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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
1 to 23 of 23 Research Studies DisplayedAustin N, Kristensen-Cabrera A, Sherman J
Analyzing the heterogeneity of labor and delivery units: a quantitative analysis of space and design.
This study evaluated the effect of space and design on labor and deliver (L&D) hospital units. A quantitative analysis was done to see if it made an impact on the risk of deliveries. The researchers recommend standardization of the space based on number of deliveries and cesarean sections.
AHRQ-funded; HS023506.
Citation: Austin N, Kristensen-Cabrera A, Sherman J .
Analyzing the heterogeneity of labor and delivery units: a quantitative analysis of space and design.
PLoS One 2018 Dec 26;13(12):e0209339. doi: 10.1371/journal.pone.0209339..
Keywords: Labor and Delivery, Pregnancy, Women
Kung SA, Saavedra-Avendano B, Velez EA
Capturing compassion: a survey of Mexican Catholics assessing abortion support by reason for abortion and degree of Catholicism.
No standard exists to measure religiosity in abortion studies. In this study, the investigators test whether religiosity was associated with support for abortion among Mexican Catholics and whether different measures of degree of Catholicism alter the relationship. The investigators found that the majority of Mexican Catholics supported abortion in some circumstances. The only measure of degree of Catholicism significantly associated with all the outcomes was belief that a person who helps someone who aborts can be a good Catholic.
AHRQ-funded; HS022981.
Citation: Kung SA, Saavedra-Avendano B, Velez EA .
Capturing compassion: a survey of Mexican Catholics assessing abortion support by reason for abortion and degree of Catholicism.
Contraception 2018 Dec;98(6):504-09. doi: 10.1016/j.contraception.2018.06.008..
Keywords: Racial and Ethnic Minorities, Pregnancy, Women
Danilack VA, Brousseau EC, Phipps MG
The effect of gestational weight gain on persistent increase in body mass index in adolescents: a longitudinal study.
Weight retention after pregnancy is a concern for adolescents who may be entering adulthood at unhealthy weights. In this article, the investigators studied associations between each of three measures: pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and post-pregnancy BMI in a longitudinal follow-up of an adolescent pregnancy study cohort. They concluded that teens experienced an increase in BMI from pre-pregnancy to within 4 years after their first delivery, and this increase was related to GWG.
AHRQ-funded; HS025013.
Citation: Danilack VA, Brousseau EC, Phipps MG .
The effect of gestational weight gain on persistent increase in body mass index in adolescents: a longitudinal study.
J Womens Health 2018 Dec;27(12):1456-58. doi: 10.1089/jwh.2017.6635..
Keywords: Children/Adolescents, Pregnancy, Obesity: Weight Management, Obesity, Women
Neal JL, Lowe NK, Caughey AB
Applying a physiologic partograph to Consortium on Safe Labor data to identify opportunities for safely decreasing cesarean births among nulliparous women.
The aims of this study were to assess associations of labor status at admission (i.e., preactive or active) and active labor progress (i.e., dystocic or physiologic) with oxytocin augmentation, cesarean birth, and adverse neonatal outcome rates. The authors suggest that adoption of evidence-based, standardized approaches for diagnosing active labor onset, assessing labor progress, and diagnosing dystocia may safely decrease oxytocin augmentation and cesarean birth rates in the United States.
AHRQ-funded; HS024733.
Citation: Neal JL, Lowe NK, Caughey AB .
Applying a physiologic partograph to Consortium on Safe Labor data to identify opportunities for safely decreasing cesarean births among nulliparous women.
Birth 2018 Dec;45(4):358-67. doi: 10.1111/birt.12358..
Keywords: Labor and Delivery, Pregnancy, Women
Neal JL, Lowe NK, Phillippi JC
Likelihood of cesarean birth among parous women after applying leading active labor diagnostic guidelines.
The goals of this study were: Determine the proportions of women admitted to the hospital before or in active labor per the leading National Institute for Health and Care Excellence (NICE), and the American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) guidelines; Compare associations of labor status at admission with oxytocin augmentation, cesarean birth, and adverse birth outcomes when using the different active labor diagnostic guidelines. Active labor diagnostic guidelines were applied retrospectively to cervical examination data. The authors conclude that many parous women with spontaneous labor onset are admitted to the hospital before active labor, and these women are more likely to receive oxytocin augmentation during labor and to have a cesarean birth. Implications for practice are discussed.
AHRQ-funded; HS024733.
Citation: Neal JL, Lowe NK, Phillippi JC .
Likelihood of cesarean birth among parous women after applying leading active labor diagnostic guidelines.
Midwifery 2018 Dec;67:64-69. doi: 10.1016/j.midw.2018.09.007..
Keywords: Decision Making, Guidelines, Hospitalization, Labor and Delivery, Pregnancy, Women
Rice WS, Turan B, White K
Norms and stigma around unintended pregnancy in Alabama: associations with recent contraceptive use and dual method use among young women.
This study investigated the role of unintended pregnancy norms and stigma in contraceptive use among young women in Alabama. A total of 390 women aged 18-24 were surveyed from November 2014 to October 2015 at university and public health clinics. These women were considered at risk for unintended pregnancy and sexually transmitted diseases. Compared to nonusers, users of contraceptives were more likely to be White, nulliparous, from the university and had higher income. Disapproval of unintended pregnancy by close family and friends was associated with greater contraceptive use.
AHRQ-funded; HS013852.
Citation: Rice WS, Turan B, White K .
Norms and stigma around unintended pregnancy in Alabama: associations with recent contraceptive use and dual method use among young women.
Women Health 2018 Nov-Dec;58(10):1151-66. doi: 10.1080/03630242.2017.1414099.
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Keywords: Sexual Health, Pregnancy, Social Stigma, Women, Young Adults
Guo M, Quensell M, Chang A
Understanding of key obstetric quality terminology by Asian and Pacific Islander subgroups: implications for patient engagement and health equity.
In this study, women in Oahu, Hawai'i with a recent delivery were interviewed about their understanding of ten common obstetric terms. Health literacy was assessed by the rapid estimate of adult literacy in medicine (REALM). Multivariable models predicted total terms comprehended by demographic factors. The investigators found that participants were unfamiliar with common obstetrics terminology. Comprehension struggles were more common among populations with maternal health disparities, including Asian and Pacific Islander subgroups, and those with low health literacy.
AHRQ-funded; HS021903.
Citation: Guo M, Quensell M, Chang A .
Understanding of key obstetric quality terminology by Asian and Pacific Islander subgroups: implications for patient engagement and health equity.
Matern Child Health J 2018 Nov;22(11):1543-49. doi: 10.1007/s10995-018-2597-8..
Keywords: Health Literacy, Patient and Family Engagement, Pregnancy, Women
Phillippi JC, Doersam JK, Neal JL
Electronic informed consent to facilitate recruitment of pregnant women into research.
This study examined the use of electronic informed consent to increase the participation of racially and geographically diverse pregnant women in prospective research. They evaluated the feasibility and utility of e-consent in the first year of a multiyear clinical trial involving pregnant women. Out of 86 women screened, 71 were eligible, 65 agreed to review the e-consent form, and 61 completed the process. Even those women who reported low health literacy were able to complete the form and may expedite enrollment of a representative sample.
AHRQ-funded; HS024733.
Citation: Phillippi JC, Doersam JK, Neal JL .
Electronic informed consent to facilitate recruitment of pregnant women into research.
J Obstet Gynecol Neonatal Nurs 2018 Jul;47(4):529-34. doi: 10.1016/j.jogn.2018.04.134.
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Keywords: Women, Pregnancy, Health Literacy
Connor KA, Duran G, Faiz-Nassar M
Feasibility of implementing group well baby/well woman dyad care at federally qualified health centers.
The aim of this qualitative study was to assess stakeholder perspectives on the feasibility of implementing Centering Parenting (CP) in federally qualified health centers (FQHCs) in Baltimore. The investigators concluded that perceptions regarding facilitators and barriers to CP implementation in FQHCs were similar to existing group well-child care literature; however the benefit of emphasis on maternal wellness was a unique finding. The investigators suggested that a maternal wellness integration might make CP a particularly desirable model for implementation at FQHCs, but potential systems barriers must be addressed.
AHRQ-funded; HS017596.
Citation: Connor KA, Duran G, Faiz-Nassar M .
Feasibility of implementing group well baby/well woman dyad care at federally qualified health centers.
Acad Pediatr 2018 Jul;18(5):510-15. doi: 10.1016/j.acap.2017.09.011..
Keywords: Caregiving, Children/Adolescents, Education: Patient and Caregiver, Health Promotion, Healthcare Delivery, Maternal Care, Newborns/Infants, Pregnancy, Women
Hedderson MM, Brown SD, Ehrlich SF
A tailored letter based on electronic health record data improves gestational weight gain among women with gestational diabetes mellitus: the Gestational Diabetes' Effects on Moms (GEM) cluster-randomized controlled trial.
The purpose of this study was to evaluate whether a tailored letter improved gestational weight gain (GWG) and whether GWG mediated a multicomponent intervention's effect on postpartum weight retention among women with gestational diabetes mellitus (GDM). The authors concluded that a tailored electronic health record-based letter improved GWG, which mediated the effect of a multicomponent intervention in reducing postpartum weight retention.
AHRQ-funded; HS019367.
Citation: Hedderson MM, Brown SD, Ehrlich SF .
A tailored letter based on electronic health record data improves gestational weight gain among women with gestational diabetes mellitus: the Gestational Diabetes' Effects on Moms (GEM) cluster-randomized controlled trial.
Diabetes Care 2018 Jul;41(7):1370-77. doi: 10.2337/dc17-1133..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Lifestyle Changes, Patient-Centered Outcomes Research, Pregnancy, Women
Glazer KB, Eliot MN, Danilack VA
Residential green space and birth outcomes in a coastal setting.
The objective of this study was to evaluate associations between green and blue space and birth outcomes in a coastal area of the northeastern US. Findings from this study did not support the hypothesis that residential green space was associated with reduced risk of preterm birth or higher birthweight after adjustment for individual and contextual socioeconomic factors, but variation in results with incremental adjustment raised questions about the optimal degree of control for confounding by markers of SES. The investigators found that living near a freshwater body was associated with higher birthweight.
AHRQ-funded; HS025013.
Citation: Glazer KB, Eliot MN, Danilack VA .
Residential green space and birth outcomes in a coastal setting.
Environ Res 2018 May;163:97-107. doi: 10.1016/j.envres.2018.01.006..
Keywords: Pregnancy, Newborns/Infants, Outcomes, Adverse Events, Women
Lyndon A, Malana J, Hedi LC
Thematic analysis of women's perspectives on the meaning of safety during hospital-based birth.
This study used an interdisciplinary team of five investigators to examine women’s birth experiences in the perspective of patient safety. Five investigators in the fields of nursing, medicine, product design, and journalism analyzed transcripts to see how women felt about their physical or emotional safety during birth, and to identify opportunities for improvement in care. Teams that were well-organized promoted feelings of safety as well as human connection.
AHRQ-funded; HS023506.
Citation: Lyndon A, Malana J, Hedi LC .
Thematic analysis of women's perspectives on the meaning of safety during hospital-based birth.
J Obstet Gynecol Neonatal Nurs 2018 May;47(3):324-32. doi: 10.1016/j.jogn.2018.02.008..
Keywords: Labor and Delivery, Pregnancy, Women, Patient Safety, Patient Experience
Liu CH, Phan J, Yasui M
Prenatal life events, maternal employment, and postpartum depression across a diverse population in New York City.
This study examined racial and ethnic disparities in three postpartum depression (PPDF) symptoms and identified specific predictors. Women from the New York City area completed the 2009-2011 Pregnancy Risk Assessment Monitoring System survey. White women were more likely to have PPD than African American women. Employment was also associated with PPD for white women.
AHRQ-funded; HS023007.
Citation: Liu CH, Phan J, Yasui M .
Prenatal life events, maternal employment, and postpartum depression across a diverse population in New York City.
Community Ment Health J 2018 May;54(4):410-19. doi: 10.1007/s10597-017-0171-2..
Keywords: Depression, Disparities, Pregnancy, Racial and Ethnic Minorities, Women
Wynn A, Ramogola-Masire D, Gaolebale P
Prevalence and treatment outcomes of routine Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis testing during antenatal care, Gaborone, Botswana.
AHRQ-funded; HS000046.
Citation: Wynn A, Ramogola-Masire D, Gaolebale P .
Prevalence and treatment outcomes of routine Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis testing during antenatal care, Gaborone, Botswana.
Sex Transm Infect 2018 May;94(3):230-35. doi: 10.1136/sextrans-2017-053134..
Keywords: Antibiotics, Human Immunodeficiency Virus (HIV), Infectious Diseases, Pregnancy, Women
Brousseau EC, Danilack V, Cai F
Emergency department visits for postpartum complications.
The investigators performed a retrospective analysis of all postpartum visits to the emergency department (ED) at a tertiary care women's hospital over 6 months and described characteristics of the population and clinical details of the ED visit, specifically the presenting complaint, delivery type, final diagnosis, and admission rate. They found that women presenting to the ED postpartum period had a wide variety of medical issues but 78% were not admitted.
AHRQ-funded; HS025013.
Citation: Brousseau EC, Danilack V, Cai F .
Emergency department visits for postpartum complications.
J Womens Health 2018 Mar;27(3):253-57. doi: 10.1089/jwh.2016.6309..
Keywords: Adverse Events, Emergency Department, Maternal Care, Pregnancy, Women
Dickens LT, Naylor RN
Clinical management of women with monogenic diabetes during pregnancy.
This study discusses clinical management of women with monogenic diabetes during pregnancy. Monogenic diabetes is rare and only accounts for 1-2% of all diabetes cases so it is frequently misdiagnoses as one of the other diabetes types. Diabetes treatment is different for this type of diabetes, and if untreated can cause fetal mutations. However, if treated there can be transplacental transfer of the medication (sulfonylurea). The study authors recommend large prospective studies be conducted to better define the need and timing of initiation of insulin treatment.
AHRQ-funded; HS023007.
Citation: Dickens LT, Naylor RN .
Clinical management of women with monogenic diabetes during pregnancy.
Curr Diab Rep 2018 Feb 15;18(3):12. doi: 10.1007/s11892-018-0982-8..
Keywords: Care Management, Chronic Conditions, Diabetes, Maternal Care, Pregnancy, Women
Saavedra-Avendano B, Schiavon R, Sanhueza P
Who presents past the gestational age limit for first trimester abortion in the public sector in Mexico City?
This study identified socio-demographic factors associated with presenting for abortion services past the gestational age (GA) limit (12 weeks), and thus not receiving services, in Mexico City's public sector first trimester abortion program. Adult women had significantly lower odds than adolescents of presenting past the limit. There was an educational gradient across all age groups.
AHRQ-funded; HS022981.
Citation: Saavedra-Avendano B, Schiavon R, Sanhueza P .
Who presents past the gestational age limit for first trimester abortion in the public sector in Mexico City?
PLoS One 2018 Feb 7;13(2):e0192547. doi: 10.1371/journal.pone.0192547.
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Keywords: Education, Pregnancy, Social Determinants of Health, Women
Fletcher 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
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