National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
51 to 75 of 289 Research Studies DisplayedChua KP, Fendrick AM, Conti RM
Out-of-pocket spending for deliveries and newborn hospitalizations among the privately insured.
The authors estimated national data on out-of-pocket spending across the childbirth episode, including both deliveries and newborn hospitalizations, using national commercial claims data. They found that, during 2016–2019, privately insured families paid $3000 out-of-pocket for maternal and newborn hospitalizations, with out-of-pocket spending exceeding $5000 for 1 in 6 families. They recommended that clinicians counsel privately insured families concerning their childbirth benefits.
Citation: Chua KP, Fendrick AM, Conti RM .
Out-of-pocket spending for deliveries and newborn hospitalizations among the privately insured.
Pediatrics 2021 Jul;148(1):e2021050552. doi: 10.1542/peds.2021-050552..
Keywords: Newborns/Infants, Labor and Delivery, Pregnancy, Healthcare Costs
Lange EMS, Toledo P
Peripartum racial/ethnic disparities.
Addressing disparities has been a focus of the US Department of Health and Human Services Healthy People initiative for decades, with the most recent Healthy People 2020 establishing a need for health equity in the United States. In this article, the investigators presented an overview of peripartum racial/ethnic disparities and address potential structural solutions to improve maternal health equity.
AHRQ-funded; HS025267.
Citation: Lange EMS, Toledo P .
Peripartum racial/ethnic disparities.
Int Anesthesiol Clin 2021 Jul 1;59(3):1-7. doi: 10.1097/aia.0000000000000326..
Keywords: Maternal Care, Pregnancy, Disparities, Racial and Ethnic Minorities, Women
Calthorpe LM, Baer RJ, Chambers BD
The association between preterm birth and postpartum mental healthcare utilization among California birthing people.
This study’s objective was to determine whether preterm birth is associated with postpartum inpatient and emergency mental healthcare utilization. The study sample was taken from a database of live-born neonates delivered in California, 2011-2017, and included all births to singleton infants between the gestational ages of 20 and 44 weeks. The findings indicate found that preterm birth is an independent risk factor for postpartum mental healthcare utilization. These findings suggest that screening for and providing mental health resources to birthing people after delivery are crucial, particularly among people giving birth to preterm infants, regardless of mental health history.
AHRQ-funded; HS026383.
Citation: Calthorpe LM, Baer RJ, Chambers BD .
The association between preterm birth and postpartum mental healthcare utilization among California birthing people.
Am J Obstet Gynecol MFM 2021 Jul;3(4):100380. doi: 10.1016/j.ajogmf.2021.100380..
Keywords: Behavioral Health, Pregnancy, Women, Labor and Delivery, Risk
Fan T, Lee G
AHRQ Author: Fan T
Interventions for tobacco smoking cessation in adults, including pregnant persons.
This AHRQ-authored Putting Preventions in Practice quiz has three questions and answers on the US Preventive Services Task Force final recommendation on interventions for tobacco smoking cessation in adults, including pregnant persons. A case study is presented with questions on the best behavioral interventions, e-cigarette use, and pharmacotherapy for tobacco cessation in pregnant persons. References are also provided at the end of the answers.
AHRQ-authored.
Citation: Fan T, Lee G .
Interventions for tobacco smoking cessation in adults, including pregnant persons.
Am Fam Physician 2021 Jun 15;103(12):753-54..
Keywords: U.S. Preventive Services Task Force (USPSTF), Tobacco Use, Prevention, Case Study, Pregnancy, Women, Substance Abuse
Hatch B, Schmidt T, Davis E
Clinic factors associated with utilization of a pregnancy-intention screening tool in community health centers.
The authors’ goal was to describe the utilization of a pregnancy-intention screening tool integrated in the electronic health record (EHR) of a national network of community health centers (CHCs) and to identify clinic-level factors associated with tool use. They found that medical assistants performed 60.3% of screenings and clinicians performed 11.2%. CHCs with higher tool utilization rates were more likely to be located in rural settings and to serve patient populations with higher proportions of women and lower proportions of patients with non-English language preference. They concluded that many health centers utilized pregnancy-intention screening after an EHR-based tool was made available, though overall screening rates were low.
AHRQ-funded; HS025155.
Citation: Hatch B, Schmidt T, Davis E .
Clinic factors associated with utilization of a pregnancy-intention screening tool in community health centers.
Contraception 2021 May;103(5):336-41. doi: 10.1016/j.contraception.2021.02.003..
Keywords: Community-Based Practice, Pregnancy, Women, Screening
Barrero-Castillero A, Beam KS, Bernardini LB
COVID-19: neonatal-perinatal perspectives.
This review provides a comprehensive overview of neonatal-perinatal perspectives of COVID-19, ranging from the basic science of infection and recommendations for care of pregnant women and neonates to important psychosocial, ethical, and racial/ethnic topics emerging as a result of both the pandemic and the response of the healthcare community to the care of infected individuals.
AHRQ-funded; HS000063.
Citation: Barrero-Castillero A, Beam KS, Bernardini LB .
COVID-19: neonatal-perinatal perspectives.
J Perinatol 2021 May;41(5):940-51. doi: 10.1038/s41372-020-00874-x..
Keywords: COVID-19, Newborns/Infants, Infectious Diseases, Pregnancy, Women
Iroz CB, Dahl CM, Cassimatis IR
Prophylactic anticoagulation for preterm premature rupture of membranes: a decision analysis.
The objective of this study was to determine the optimal modality for venous thromboembolism prophylaxis during hospitalization for preterm premature rupture of membranes using a decision analysis model. The investigators concluded that their results did not support the routine use of prophylactic anticoagulation in women admitted to the hospital for preterm premature rupture of membranes.
AHRQ-funded; HS000084.
Citation: Iroz CB, Dahl CM, Cassimatis IR .
Prophylactic anticoagulation for preterm premature rupture of membranes: a decision analysis.
Am J Obstet Gynecol MFM 2021 May;3(3):100311. doi: 10.1016/j.ajogmf.2021.100311..
Keywords: Blood Clots, Blood Thinners, Prevention, Shared Decision Making, Pregnancy, Maternal Care, Inpatient Care, Women, Medication
Peahl AF, Powell A, Berlin H
Patient and provider perspectives of a new prenatal care model introduced in response to the coronavirus disease 2019 pandemic.
The authors evaluated institutional-level adoption and patient and provider experiences with a coronavirus disease 2019 prenatal care model. They found that reduced visit schedules and virtual visits were rapidly integrated into real-world care, with positive experiences for many patients and providers. They recommended future research to understand the health outcomes and care experience associated with alternative approaches to prenatal care delivery across more diverse patient populations outside of the coronavirus disease 2019 pandemic to inform broader health policy decisions.
AHRQ-funded; HS025465.
Citation: Peahl AF, Powell A, Berlin H .
Patient and provider perspectives of a new prenatal care model introduced in response to the coronavirus disease 2019 pandemic.
Am J Obstet Gynecol 2021 Apr;224(4):384.e1-84.e11. doi: 10.1016/j.ajog.2020.10.008..
Keywords: Maternal Care, Pregnancy, Patient-Centered Healthcare, Telehealth, Health Information Technology (HIT), Healthcare Delivery, COVID-19
Peahl AF, Smith RD, Moniz MN
Prenatal care redesign: creating flexible maternity care models through virtual care.
Each year, over 98% of the almost 4 million pregnant patients in the United States receive prenatal care-a crucial preventive service to improve outcomes for moms and babies. In this paper, the authors outline their experience rapidly transitioning prenatal care to a new model with 4 in-person visits, 1 ultrasound visit, and 4 virtual visits (the 4-1-4 prenatal plan). They then explore how lessons from this implementation can inform patient-centered prenatal care redesign during and beyond the COVID-19 pandemic.
AHRQ-funded; HS025465.
Citation: Peahl AF, Smith RD, Moniz MN .
Prenatal care redesign: creating flexible maternity care models through virtual care.
Am J Obstet Gynecol 2020 Sep;223(3):389.e1-89.e10. doi: 10.1016/j.ajog.2020.05.029..
Keywords: Maternal Care, Telehealth, Health Information Technology (HIT), Pregnancy, Women, Healthcare Delivery, Patient-Centered Healthcare
Vemulakonda VM
Ureteropelvic junction obstruction: diagnosis and management.
Ureteropelvic junction obstruction (UPJO) is the most common cause of prenatally diagnosed hydronephrosis. Although associated with obstruction of the kidney, the natural history is variable, ranging from spontaneous resolution to progressive loss of function over the first few years of life. The purpose of this article is to review recent literature focused on the prenatal and postnatal evaluation of infants with prenatally diagnosed hydronephrosis suspicious for UPJO.
AHRQ-funded; HS024597.
Citation: Vemulakonda VM .
Ureteropelvic junction obstruction: diagnosis and management.
Curr Opin Pediatr 2021 Apr 1;33(2):227-34. doi: 10.1097/mop.0000000000000994..
Keywords: Newborns/Infants, Pregnancy, Diagnostic Safety and Quality
Bossick AS, Brown J, Hanna A
Impact of state-level reproductive health legislation on access to and use of reproductive health services and reproductive health outcomes: a systematic scoping review in the Affordable Care Act era.
This literature review looked at the association between state-level reproductive laws and reproductive health outcomes related to services such as family planning, maternity care, abortion, and prenatal care use. A PubMed search was conducted for studies published between March 10, 2010 and August 31, 2019 and focused on research conducted after the implementation of the Affordable Care Act. Search results returned 1,529 articles with only 56 meeting the inclusion criteria for review. After further review, only 8 were selected for inclusion. Two included all 50 states and Washington, DC; one included Oregon and Washington; and the remaining 5 studies included single states (Texas, Arizona, Ohio, and Utah). Half of the studies focused solely on restrictive abortion legislation. Restricting access to family planning and abortion services were associated with negative outcomes. Expanding maternity care through Medicaid reform and autonomous midwifery laws were associated with positive outcomes for maternal and newborn health.
AHRQ-funded; HS013853.
Citation: Bossick AS, Brown J, Hanna A .
Impact of state-level reproductive health legislation on access to and use of reproductive health services and reproductive health outcomes: a systematic scoping review in the Affordable Care Act era.
Womens Health Issues 2021 Mar-Apr;31(2):114-21. doi: 10.1016/j.whi.2020.11.005..
Keywords: Women, Policy, Maternal Care, Pregnancy
Herrick CJ, Keller MR, Trolard AM
Factors associated with postpartum diabetes screening in women with gestational diabetes and Medicaid during pregnancy.
This study’s goal was to understand the factors associated with the receipt of postpartum diabetes screening for women with gestational diabetes in a state without Medicaid expansion. Findings showed that prenatal certified diabetes education and access to public transportation were associated with increased screening, the total number of prenatal visits, the use of diabetes medication during pregnancy, and a pregnancy-specific comorbidity index that incorporated age.
AHRQ-funded; HS019455.
Citation: Herrick CJ, Keller MR, Trolard AM .
Factors associated with postpartum diabetes screening in women with gestational diabetes and Medicaid during pregnancy.
Am J Prev Med 2021 Feb;60(2):222-31. doi: 10.1016/j.amepre.2020.08.028..
Keywords: Diabetes, Screening, Maternal Care, Pregnancy, Women, Medicaid, Access to Care
Hirai AH, Ko JY, Owens PL
AHRQ Author: Owens PL, Stocks C
Neonatal abstinence syndrome and maternal opioid-Related diagnoses in the US, 2010-2017.
This study analyzed trends in neonatal abstinence syndrome (NAS) and maternal opioid-Related diagnosis (MOD) in the United States from 2010 to 2017. A cross-sectional analysis was done of the HCUP National Inpatient Sample and State Inpatient Database from 2010 through 2017. Diagnoses of NAS and MOD were found using the ICD-10, CM codes. Significant increases occurred in rates of NAS, from 4.0 to 7.3 per birth hospitalizations and MOD, from 3.5 to 8.2 per 1000 delivery hospitalizations. A census of 47 state databases in 2017 found a large range of NAS rates – from 1.3 per 1000 birth hospitalizations in Nebraska to 53.5 per 1000 hospitalizations in West Virginia with the same ranges found for MOD rates. In all states except Nebraska and Vermont which only had significant MOD increases, NAS and MOD rates rose significantly from 2010 to 2017.
AHRQ-authored; AHRQ-funded; 290201800001C.
Citation: Hirai AH, Ko JY, Owens PL .
Neonatal abstinence syndrome and maternal opioid-Related diagnoses in the US, 2010-2017.
Neonatal abstinence syndrome and maternal opioid-Related diagnoses in the US, 2010-2017..
Keywords: Healthcare Cost and Utilization Project (HCUP), Newborns/Infants, Opioids, Medication, Substance Abuse, Hospitalization, Pregnancy
Berger BO, Wolfson C, Reid LD
AHRQ Author: Reid LD
Adverse birth outcomes among women of advanced maternal age with and without health conditions in Maryland.
This study examined the association between advanced maternal age (AMA) and adverse birth outcomes among women with and without preexisting and pregnancy-related health conditions. Data for singleton births from the population-based Maryland Pregnancy Risk Assessment Monitoring System 2004-2015 were used to compare women aged 20-34 years and 35 years and older. Findings indicated that AMA is associated with adverse birth outcomes among women with and without health conditions compared with younger women with similar health status. Recommendations included improved screening and management of health conditions during pregnancy for older women, regardless of parity.
AHRQ-authored.
Citation: Berger BO, Wolfson C, Reid LD .
Adverse birth outcomes among women of advanced maternal age with and without health conditions in Maryland.
Womens Health Issues 2021 Jan-Feb;31(1):40-48. doi: 10.1016/j.whi.2020.08.008..
Keywords: Pregnancy, Newborns/Infants, Outcomes, Women, Risk
Rodriguez PJ, Roberts DA, Meisner J
Cost-effectiveness of dual maternal HIV and syphilis testing strategies in high and low HIV prevalence countries: a modelling study.
Dual HIV and syphilis testing might help to prevent mother-to-child transmission (MTCT) of HIV and syphilis through increased case detection and treatment. In this study, the investigators aimed to model and assess the cost-effectiveness of dual testing during antenatal care in four countries with varying HIV and syphilis prevalence. The authors concluded that incorporating dual rapid diagnostic tests in antenatal care could be cost-saving across countries with varying HIV prevalence.
AHRQ-funded; HS013853.
Citation: Rodriguez PJ, Roberts DA, Meisner J .
Cost-effectiveness of dual maternal HIV and syphilis testing strategies in high and low HIV prevalence countries: a modelling study.
Lancet Glob Health 2021 Jan;9(1):e61-e71. doi: 10.1016/s2214-109x(20)30395-8..
Keywords: Human Immunodeficiency Virus (HIV), Infectious Diseases, Prevention, Pregnancy, Women, Diagnostic Safety and Quality, Healthcare Costs
Wilson BL, Butler RJ
Identifying optimal labor and delivery nurse staffing: the case of cesarean births and nursing hours.
Numerous studies have identified a relationship between nurse staffing and adverse patient outcomes in medical / surgical patient populations. However, little is known about the impact of labor and delivery (L&D) nurse staffing and adverse birth outcomes, such as unintended cesarean delivery, in low-risk term-gestation women. In this study the investigators examined nurse staffing patterns on the likelihood of cesarean sections (C-sections) among low- risk, full gestation births and provided a testing framework to distinguish optimal from ineffective levels of nurse staffing.
AHRQ-funded; HS024607.
Citation: Wilson BL, Butler RJ .
Identifying optimal labor and delivery nurse staffing: the case of cesarean births and nursing hours.
Nurs Outlook 2021 Jan-Feb;69(1):84-95. doi: 10.1016/j.outlook.2020.07.003..
Keywords: Provider: Nurse, Provider, Workforce, Labor and Delivery, Pregnancy, Quality of Care, Risk, Women
Saldanha IJ, Cao W, Bhuma MR
Management of primary headaches during pregnancy, postpartum, and breastfeeding: a systematic review.
Primary headaches (migraine, tension headache, cluster headache, and other trigeminal autonomic cephalgias) are common in pregnancy and postpartum. It is unclear how to best and most safely manage them. In this study, the investigators conducted a systematic review (SR) of interventions to prevent or treat primary headaches in women who are pregnant, attempting to become pregnant, postpartum, or breastfeeding.
AHRQ-funded; 290201500002I.
Citation: Saldanha IJ, Cao W, Bhuma MR .
Management of primary headaches during pregnancy, postpartum, and breastfeeding: a systematic review.
Headache 2021 Jan;61(1):11-43. doi: 10.1111/head.14041..
Keywords: Pregnancy, Maternal Care, Care Management, Women, Evidence-Based Practice
Huth HB, Skeens R, Anders S
Health management in the home: a qualitative study of pregnant women and their caregivers.
This qualitative study examined how pregnant women and their caregivers managed health in their home. Participants filled out sociodemographic surveys and had semi-structured interviews about living situations, information needs, and technology use. The authors identified themes about health management, including the physical home, help at home, community, the virtual home, and largest concerns. Caregivers often did not know how to help expectant mothers and needed to learn new roles. Many expectant families did not trust online advice.
AHRQ-funded; HS021496.
Citation: Huth HB, Skeens R, Anders S .
Health management in the home: a qualitative study of pregnant women and their caregivers.
J Patient Exp 2020 Dec;7(6):1227-33. doi: 10.1177/2374373520948442..
Keywords: Pregnancy, Women, Home Healthcare, Caregiving
Henke RM, Karaca Z, Gibson TB
Medicaid Accountable Care Organizations and childbirth outcomes.
This study examined the impact of Accountable Care Organizations (ACOs) to childbirth outcomes. States that use Medicaid ACOs were compared with states that had not adopted ACO. Using HCUP data, the relationship between Medicaid ACO adoption and neonatal and maternal outcomes, and cost per birth was examined. Medicaid ACO implementation was associated with a moderate reduction in hospital costs per birth and decreased cesarean section rates with results varying by state. There was no association with other birth outcomes, including infant inpatient mortality, low birthweight, neonatal intensive care unit utilization and severe maternal morbidity.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Henke RM, Karaca Z, Gibson TB .
Medicaid Accountable Care Organizations and childbirth outcomes.
Med Care Res Rev 2020 Dec;77(6):559-73. doi: 10.1177/1077558718823132..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Health Insurance, Healthcare Costs, Labor and Delivery, Pregnancy, Women, Outcomes
Tilden EL, Phillippi JC, Carlson N
The association between longer durations of the latent phase of labor and subsequent perinatal processes and outcomes among midwifery patients.
The purpose of this study was to evaluate the association between the duration of the latent phase of labor and subsequent processes and outcomes. The investigators concluded that longer duration of the spontaneous latent phase of labor among women with low-risk pregnancies may signal longer total labor processes, leading to an increase in diagnosis of dystocia, interventions to manage dystocia, and epidural use. Apart from multiparous neonatal NICU admission, no other maternal or child morbidity outcomes were elevated with longer duration of the latent phase of labor.
AHRQ-funded; HS024733.
Citation: Tilden EL, Phillippi JC, Carlson N .
The association between longer durations of the latent phase of labor and subsequent perinatal processes and outcomes among midwifery patients.
Birth 2020 Dec;47(4):418-29. doi: 10.1111/birt.12494..
Keywords: Labor and Delivery, Pregnancy, Women, Outcomes
Leifheit KM, Schwartz GL, Pollack CE
Severe housing insecurity during pregnancy: association with adverse birth and infant outcomes.
This study measured the association of severe housing insecurity with adverse birth and infant outcomes. Data was analyzed from 3248 mother-infant dyads enrolled in the Fragile Families and Child Wellbeing Study. This prospective cohort study represented births in 20 large U.S. cities from 1998 to 2000. Severe housing insecurity was defined as threatened eviction or homelessness. Adverse outcomes included low birth weight and/or preterm birth, admission to a neonatal intensive care unit (NICU) or stepdown facility, extended hospitalization after delivery, and infant health and temperament. There were statistically significant associations found between severe housing insecurity during pregnancy and low birth weight and/or preterm births. Housing insecurity and infant fair or poor health and poor temperament were not found to have statistically significant associations. Population attributable fraction (PAF) estimates suggested that up to 3% of adverse birth and infant outcomes could be avoided by eliminating severe housing insecurity among low-income, pregnant women.
AHRQ-funded; HS000046.
Citation: Leifheit KM, Schwartz GL, Pollack CE .
Severe housing insecurity during pregnancy: association with adverse birth and infant outcomes.
Int J Environ Res Public Health 2020 Nov 21;17(22):8659. doi: 10.3390/ijerph17228659..
Keywords: Pregnancy, Labor and Delivery, Vulnerable Populations, Outcomes, Adverse Events, Women, Low-Income, Newborns/Infants
Geissler K, Ranchoff BL, Cooper MI
Association of insurance status with provision of recommended services during comprehensive postpartum visits.
Investigators examined rates of recommended services during the comprehensive postpartum visits and differences by insurance type. Data was taken from annual National Ambulatory Medical Care Surveys. Their findings suggested that receipt of recommended services during comprehensive postpartum visits was less than 50% for most services and was similar across insurance types. These findings underscored the importance of efforts to reconceptualize postpartum care to ensure that women have access to a range of supports to manage their health during this sensitive period.
AHRQ-funded; HS025515.
Citation: Geissler K, Ranchoff BL, Cooper MI .
Association of insurance status with provision of recommended services during comprehensive postpartum visits.
JAMA Netw Open 2020 Nov 2;3(11):e2025095. doi: 10.1001/jamanetworkopen.2020.25095..
Keywords: Maternal Care, Pregnancy, Women, Health Insurance, Access to Care, Healthcare Utilization
Dalton VK, Moniz MH, Bailey MJ
Trends in birth rates after elimination of cost sharing for contraception by the Patient Protection and Affordable Care Act.
Researchers evaluated changes in birth rates by income level among commercially insured women before (2008-2013) and after (2014-2018) the elimination of cost sharing for contraception under the Patient Protection and Affordable Care Act (ACA). The analytic sample included over 4.5 million women enrolled in 47,721 health plans. In this cross-sectional study, the researchers found that the elimination of cost sharing for contraception under the ACA was associated with improvements in contraceptive method prescription fills and a decrease in births among commercially insured women. Women with low income had more precipitous decreases than women with higher income, suggesting that enhanced access to contraception may address well-documented income-related disparities in unintended birth rates.
AHRQ-funded; HS025465; HS023784.
Citation: Dalton VK, Moniz MH, Bailey MJ .
Trends in birth rates after elimination of cost sharing for contraception by the Patient Protection and Affordable Care Act.
JAMA Netw Open 2020 Nov 2;3(11):e2024398. doi: 10.1001/jamanetworkopen.2020.24398..
Keywords: Policy, Health Insurance, Women, Healthcare Costs, Pregnancy, Sexual Health
Mehra R, Boyd LM, Magriples U
Black pregnant women "get the most judgment": a qualitative study of the experiences of Black women at the intersection of race, gender, and pregnancy.
This qualitative study examined the experiences of Black pregnant women and how being stereotyped can cause stress. Semistructured interviews with 24 Black pregnant women in New Haven, Connecticut was conducted. The women were asked about their experience of being pregnant, experiences of gendered racism, and concerns related to pregnancy and parenting Black children. Many of the women experienced gendered racism stigmatizing Black motherhood that devalued Black pregnancies. They reported encountering assumptions that they were poor, single, and had multiple children regardless of socioeconomic status, marital status, or parity. This pregnancy stigma occurred in everyday, health care, social services, and housing-related contexts. This may contribute to poorer maternal and infant outcomes by way of reduced access to quality health care; impediments to services, resources, and social support; and poorer psychological health. Interventions to combat this problem include anti-bias training for health care and social service providers; screening for racialized pregnancy stigma and providing evidence-based coping strategy; creating pregnancy support groups; and developing broader societal discourse that values Black women and their pregnancies.
AHRQ-funded; HS017589.
Citation: Mehra R, Boyd LM, Magriples U .
Black pregnant women "get the most judgment": a qualitative study of the experiences of Black women at the intersection of race, gender, and pregnancy.
Womens Health Issues 2020 Nov-Dec;30(6):484-92. doi: 10.1016/j.whi.2020.08.001..
Keywords: Pregnancy, Women, Racial and Ethnic Minorities
Guglielminotti J, Li G
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
This retrospective cohort study evaluated the risk of general anesthesia use in cesarean delivery versus neuraxial anesthesia on maternal mental health. Cesarean deliveries performed in New York State hospitals between 2006 and 2013 were included. Exclusion criteria included having more than 1 cesarean delivery during the study period, residing outside of New York State, and having a general anesthetic for other surgery or delivery in the year before or after the index case. The primary outcome looked at was severe postpartum depression (PPD), and secondary outcomes were suicidal ideation, anxiety disorders, and posttraumatic stress disorder (PTSD). The majority of cesareans used neuraxial anesthesia and only 8% (34,356) had general anesthesia. Severe PPD requiring hospitalization occurred in 1158 women with 60% identified during readmission. General anesthesia was found to be associated with a 54% increased odds of PPD, and a 91% increased odds of suicidal ideation or self-inflicted injury. There was insufficient evidence for increased risk of anxiety orders.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Li G .
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
Anesth Analg 2020 Nov;131(5):1421-29. doi: 10.1213/ane.0000000000004663..
Keywords: Labor and Delivery, Pregnancy, Women, Depression, Behavioral Health, Surgery, Risk, Hospitalization, Medication, Adverse Drug Events (ADE), Adverse Events