National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Antibiotics (1)
- Behavioral Health (1)
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- Case Study (2)
- Children/Adolescents (1)
- Depression (1)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Domestic Violence (1)
- Evidence-Based Practice (3)
- Guidelines (2)
- Health Insurance (1)
- Hepatitis (1)
- Low-Income (1)
- (-) Maternal Care (9)
- Medicaid (1)
- Medication (1)
- Pregnancy (7)
- Prevention (3)
- (-) Screening (9)
- Social Determinants of Health (1)
- U.S. Preventive Services Task Force (USPSTF) (5)
- Urinary Tract Infection (UTI) (1)
- Women (9)
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 9 of 9 Research Studies DisplayedHenderson JT, Webber EM, Thomas RG
Screening for hypertensive disorders of pregnancy: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to conduct a systematic review to update the evidence on the effectiveness of screening for hypertensive disorders of pregnancy with the purpose of informing the U.S. Preventive Services Task Force. The main outcome was Morbidity or mortality, with measures of health-related quality of life. The review included 6 fair-quality studies comparing changes in prenatal screening practices with routine screening at in-person office visits (usual care). This systematic review did not find evidence that any alternate screening strategies for hypertensive disorders of pregnancy had increased effectiveness over routine blood pressure measurement at in-person prenatal visits. No harms of the different screening strategies were identified.
AHRQ-funded; 75Q80120D00004.
Citation: Henderson JT, Webber EM, Thomas RG .
Screening for hypertensive disorders of pregnancy: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Sep 19; 330(11):1083-91. doi: 10.1001/jama.2023.4934..
Keywords: U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Screening, Prevention, Evidence-Based Practice, Guidelines, Maternal Care, Women
Kozhimannil KB, Lewis VA, Interrante JD
Screening for and experiences of intimate partner violence in the United States before, during, and after pregnancy, 2016-2019.
The objective of this study was to measure rates of intimate partner violence (IPV) screening during the perinatal period among people experiencing physical violence in the US. Data from the Pregnancy Risk Assessment Monitoring System was used to describe the incidence of physical IPV before or during pregnancy. The results indicated that nearly half of those reporting physical IPV were not screened before or after pregnancy. The authors concluded that public health efforts to improve maternal health must address universal screening for IPV as well as access to care.
AHRQ-funded; HS027640.
Citation: Kozhimannil KB, Lewis VA, Interrante JD .
Screening for and experiences of intimate partner violence in the United States before, during, and after pregnancy, 2016-2019.
Am J Public Health 2023 Mar; 113(3):297-305. doi: 10.2105/ajph.2022.307195..
Keywords: Screening, Domestic Violence, Pregnancy, Women, Maternal Care
Ellison J, Wang C, Yarrington C
Insurance and geographic variations in non-invasive prenatal testing.
The purpose of this study was to estimate the population-level rate of non-invasive prenatal testing (NIPT) uptake in Massachusetts and identify disparities based on patient zip-code and insurance type. The researchers identified pregnant patients aged 35 years or older at their delivery between 7/1/2015 to 12/31/2015 who were eligible for NIPT use, to assess the role of area‐level sociodemographic characteristics and NIPT uptake. The study reported that considerable geographic variation was discovered. Patients living in zip‐codes within and surrounding the Boston metropolitan area were more likely to receive NIPT, as were those living in Eastern MA. The observed NIPT rate (per 1000 pregnant individuals aged 35 and over) was 48.7 for Medicaid enrollees and 272.1 for commercial enrollees; 123.0 and 223.2 for patients living in a zip‐code with a high versus low proportion of Black/Hispanic residents; and 107.7 and 218.4 for those in a zip‐code with a high versus low proportion of low‐income residents. The researchers reported that birthing people covered by Medicaid were over five times less likely to receive NIPT than their counterparts with commercial coverage. Lower NIPT rates in zip‐codes with a high proportion of low‐income or Black/Hispanic residents also suggests that geographic variations in uptake may reflect racial/ethnic and income disparities independent of insurance coverage. The researchers concluded that the study findings emphasize the presence of substantial disparities in NIPT uptake based on insurance and zip-code of residence, and that further research is needed to identify barriers and facilitators to uptake and to evaluate interventions to address inequities in NIPT use.
AHRQ-funded; HS000011.
Citation: Ellison J, Wang C, Yarrington C .
Insurance and geographic variations in non-invasive prenatal testing.
Prenat Diagn 2022 Jul;42(8):1004-07. doi: 10.1002/pd.6155..
Keywords: Pregnancy, Maternal Care, Women, Health Insurance, Screening
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
Mills J, Hulse S
AHRQ Author: Mills J
Screening for asymptomatic bacteriuria in adults.
This case study poses three questions concerning a 33-year-old woman presenting for a first prenatal visit at 8 weeks' gestation. The woman reported morning nausea and breast tenderness. A review of systems and physical examination were consistent with early pregnancy but were otherwise unremarkable.
AHRQ-authored.
Citation: Mills J, Hulse S .
Screening for asymptomatic bacteriuria in adults.
Am Fam Physician 2020 Apr 15;101(8):493-94..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Prevention, Urinary Tract Infection (UTI), Pregnancy, Maternal Care, Women, Case Study
Kahwati LC, Clark R, Berkman N
Screening for bacterial vaginosis in pregnant adolescents and women to prevent preterm delivery: updated evidence report and systematic review for the US Preventive Services Task Force.
Researchers sought to update the evidence on screening and treatment of asymptomatic bacterial vaginosis in pregnancy for the USPSTF. They found that the evidence suggests no difference in the incidence of preterm delivery and related outcomes from treatment for asymptomatic bacterial vaginosis in a general obstetric population but was inconclusive for women with a prior preterm delivery. Maternal adverse events from treatment appear to be infrequent and minor, but the evidence about harms from in utero exposure was inconclusive.
AHRQ-funded; 290201500011I.
Citation: Kahwati LC, Clark R, Berkman N .
Screening for bacterial vaginosis in pregnant adolescents and women to prevent preterm delivery: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Apr 7;323(13):1293-309. doi: 10.1001/jama.2020.0233..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Evidence-Based Practice, Prevention, Women, Children/Adolescents, Pregnancy, Maternal Care, Antibiotics, Medication
Mabry-Hernandez I, Yan LD
AHRQ Author: Mabry-Hernandez I
Screening for hepatitis B virus in pregnant women.
This case study involves a 33-year-old U.S.-born pregnant clinician presenting for a first prenatal visit. She was pregnant once, more than two years ago; at that time she screened negative for the hepatitis B virus (HBV). She reports that she received an HBV vaccination one year ago during a work-related physical examination.
AHRQ-authored.
Citation: Mabry-Hernandez I, Yan LD .
Screening for hepatitis B virus in pregnant women.
Am Fam Physician 2020 Jan 15;101(2):115-16..
Keywords: U.S. Preventive Services Task Force (USPSTF), Hepatitis, Pregnancy, Women, Maternal Care, Screening, Pregnancy, Case Study
Klawetter S, McNitt C, Hoffman JA
Perinatal depression in low-income women: a literature review and innovative screening approach.
This paper is a literature review of perinatal depression prevalence, consequences, and screening among low-income women and women of color. The Warm Connections program has an innovative perinatal depression screening protocol and was used with WIC participants. The literature showed mixed findings of perinatal prevalence among low-income women and women of color. There were lower perinatal depression rates in the Warm Connections program in studies using less specific perinatal depression screening instruments with similar samples.
AHRQ-funded; HS026370.
Citation: Klawetter S, McNitt C, Hoffman JA .
Perinatal depression in low-income women: a literature review and innovative screening approach.
Curr Psychiatry Rep 2020 Jan 7;22(1):1. doi: 10.1007/s11920-019-1126-9.
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Keywords: Depression, Pregnancy, Women, Low-Income, Social Determinants of Health, Screening, Behavioral Health, Maternal Care, Disparities, Diagnostic Safety and Quality
Fan T, Blitz J
AHRQ Author: Fan T
Screening for iron deficiency anemia and iron supplementation in pregnant women to improve maternal health and birth outcomes.
This case study involves a 28-year-old woman presents for a routine antepartum visit. She is 33 weeks pregnant and also has a four-year-old son. She has no particular problems, and the findings from your examination are unremarkable. She asks if her blood iron level should be tested. Based on the recommendations of the U.S. Preventive Services Task Force, the quiz asks 3 questions involving screening and treatment.
AHRQ-authored.
Citation: Fan T, Blitz J .
Screening for iron deficiency anemia and iron supplementation in pregnant women to improve maternal health and birth outcomes.
Am Fam Physician 2016 Jan 15;93(2):137-8..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Maternal Care, Women, Guidelines, Evidence-Based Practice