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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
251 to 275 of 289 Research Studies DisplayedShorten 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
Camelo Castillo W, Boggess K, Sturmer T
Association of adverse pregnancy outcomes with glyburide vs insulin in women with gestational diabetes.
The purpose of this study was to estimate the risks of adverse pregnancy outcomes among women receiving glyburide compared with insulin for the treatment of gestational diabetes mellitus (GDM) in a US population-based cohort. It found an association between glyburide (compared with insulin) and elevated risk of NICU admission, neonatal hypoglycemia, respiratory distress, birth injury, and large for gestational age in women with GDM.
AHRQ-funded; HS017950.
Citation: Camelo Castillo W, Boggess K, Sturmer T .
Association of adverse pregnancy outcomes with glyburide vs insulin in women with gestational diabetes.
JAMA Pediatr 2015 May;169(5):452-8. doi: 10.1001/jamapediatrics.2015.74..
Keywords: Adverse Drug Events (ADE), Adverse Events, Comparative Effectiveness, Diabetes, Labor and Delivery, Maternal Care, Medication, Newborns/Infants, Outcomes, Pregnancy, Women
Witt WP, Park H, Wisk LE
Neighborhood disadvantage, preconception stressful life events, and infant birth weight.
This study investigated the impact of neighborhood conditions on the association between stressful life events prior to pregnancy and birth weight in a national sample of women living in the United States. It found that women who experienced preconception stressful life events, who had chronic conditions, or were racial/ethnic minorities had the greatest risk of having very low birth weight infants if they lived in disadvantaged neighborhoods.
AHRQ-funded; HS000083; HS000063
Citation: Witt WP, Park H, Wisk LE .
Neighborhood disadvantage, preconception stressful life events, and infant birth weight.
Am J Public Health 2015 May;105(5):1044-52. doi: 10.2105/ajph.2015.302566.
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Keywords: Pregnancy, Social Determinants of Health, Chronic Conditions
Leis JA, Solomon BS, Wasserman KE
Preventing postpartum depression in a pediatric primary care clinic: a pilot study.
The goal of this study was to integrate an evidence-based preventive intervention for perinatal depression—the Mothers and Babies (MB) Course—into a pediatric primary care clinic serving low-income, minority families, and to explore intervention acceptability and preliminary outcomes. Findings from this pilot study provide preliminary evidence for the acceptability and feasibility of implementing an evidence-based preventive intervention for postpartum depression.
AHRQ-funded; HS017596.
Citation: Leis JA, Solomon BS, Wasserman KE .
Preventing postpartum depression in a pediatric primary care clinic: a pilot study.
Clin Pediatr 2015 May;54(5):487-90. doi: 10.1177/0009922814536775..
Keywords: Pregnancy, Primary Care, Evidence-Based Practice, Low-Income, Racial and Ethnic Minorities
Cantor AG, Bougatsos C, Blazina I
Routine iron supplementation and screening for iron deficiency anemia in pregnancy: a systematic review for the U.S. Preventive Services Task Force.
This study reviews screening and supplementation for iron deficiency anemia in pregnancy. Prevalence in the U.S. rises to 28.4 percent in the final trimester from 5 percent in early pregnancy. There is inconclusive evidence that prenatal iron supplementation improves maternal or infant health outcomes, but supplementation may improve maternal hematological indices.
AHRQ-funded; 290201200015I
Citation: Cantor AG, Bougatsos C, Blazina I .
Routine iron supplementation and screening for iron deficiency anemia in pregnancy: a systematic review for the U.S. Preventive Services Task Force.
Ann Intern Med. 2015 Apr 21;162(8):566-76. doi: 10.7326/m14-2932..
Keywords: U.S. Preventive Services Task Force (USPSTF), Pregnancy, Vitamins and Supplements, Screening
Margulis AV, Palmsten K, Andrade SE
Beginning and duration of pregnancy in automated health care databases: review of estimation methods and validation results.
The authors describe methods reported in the literature to estimate the beginning or duration of pregnancy in automated health care data, and to present results of validation exercises where available. They concluded that a number of methods of varying complexity are available to estimate them. Validation studies have been performed for many of them and can serve as a guide for method selection for a particular study.
AHRQ-funded; HS018533.
Citation: Margulis AV, Palmsten K, Andrade SE .
Beginning and duration of pregnancy in automated health care databases: review of estimation methods and validation results.
Pharmacoepidemiol Drug Saf 2015 Apr;24(4):335-42. doi: 10.1002/pds.3743..
Keywords: Pregnancy, Comparative Effectiveness, Data
Metz TD, Allshouse AA, Faucett AM
Validation of a vaginal birth after cesarean delivery prediction model in women with two prior cesarean deliveries.
This study evaluated whether an existing vaginal birth after cesarean (VBAC) prediction model validated for women with one prior cesarean delivery also accurately predicts the likelihood of VBAC in women with two prior cesarean deliveries. It found that the estimates of VBAC success based on the Maternal-Fetal Medicines Units prediction model are similar to the actual rates observed among women with two prior cesarean deliveries.
AHRQ-funded; HS022143.
Citation: Metz TD, Allshouse AA, Faucett AM .
Validation of a vaginal birth after cesarean delivery prediction model in women with two prior cesarean deliveries.
Obstet Gynecol 2015 Apr;125(4):948-52. doi: 10.1097/aog.0000000000000744..
Keywords: Labor and Delivery, Pregnancy, Women
Bateman BT, Hernandez-Diaz S, Fischer MA
Statins and congenital malformations: cohort study.
The researchers undertook an epidemiologic study to assess the association between statin use in the first trimester and the risk of congenital malformations, using data derived from a large cohort of Medicaid beneficiaries. They found that women taking statins during the first trimester of pregnancy were at an increased risk of delivering an infant with malformations. The association was explained by underlying characteristics of users, mainly pre-existing diabetes.
AHRQ-funded; HS018533.
Citation: Bateman BT, Hernandez-Diaz S, Fischer MA .
Statins and congenital malformations: cohort study.
BMJ 2015 Mar 17;350:h1035. doi: 10.1136/bmj.h1035..
Keywords: Pregnancy, Medication, Risk, Newborns/Infants
Bateman BT, Huybrechts KF, Fischer MA
Chronic hypertension in pregnancy and the risk of congenital malformations: a cohort study.
The researchers sought to examine the effect of chronic hypertension on the risk of congenital malformations in a large cohort of pregnancies in Medicaid beneficiaries. In a cohort of 878,126 pregnancies, they found that both treated and untreated maternal chronic hypertension were associated with a similar 20-30 percent increase in the risk of congenital malformations in the infant after adjusting for confounding factors as compared with normotensive controls.
AHRQ-funded; HS018533.
Citation: Bateman BT, Huybrechts KF, Fischer MA .
Chronic hypertension in pregnancy and the risk of congenital malformations: a cohort study.
Am J Obstet Gynecol 2015 Mar;212(3):337.e1-14. doi: 10.1016/j.ajog.2014.09.031..
Keywords: Blood Pressure, Chronic Conditions, Pregnancy, Risk, Maternal Care, Women
Dalton VK, Liang A, Hutton DW
Beyond usual care: the economic consequences of expanding treatment options in early pregnancy loss.
The objective of this study was to estimate the economic consequences of expanding options for early pregnancy loss treatment beyond expectant management and operating room surgical evacuation (usual care). It found that the cost per case was $241.29 lower for women undergoing treatment in the expanded care model as compared with the usual care model.
AHRQ-funded; HS015491.
Citation: Dalton VK, Liang A, Hutton DW .
Beyond usual care: the economic consequences of expanding treatment options in early pregnancy loss.
Am J Obstet Gynecol 2015 Feb;212(2):177.e1-6. doi: 10.1016/j.ajog.2014.08.031..
Keywords: Healthcare Costs, Pregnancy, Treatments, Ambulatory Care and Surgery
Salihu HM, Mogos MF, Salinas-Miranda AA
National trends in maternal use of opioid drugs among pregnancy-related hospitalizations in the United States, 1998 to 2009.
AHRQ-funded; HS019997.
Citation: Salihu HM, Mogos MF, Salinas-Miranda AA .
National trends in maternal use of opioid drugs among pregnancy-related hospitalizations in the United States, 1998 to 2009.
Am J Perinatol 2015 Feb;32(3):289-98. doi: 10.1055/s-0034-1384642..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Medication, Opioids, Pregnancy
Witt WP, Wisk LE, Cheng ER
Determinants of cesarean delivery in the US: a lifecourse approach.
The researchers sought to determine whether the effects of preconception stressful life events (PSLEs) on birth weight differed by neighborhood disadvantage. They found that the risk of having very low birthweight infants among women with PSLEs, women with chronic conditions, or minority women was strongest among those living in disadvantaged neighborhoods, which suggests exacerbation of risk within disadvantaged environments.
AHRQ-funded; HS000083; HS000063.
Citation: Witt WP, Wisk LE, Cheng ER .
Determinants of cesarean delivery in the US: a lifecourse approach.
Matern Child Health J 2015 Jan;19(1):84-93. doi: 10.1007/s10995-014-1498-8..
Keywords: Labor and Delivery, Maternal Care, Pregnancy, Risk, Social Determinants of Health
Fleisch AF, Rifas-Shiman SL, Koutrakis P
Prenatal exposure to traffic pollution: associations with reduced fetal growth and rapid infant weight gain.
The authors explored air pollution exposure implications for postnatal growth. They found that infants exposed to the highest quartile of neighborhood traffic density had lower fetal growth, more rapid 0- to 6-month weight-for-length gain, and higher odds of weight-for-length ≥95th percentile at 6 months. Neighborhood traffic density was additionally associated with an infant being in both the lowest quartile of fetal growth and the highest quartile of 0- to 6-month weight-for-length gain.
AHRQ-funded; HS000063.
Citation: Fleisch AF, Rifas-Shiman SL, Koutrakis P .
Prenatal exposure to traffic pollution: associations with reduced fetal growth and rapid infant weight gain.
Epidemiology 2015 Jan;26(1):43-50. doi: 10.1097/ede.0000000000000203.
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Keywords: Newborns/Infants, Newborns/Infants, Obesity, Pregnancy, Risk
Turan B, Stringer KL, Onono M
Linkage to HIV care, postpartum depression, and HIV-related stigma in newly diagnosed pregnant women living with HIV in Kenya: a longitudinal observational study.
The investigators examined associations between linkage to HIV care, postpartum depression, and internalized stigma in a population with a high risk of depression: newly diagnosed HIV-positive pregnant women. They found that, in this study group of women from rural Kenya, at 6 weeks postpartum, those who had not linked to HIV care after testing positive at their first antenatal visit had higher levels of depression and internalized stigma, compared to women who had linked to care. Internalized stigma mediated the effect of linkage to care on depression. Furthermore, participants who had both linked to HIV care and initiated antiretroviral therapy reported the lowest levels of depressive symptoms.
AHRQ-funded; HS013852.
Citation: Turan B, Stringer KL, Onono M .
Linkage to HIV care, postpartum depression, and HIV-related stigma in newly diagnosed pregnant women living with HIV in Kenya: a longitudinal observational study.
BMC Pregnancy Childbirth 2014 Dec 3;14:400. doi: 10.1186/s12884-014-0400-4.
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Keywords: Depression, Human Immunodeficiency Virus (HIV), Pregnancy, Social Stigma
Fowler TT, Schiff J, Applegate MS
Early elective deliveries accounted for nearly 9 percent of births paid for by Medicaid.
The authors reported the results of a perinatal project, led by the state Medicaid medical directors, that sought to coordinate quality improvement efforts related to early elective deliveries for the Medicaid population. Using data from 22 states, they found that 8.9% of Medicaid singleton births were early elective deliveries, and they therefore estimated that there are 160,000 early elective Medicaid deliveries nationwide each year. They concluded that their study offers additional evidence and new tools for policy makers pursuing strategies to further reduce the number of such deliveries.
AHRQ-funded; 29020090015C.
Citation: Fowler TT, Schiff J, Applegate MS .
Early elective deliveries accounted for nearly 9 percent of births paid for by Medicaid.
Health Aff 2014 Dec;33(12):2170-8. doi: 10.1377/hlthaff.2014.0534.
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Keywords: Labor and Delivery, Maternal Care, Medicaid, Pregnancy
Rokicki S, Montana L, Fink G
Impact of migration on fertility and abortion: evidence from the household and welfare study of Accra.
The researchers used detailed pregnancy and migration histories collected as part of the Household and Welfare Study of Accra (HAWS) to examine the association between migration and pregnancy outcomes among women residing in the urban slums of Accra, Ghana. They found that the completed fertility patterns of lifetime Accra residents are remarkably similar to those of residents who migrated.
AHRQ-funded; HS000055.
Citation: Rokicki S, Montana L, Fink G .
Impact of migration on fertility and abortion: evidence from the household and welfare study of Accra.
Demography 2014 Dec;51(6):2229-54. doi: 10.1007/s13524-014-0339-0..
Keywords: Pregnancy, Urban Health, Social Determinants of Health, Labor and Delivery
Lorch SA, Martin AE, Ranade R
Lessons for providers and hospitals from Philadelphia's obstetric services closures and consolidations, 1997-2012.
The researchers examined the experience of Philadelphia County, Pennsylvania, where thirteen of nineteen hospital obstetric units closed between 1997 and 2012, and they conducted interviews at eleven hospitals whose obstetric units remained open. Interviewees reported sharp surges in delivery volume and an increase in the proportion of patients with public insurance or no insurance. The authors concluded that their study supports the need for policy makers to anticipate reductions in supply and monitor patient outcomes.
AHRQ-funded; HS018661.
Citation: Lorch SA, Martin AE, Ranade R .
Lessons for providers and hospitals from Philadelphia's obstetric services closures and consolidations, 1997-2012.
Health Aff 2014 Dec;33(12):2162-9. doi: 10.1377/hlthaff.2014.0136.
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Keywords: Labor and Delivery, Pregnancy, Hospitals
Connor KA, Cheng D, Strobino D
Preconception health promotion among Maryland women.
The objective of this study was to identify factors associated with receipt of preconception care (PCC) health promotion counseling among Maryland women and to assess whether prior birth outcome affects receipt of counseling. PCC receipt in the sample, consistent with analyses of older data, was low at 33 percent for all women and 28 percent for women with a prior live birth.
AHRQ-funded; HS017596.
Citation: Connor KA, Cheng D, Strobino D .
Preconception health promotion among Maryland women.
Matern Child Health J 2014 Dec;18(10):2437-45. doi: 10.1007/s10995-014-1482-3..
Keywords: Health Promotion, Maternal Care, Pregnancy, Women