandemic was a necessary measure to limit face-to-face contact and curb the spread of the SARS-CoV-2 virus. However, as Dr. Katie Dalrymple, Lecturer at King’s and first author of the study, explained, “Our work adds an important outlook to the growing evidence base on virtual antenatal care, suggesting that the timing of its use during pregnancy may influence pregnancy outcomes.”
This research builds upon previous work by the same team,which demonstrated that virtual maternity care during the COVID-19 pandemic was linked to higher costs for the National Health Service (NHS)-specifically,a £7 increase in maternity costs for each 1% rise in virtual antenatal care. The current findings add another layer of complexity, suggesting potential risks to both mother and baby.
“our study findings suggest the need for careful integration of virtual care in maternity services, to minimize potential risks,” stated Professor Laura Magee, Professor of Women’s Health at King’s and co-senior author of the paper. The authors emphasize the importance of careful consideration before widely adopting virtual antenatal care, notably as a replacement for in-person care, or in response to future public health crises. A more nuanced approach is needed to balance the convenience and accessibility of virtual care with the potential for adverse outcomes.
Did you know?-Virtual antenatal care rose during the COVID-19 pandemic to limit in-person contact.A new study suggests later virtual appointments may increase risks of preterm birth and cesarean sections. Careful integration is key.
More details: Kathryn V. Dalrymple et al, The relationship between virtual antenatal care and pregnancy outcomes in a diverse UK inner-city population: a group-based trajectory modeling approach using routine health records, American Journal of Obstetrics and Gynecology (2025). DOI: 10.1016/j.ajog.2025.08.004
