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
26 to 50 of 62 Research Studies DisplayedFletcher GE, Teeters L, Schlundt D
Maternal conception of gestational weight gain among Latinas: a qualitative study.
The objective of this study was to develop a model of how pregnant Latinas- who have a higher risk of poor maternal and neonatal weight-related outcomes- conceptualize healthy gestational weight gain, providing guidance for future interventions. The investigators suggest that women's sociocultural and interpersonal context influence weight-related behaviors through the lens of personal health schemas and assert that understanding how cognitive aspects relate to traditional behavioral determinants suggested several opportunities for intervention.
AHRQ-funded; HS022990.
Citation: Fletcher GE, Teeters L, Schlundt D .
Maternal conception of gestational weight gain among Latinas: a qualitative study.
Health Psychol 2018 Feb;37(2):132-38. doi: 10.1037/hea0000555..
Keywords: Pregnancy, Racial and Ethnic Minorities, Women
Jou J, Kozhimannil KB, Abraham JM
Paid maternity leave in the United States: associations with maternal and infant health.
Using data from Listening to Mothers III, a national survey of women ages 18-45 who gave birth in 2011-2012, the investigators conducted multivariate logistic regression to predict the likelihood of outcomes related to infant health, maternal physical and mental health, and maternal health behaviors by the use and duration of paid maternity leave. They concluded that Practice Paid maternity leave significantly predicted lower odds of maternal and infant re-hospitalization and higher odds of doing well with exercise and stress management.
AHRQ-funded; HS023950.
Citation: Jou J, Kozhimannil KB, Abraham JM .
Paid maternity leave in the United States: associations with maternal and infant health.
Matern Child Health J 2018 Feb;22(2):216-25. doi: 10.1007/s10995-017-2393-x..
Keywords: Maternal Care, Newborns/Infants, Policy, Pregnancy, Women
Lundsberg LS, Lee HC, Duenas GV
Quality assurance practices in obstetric care: a survey of hospitals in California.
The purpose of this study was to assess hospital practices in obstetric quality management activities and identify institutional characteristics associated with utilization of evidence-supported practices. The investigators found that hospitals in California engage in a wide range of practices to assure or improve quality of obstetric care, but substantial variation in practice exists among hospitals.
AHRQ-funded; HS023801.
Citation: Lundsberg LS, Lee HC, Duenas GV .
Quality assurance practices in obstetric care: a survey of hospitals in California.
Obstet Gynecol 2018 Feb;131(2):214-23. doi: 10.1097/aog.0000000000002437..
Keywords: Quality of Care, Pregnancy, Practice Patterns, Women
Mabry-Hernandez I, Romano MJ
AHRQ Author: Mabry-Hernandez I
Screening for preeclampsia.
A 28-year-old white woman comes to your clinic for prenatal care reporting a new-onset severe headache. She is currently pregnant with twins at an estimated gestational age of 22 weeks. Her obstetric history is significant for one previous term singleton vaginal delivery at 24 years of age without complications. This case study poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Mabry-Hernandez I, Romano MJ .
Screening for preeclampsia.
Am Fam Physician 2018 Jan 15;97(2):117-18.
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Keywords: Blood Pressure, Case Study, Maternal Care, Pregnancy, U.S. Preventive Services Task Force (USPSTF)
Santos P, Hefele JG, Ritter G
Population-based risk factors for shoulder dystocia.
This retrospective observational study examined population-based risk factors for infant shoulder dystocia during labor. Five hospitals in 5 states were used and over 19,000 births evaluated between April 2011 and July 2013. An increased risk for dystocia was found for women who were prescribed insulin, indicating gestational diabetes. However this was not true of women with gestational diabetes who were not prescribed insulin. Other risk factors included being Black, Hispanic, covered by Medicaid or no insurance, infant gestational age of 41 weeks or greater, and chronic diabetes.
AHRQ-funded; HS019608.
Citation: Santos P, Hefele JG, Ritter G .
Population-based risk factors for shoulder dystocia.
J Obstet Gynecol Neonatal Nurs 2018 Jan;47(1):32-42. doi: 10.1016/j.jogn.2017.11.011..
Keywords: Labor and Delivery, Newborns/Infants, Risk, Pregnancy, Injuries and Wounds, Adverse Events
Hantsoo L, Criniti S, Khan A
A mobile application for monitoring and management of depressed mood in a vulnerable pregnant population.
The researchers tested whether a mood tracking and alert (MTA) mobile application (app) improved mental health care delivery in a high-risk obstetric population. They found that a mobile MTA app improved service delivery and patient engagement among patients with perinatal depression symptoms.
AHRQ-funded; HS022441.
Citation: Hantsoo L, Criniti S, Khan A .
A mobile application for monitoring and management of depressed mood in a vulnerable pregnant population.
Psychiatr Serv 2018 Jan;69(1):104-07. doi: 10.1176/appi.ps.201600582.
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Keywords: Healthcare Delivery, Depression, Pregnancy, Telehealth, Vulnerable Populations
Palmsten K, Hulugalle A, Bandoli G
Agreement between maternal report and medical records during pregnancy: medications for rheumatoid arthritis and asthma.
This study examined the agreement between maternal report and medical records during pregnancy for rheumatoid arthritis and asthma-related medications. The investigators concluded that agreement was higher for medications typically used continuously than sporadically. Information on medication use from medical records alone may not be adequate when studying the impact of intermittently used medications during pregnancy on perinatal outcomes.
AHRQ-funded; HS018474.
Citation: Palmsten K, Hulugalle A, Bandoli G .
Agreement between maternal report and medical records during pregnancy: medications for rheumatoid arthritis and asthma.
Paediatr Perinat Epidemiol 2018 Jan;32(1):68-77. doi: 10.1111/ppe.12415..
Keywords: Asthma, Medication, Pregnancy, Arthritis
Phillippi JC, Hartmann KE
Differentiating research, quality improvement, and case studies to ethically incorporate pregnant women.
This article discusses the need to involve pregnant women in research, quality improvement, and case studies and how to involve them in an ethical way with high standards to protect participants. This review includes vignettes to distinguish between the different types of studies and emphasizes that perinatal care providers will need to seek institutional review board approval for all research to be conducted.
AHRQ-funded; HS024733.
Citation: Phillippi JC, Hartmann KE .
Differentiating research, quality improvement, and case studies to ethically incorporate pregnant women.
J Midwifery Womens Health 2018 Jan;63(1):104-14. doi: 10.1111/jmwh.12673..
Keywords: Health Services Research (HSR), Healthcare Delivery, Maternal Care, Pregnancy, Quality of Care, Quality Improvement, Research Methodologies, Women
Phillippi JC, Danhausen K, Alliman J
Neonatal outcomes in the birth center setting: a systematic review.
This systematic review examined the effects of the birth center setting on neonatal mortality in economically developed countries. The criteria for inclusion included being in English, published after 1980 and in countries with similar guidelines to the American Association of Birth Centers Standards. The only measure used was neonatal mortality and results did not find any difference between using a birth center as opposed to a traditional hospital setting. The literature was not found to have many good quality studies, and further research is recommended.
AHRQ-funded; HS024733.
Citation: Phillippi JC, Danhausen K, Alliman J .
Neonatal outcomes in the birth center setting: a systematic review.
J Midwifery Womens Health 2018 Jan;63(1):68-89. doi: 10.1111/jmwh.12701..
Keywords: Evidence-Based Practice, Labor and Delivery, Mortality, Newborns/Infants, Outcomes, Pregnancy, Women
Sanders BD, Davis MG, Holley SL
Pregnancy-associated stroke.
This article reviews assessment and treatment of pregnant and postpartum women experiencing stroke. There are 2 main types of stroke, ischemic and hemorrhagic that present similar symptoms but have very different pathophysiology and treatment. This article provides guidance for subsequent maternity and primary care for front-line perinatal care providers.
AHRQ-funded; HS024733.
Citation: Sanders BD, Davis MG, Holley SL .
Pregnancy-associated stroke.
J Midwifery Womens Health 2018 Jan;63(1):23-32. doi: 10.1111/jmwh.12720..
Keywords: Cardiovascular Conditions, Maternal Care, Pregnancy, Primary Care, Risk, Stroke, Women
Upadhya KK, Burke AE, Marcell AV
AHRQ Author: Mistry K
Contraceptive service needs of women with young children presenting for pediatric care.
The primary objective of this study was to characterize the need for contraceptive services and contraceptive method use among women with young children presenting to child health clinics. It found that most women presenting with young children for pediatric care indicated that they were not currently trying to become pregnant and reported current methods of pregnancy prevention that ranged from none to highly effective.
AHRQ-authored.
Citation: Upadhya KK, Burke AE, Marcell AV .
Contraceptive service needs of women with young children presenting for pediatric care.
Contraception 2015 Nov;92(5):508-12. doi: 10.1016/j.contraception.2015.07.004..
Keywords: Pregnancy, Women, Sexual Health
Patnode CD, Henderson JT, Thompson JH
Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: a review of reviews for the U.S. Preventive Services Task Force.
The researchers reviewed the effectiveness and safety of pharmacotherapy and behavioral interventions for tobacco cessation. They concluded that behavioral and pharmacotherapy interventions improve rates of smoking cessation among the general adult population, alone or in combination. Data on the effectiveness and safety of electronic nicotine delivery systems are limited.
AHRQ-funded; 290201200015I.
Citation: Patnode CD, Henderson JT, Thompson JH .
Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: a review of reviews for the U.S. Preventive Services Task Force.
Ann Intern Med 2015 Oct 20;163(8):608-21. doi: 10.7326/m15-0171..
Keywords: Behavioral Health, Evidence-Based Practice, Medication, Pregnancy, Prevention, Tobacco Use, U.S. Preventive Services Task Force (USPSTF), Women
Cha S, Chapman DA, Wan W
Intimate partner violence and postpartum contraceptive use: the role of race/ethnicity and prenatal birth control counseling.
The objective of the study was to examine the extent to which intimate partner violence (IPV) around the time of pregnancy is associated with postpartum contraceptive use among women in the United States. Approximately 6.2 percent of women reported IPV, and 15.5 percent reported no postpartum contraceptive use. Regardless of the timing of abuse, IPV-exposed women were significantly less likely to report contraceptive use after delivery.
AHRQ-funded; HS023724.
Citation: Cha S, Chapman DA, Wan W .
Intimate partner violence and postpartum contraceptive use: the role of race/ethnicity and prenatal birth control counseling.
Contraception 2015 Sep;92(3):268-75. doi: 10.1016/j.contraception.2015.04.009..
Keywords: Domestic Violence, Sexual Health, Women, Pregnancy
Swanson SA, Hernandez-Diaz S, Palmsten K
Methodological considerations in assessing the effectiveness of antidepressant medication continuation during pregnancy using administrative data.
The goal of this study is to evaluate whether standard administrative claims data can be used to evaluate the effectiveness of antidepressants. Its findings suggest that either antidepressant medications do not reduce the risk of depression relapse in pregnant women, or that administrative data alone could not be used to validly estimate the effectiveness of psychotropic medications during pregnancy.
AHRQ-funded; HS018533.
Citation: Swanson SA, Hernandez-Diaz S, Palmsten K .
Methodological considerations in assessing the effectiveness of antidepressant medication continuation during pregnancy using administrative data.
Pharmacoepidemiol Drug Saf 2015 Sep;24(9):934-42. doi: 10.1002/pds.3798..
Keywords: Medication, Comparative Effectiveness, Pregnancy
Pu J, Zhao B, Wang EJ
Racial/ethnic differences in gestational diabetes prevalence and contribution of common risk factors.
This study aimed to assess racial/ethnic differences in relative contribution of risk factors of gestational diabetes mellitus (GDM) among Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese), Hispanics, non-Hispanic blacks, and non-Hispanic whites. It found that GDM was most prevalent among Asian Indians (19.3 percent). Relative risks were similar across all race/ethnic groups.
AHRQ-funded; HS019815.
Citation: Pu J, Zhao B, Wang EJ .
Racial/ethnic differences in gestational diabetes prevalence and contribution of common risk factors.
Paediatr Perinat Epidemiol 2015 Sep;29(5):436-43. doi: 10.1111/ppe.12209.
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Keywords: Diabetes, Obesity, Pregnancy, Racial and Ethnic Minorities, Risk, Women
Palmsten K, Hernandez-Diaz S, Chambers CD
The most commonly dispensed prescription medications among pregnant women enrolled in the U.S. Medicaid program.
The researchers characterize the 20 most common prescription medications and the 10 most common prescription medications classified in the former U.S. Food and Drug Administration categories D or X dispensed to pregnant women enrolled in the U.S. Medicaid program. They found that medications used to treat infections were the most commonly dispensed prescription medications.
AHRQ-funded; HS018533.
Citation: Palmsten K, Hernandez-Diaz S, Chambers CD .
The most commonly dispensed prescription medications among pregnant women enrolled in the U.S. Medicaid program.
Obstet Gynecol 2015 Sep;126(3):465-73. doi: 10.1097/aog.0000000000000982..
Keywords: Medicaid, Pregnancy, Medication
Bateman BT, Huybrechts KF, Maeda A
Calcium channel blocker exposure in late pregnancy and the risk of neonatal seizures.
This study assessed whether maternal calcium channel blocker exposure during late pregnancy is independently associated with neonatal seizures after carefully controlling for confounding factors. It found no significant increase in the risk of neonatal seizures in neonates attributable to maternal calcium channel blocker exposure in late pregnancy.
AHRQ-funded; HS018533.
Citation: Bateman BT, Huybrechts KF, Maeda A .
Calcium channel blocker exposure in late pregnancy and the risk of neonatal seizures.
Obstet Gynecol 2015 Aug;126(2):271-8. doi: 10.1097/aog.0000000000000908..
Keywords: Pregnancy, Adverse Events, Medication, Patient-Centered Outcomes Research, Newborns/Infants
Shorten A, Fagerlin A, Illuzzi J
Developing an Internet-based decision aid for women choosing between vaginal birth after cesarean and planned repeat cesarean.
This article is part of a series that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. The authors outlined a framework and process used to create an Internet-based decision aid about birth choices after previous cesarean. They transformed a paper-based decision aid into a secure, interactive Web site to meet the diverse needs of women and providers.
AHRQ-funded; HS022114.
Citation: Shorten A, Fagerlin A, Illuzzi J .
Developing an Internet-based decision aid for women choosing between vaginal birth after cesarean and planned repeat cesarean.
J Midwifery Womens Health 2015 Jul-Aug;60(4):390-400. doi: 10.1111/jmwh.12298.
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Keywords: Shared Decision Making, Health Information Technology (HIT), Pregnancy, Web-Based, Women
Scifres CM, Abebe KZ, Jones KA
Gestational diabetes diagnostic methods (GD2M) pilot randomized trial.
The researchers tested the feasibility of conducting a pragmatic randomized controlled trial (RCT) comparing the International Association of Diabetes in Pregnancy Study Groups (IADPSG) versus Carpenter-Coustan diagnostic criteria for gestational diabetes (GDM), and examined patient and provider views on GDM screening. They found that both pregnant women and providers value GDM screening, and pregnant women can be recruited to a blinded, randomized GDM screening trial with minimal attrition and missing data.
AHRQ-funded; HS019461.
Citation: Scifres CM, Abebe KZ, Jones KA .
Gestational diabetes diagnostic methods (GD2M) pilot randomized trial.
Matern Child Health J 2015 Jul;19(7):1472-80. doi: 10.1007/s10995-014-1651-4..
Keywords: Diabetes, Diagnostic Safety and Quality, Pregnancy, Screening, Women
Tang JW, Foster KE, Pumarino J
Perspectives on prevention of type 2 diabetes after gestational diabetes: a qualitative study of Hispanic, African-American and White women.
This qualitative study explored the perspectives of Hispanic, African-American, and White women affected by gestational diabetes mellitus (GDM). The goal is for this work to inform the development of effective approaches to engage diverse populations affected by GDM in taking steps to reduce their risk for type 2 diabetes mellitus.
AHRQ-funded; HS021141.
Citation: Tang JW, Foster KE, Pumarino J .
Perspectives on prevention of type 2 diabetes after gestational diabetes: a qualitative study of Hispanic, African-American and White women.
Matern Child Health J 2015 Jul;19(7):1526-34. doi: 10.1007/s10995-014-1657-y..
Keywords: Diabetes, Lifestyle Changes, Pregnancy, Prevention, Racial and Ethnic Minorities, Risk, Women
Jack B, Bickmore T, Hempstead M
Reducing preconception risks among African American women with conversational agent technology.
The researchers developed and tested “Gabby,” an online preconception conversational agent system, in a 6-month randomized controlled trial of non-pregnant African American women, most in college, to determine how well Gabby works and to identify additional areas for improvement. They found that Gabby was significantly associated with preconception risk reduction.
AHRQ-funded; 290200600012I.
Citation: Jack B, Bickmore T, Hempstead M .
Reducing preconception risks among African American women with conversational agent technology.
J Am Board Fam Med 2015 Jul-Aug;28(4):441-51. doi: 10.3122/jabfm.2015.04.140327..
Keywords: Disparities, Health Promotion, Risk, Pregnancy
Huybrechts KF, Bateman BT, Palmsten K
Antidepressant use late in pregnancy and risk of persistent pulmonary hypertension of the newborn.
This study examined the risk of persistent pulmonary hypertension of the Newborn (PPHN) associated with exposure to different antidepressant medication classes late in pregnancy. Its findings suggest that the risk of PPHN associated with late pregnancy exposure to selective serotonin reuptake inhibitor antidepressants—if present—is smaller than previous studies.
AHRQ-funded; HS018533.
Citation: Huybrechts KF, Bateman BT, Palmsten K .
Antidepressant use late in pregnancy and risk of persistent pulmonary hypertension of the newborn.
JAMA 2015 Jun 2;313(21):2142-51. doi: 10.1001/jama.2015.5605..
Keywords: Medication, Newborns/Infants, Pregnancy, Risk
Cavazos-Rehg PA, Krauss MJ, Spitznagel EL
Maternal age and risk of labor and delivery complications.
The researchers examined associations between maternal age and prevalence of maternal morbidity during complications of labor and delivery. Using HCUP data, they found that complications with the highest odds among women 11-18 years of age included preterm delivery, chorioamnionitis, endometritis, and mild preeclampsia. Pregnant women 15-19 years old had greater odds for severe preeclampsia, eclampsia, postpartum hemorrhage, poor fetal growth, and fetal distress. Pregnant women 35 and older had greater odds for preterm delivery, hypertension, superimposed preeclampsia, severe preeclampsia, and decreased risk for chorioamnionitis. Women over 40 had increased odds for mild preeclampsia, fetal distress, and poor fetal growth.
AHRQ-funded; HS019455.
Citation: Cavazos-Rehg PA, Krauss MJ, Spitznagel EL .
Maternal age and risk of labor and delivery complications.
Matern Child Health J 2015 Jun;19(6):1202-11. doi: 10.1007/s10995-014-1624-7.
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Keywords: Adverse Events, Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Pregnancy, Risk
Witt WP, Mandell KC, Wisk LE
Predictors of alcohol and tobacco use prior to and during pregnancy in the US: the role of maternal stressors.
The purpose of the study was to understand the association between stressful life events prior to conception (PSLEs) and women’s alcohol and tobacco use prior to and during pregnancy, and the continuation of such use through pregnancy. It finds that PSLEs are associated with increased tobacco use prior to and during pregnancy, as well as an increased amount of alcohol use during pregnancy among U.S. women.
AHRQ-funded; HS000063; HS000083.
Citation: Witt WP, Mandell KC, Wisk LE .
Predictors of alcohol and tobacco use prior to and during pregnancy in the US: the role of maternal stressors.
Arch Womens Ment Health 2015 Jun;18(3):523-37. doi: 10.1007/s00737-014-047-9.
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Keywords: Pregnancy, Lifestyle Changes, Alcohol Use, Tobacco Use, Maternal Care
Desai RJ, Huybrechts KF, Hernandez-Diaz S
Exposure to prescription opioid analgesics in utero and risk of neonatal abstinence syndrome: population based cohort study.
The study’s objective was to provide risk estimates of neonatal abstinence syndrome (NAS) based on prescription opioid duration and timing of use during pregnancy in the presence or absence of additional risk factors for NAS. It found that the risk of NAS is higher in women using long term prescription opioids when there is a history of drug or alcohol misuse and smoking.
AHRQ-funded; HS018533.
Citation: Desai RJ, Huybrechts KF, Hernandez-Diaz S .
Exposure to prescription opioid analgesics in utero and risk of neonatal abstinence syndrome: population based cohort study.
BMJ 2015 May 14;350:h2102. doi: 10.1136/bmj.h2102..
Keywords: Newborns/Infants, Substance Abuse, Pregnancy, Risk