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
176 to 200 of 545 Research Studies DisplayedHerrick 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
Baskin AS, Wang T, Mott NM
Gaps in online breast cancer treatment information for older women.
This study’s goal was to assess the availability of web-based educational materials targeting older women facing early-stage breast cancer treatment. Routine use of sentinel lymph node biopsy (SLNB) and adjuvant radiotherapy offers no overall survival benefit and may not be perceived as desirable by older women. National guidelines allow omission of these treatments for older women. The authors systematically reviewed the top 25 hospital websites ranked as “Best Hospitals for Cancer” by U.S. News & World Report, as well as the websites of four prominent national cancer organizations. Only one national organization and no hospital websites included the recommendation to avoid routine SLNB. Only 2 hospitals and 2 national organizations included information for patients older than 70 years suggesting possible omission of adjuvant radiotherapy.
AHRQ-funded; HS026030.
Citation: Baskin AS, Wang T, Mott NM .
Gaps in online breast cancer treatment information for older women.
Ann Surg Oncol 2021 Feb;28(2):950-57. doi: 10.1245/s10434-020-08961-1..
Keywords: Elderly, Education: Patient and Caregiver, Health Information Technology (HIT), Cancer: Breast Cancer, Cancer, Women
Mott N, Wang T, Miller J
Medical maximizing-minimizing preferences in relation to low-value services for older women with hormone receptor-positive breast cancer: a qualitative study.
In this qualitative study, researchers conducted 30 semi-structured interviews with women age 70 or older without a previous diagnosis of breast cancer in order to elicit perspectives on breast cancer treatment in relation to their medical maximizing-minimizing preferences, as determined by the single-item maximizer-minimizer elicitation question (MM1). They found that medical maximizing-minimizing preferences in older women corresponded with preferences for breast cancer treatment options that guidelines identify as potentially unnecessary.
AHRQ-funded; HS026030.
Citation: Mott N, Wang T, Miller J .
Medical maximizing-minimizing preferences in relation to low-value services for older women with hormone receptor-positive breast cancer: a qualitative study.
Ann Surg Oncol 2021 Feb;28(2):941-49. doi: 10.1245/s10434-020-08924-6..
Keywords: Elderly, Women, Cancer: Breast Cancer, Cancer
Wang T, Baskin A, Miller J
Trends in breast cancer treatment de-implementation in older patients with hormone receptor-positive breast cancer: a mixed methods study.
Guidelines allow for the omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy in women >/= 70 years of age with hormone receptor-positive (HR +) breast cancer. Despite this, national data suggest these procedures have not been widely de-implemented. The objectives of this study were to evaluate trends in SLNB and post-lumpectomy radiotherapy utilization in patients who were eligible for omission and evaluate patient preferences as a target for de-implementation of low-value care.
AHRQ-funded; HS026030.
Citation: Wang T, Baskin A, Miller J .
Trends in breast cancer treatment de-implementation in older patients with hormone receptor-positive breast cancer: a mixed methods study.
Ann Surg Oncol 2021 Feb;28(2):902-13. doi: 10.1245/s10434-020-08823-w..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Healthcare Utilization, Practice Patterns, Women
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 SA, Higashi RT, Betts AC
Anal cancer and anal cancer screening knowledge, attitudes, and perceived risk among women living with HIV.
The aims of this study were (1) to describe anal cancer knowledge, perceived risk, screening barriers, and acceptability of sample self-collection among women living with HIV (WLWH) at an integrated safety-net system and (2) to describe differences in demographic and psychosocial variables among a subsample of WLWH with a history of abnormal cervical cytology results versus those with normal results. The investigators concluded that this study highlighted a gap in knowledge and awareness among WLWH regarding their heightened risk for anal cancer.
AHRQ-funded; HS022418.
Citation: Rodriguez SA, Higashi RT, Betts AC .
Anal cancer and anal cancer screening knowledge, attitudes, and perceived risk among women living with HIV.
J Low Genit Tract Dis 2021 Jan;25(1):43-47. doi: 10.1097/lgt.0000000000000578..
Keywords: Cancer, Screening, Human Immunodeficiency Virus (HIV), Risk, Women
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
Reese TJ, Schlechter CR, Potter LN
Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations.
The purpose of this study was to determine the changes associated with the revised USPSTF guideline for lung cancer screening eligibility among female, Black, and Hispanic populations using a large nationwide survey. The investigators concluded that the revised USPSTF guideline may likely increase lung cancer screening rates for female, Black, and Hispanic populations. However, despite these potential improvements, lung cancer screening inequities may persist without tailored eligibility criteria.
AHRQ-funded; HS026198.
Citation: Reese TJ, Schlechter CR, Potter LN .
Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations.
JAMA Netw Open 2021 Jan;4(1):e2033769. doi: 10.1001/jamanetworkopen.2020.33769..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Lung Cancer, Cancer, Screening, Racial and Ethnic Minorities, Women, Guidelines, Evidence-Based Practice
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
Hatch B, Hoopes M, Darney BG
Impacts of the Affordable Care Act on receipt of women's preventive services in Community Health Centers in Medicaid expansion and nonexpansion states.
Researchers assessed whether ACA implementation and Medicaid expansion were followed by greater receipt of recommended preventive services among women and girls in a large network of community health centers. Data was collected from electronic health records in 14 states. The researchers found that among female patients at community health centers, receipt of recommended preventive care improved after ACA implementation in both Medicaid expansion and non-expansion states, although the overall rates remained low. They recommended continued support to overcome barriers to preventive care in this population.
AHRQ-funded; HS025155.
Citation: Hatch B, Hoopes M, Darney BG .
Impacts of the Affordable Care Act on receipt of women's preventive services in Community Health Centers in Medicaid expansion and nonexpansion states.
Womens Health Issues 2021 Jan-Feb;31(1):9-16. doi: 10.1016/j.whi.2020.08.011..
Keywords: Cancer, Medicaid, Health Insurance, Uninsured, Access to Care, Policy, Cancer: Cervical Cancer, Prevention, Women, Healthcare Utilization
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
Ali MM, McClellan C, West KD
AHRQ Author: McClellan C
Medical marijuana laws, marijuana use, and opioid-related outcomes among women in the United States.
This study examined whether state medical marijuana laws (MMLs) was associated with lower levels of opioid-related outcomes. Data was drawn from the 2002-2014 National Survey on Drug Use and Health to compare opioid misuse in states with and without MMLs among all women, pregnant women, and parenting women. It also invested the impact of MMLs on marijuana use and marijuana use disorder. There was found to be no association of MMLs with opioid misuse, opioid misuse initiation, or opioid use disorder among all women, pregnant women and parenting women. However there was a positive correlation with marijuana use and marijuana use disorder among all women and women with children. MMLs were also associated with an increase in the frequency of opioid misuse in pregnant women and a decrease in the frequency of opioid misuse for parenting women.
AHRQ-authored.
Citation: Ali MM, McClellan C, West KD .
Medical marijuana laws, marijuana use, and opioid-related outcomes among women in the United States.
Womens Health Issues 2021 Jan-Feb;31(1):24-30. doi: 10.1016/j.whi.2020.09.003..
Keywords: Women, Opioids, Substance Abuse, Medication, Policy, Practice Patterns
Darney BG, Fuentes-Rivera E, Saavedra-Avendaño B
Contraceptive receipt among first-trimester abortion clients and postpartum women in urban Mexico.
The objective of this retrospective cohort study was to compare uptake of contraception prior to discharge between abortion clients in Mexico City's public abortion program and postpartum women from urban settings. Data were taken from clinical records of abortion clients in Mexico City and from a population-based survey of urban women on their adoption of contraception immediately postpartum. The results showed that women who received abortions in Mexico City's public abortion program were more likely to receive a reversible modern contraceptive method before leaving the facility than urban postpartum women. The authors concluded that women should be offered the full range of contraceptive methods after any obstetric event to help prevent unintended pregnancies and avoid short interpregnancy intervals.
AHRQ-funded; HS022981.
Citation: Darney BG, Fuentes-Rivera E, Saavedra-Avendaño B .
Contraceptive receipt among first-trimester abortion clients and postpartum women in urban Mexico.
Int Perspect Sex Reprod Health 2020 Dec 14; 46(Suppl 1):35-43. doi: 10.1363/46e0720..
Keywords: Sexual Health, Women, Maternal Care
Dinan MA, Wilson LE, Reed SD
Association of 21-gene assay (OncotypeDX) testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption.
This study looked at trends in the association of 21-gene assay testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption from 2001 to 2011. The investigators looked at updated SEER-Medicare data from 2004 and 2011. The cohort included 26,009 patients who met inclusion criteria. Assay use was associated with a decrease in absolute percentage use of chemotherapy by 4.5%, which became even more pronounced from 2008-2011 with a decrease of 6.8%.
AHRQ-funded; HS022189.
Citation: Dinan MA, Wilson LE, Reed SD .
Association of 21-gene assay (OncotypeDX) testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption.
Clin Breast Cancer 2020 Dec;20(6):487-94.e1. doi: 10.1016/j.clbc.2020.05.010..
Keywords: Cancer: Breast Cancer, Cancer, Treatments, Genetics, Medicare, Women, Healthcare Utilization
Bossick AS, Katon JG, Gray KE
Concomitant bilateral salpingo-oophorectomy at hysterectomy: differences by race and menopausal status in the Veterans Affairs health care system, 2007-2014.
This study compared race and menopausal status differences in the rate of concomitant bilateral salphino-oopherectomy (BSO) at hysterectomy in the Veterans Affairs health care system from 2007-2014. The authors identified 6,785 Veterans who underwent a hysterectomy, including 2,230 with concomitant BSO. After adjustment premenopausal Black Veterans had 41% lower odds of going through BSO than their White counterparts. There was insufficient evidence in postmenopausal Veterans. Black Veterans were more likely to be single, obese, and undergo abdominal hysterectomy.
AHRQ-funded; HS013853.
Citation: Bossick AS, Katon JG, Gray KE .
Concomitant bilateral salpingo-oophorectomy at hysterectomy: differences by race and menopausal status in the Veterans Affairs health care system, 2007-2014.
J Womens Health 2020 Dec;29(12):1513-19. doi: 10.1089/jwh.2020.8503..
Keywords: Surgery, Women, Racial and Ethnic Minorities
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
Sangha R, Bossick A, Su WK
A prospective study of patterns of regret in the year after hysterectomy.
This study sought to identify patterns of self-reported regret after hysterectomy. Women undergoing hysterectomy for a benign indication were recruited in the 2 weeks prior to surgery. The investigators concluded that for some women, decisional regret may worsen after hysterectomy. They suggest that future studies that identify factors strongly associated with self-reported regret could lead to improved counseling about postsurgical expectations.
AHRQ-funded; HS022417.
Citation: Sangha R, Bossick A, Su WK .
A prospective study of patterns of regret in the year after hysterectomy.
J Patient Cent Res Rev 2020 Fall;7(4):329-36..
Keywords: Women, Surgery
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
Rosenberg SM, Dominici LS, Gelber S
Association of breast cancer surgery with quality of life and psychosocial well-being in young breast cancer survivors.
This study looked at the short-term and long-term effects of breast cancer surgery on young breast cancer survivors (aged 40 and younger). The researchers compared the effects of bilateral mastectomy (BM), unilateral mastectomy (UM), and breast conserving surgery (BCS) among women diagnosed with Stage 0-3 unilateral breast cancer between 2006 and 2016 who had surgery and completed QOL and psychosocial assessments. Out of 826 women, 45% had BM, 31% BCS, and 24% UM. Of the women who had BM/UM, 84% also underwent reconstructive surgery. Women who had BM vs BCS or UM had consistently worse sexuality and body image. Anxiety improved across all groups, but adjusted mean scores remained higher among women who had BM vs BCS/UM at 1 year. There were minimal between-group differences in depression levels.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Dominici LS, Gelber S .
Association of breast cancer surgery with quality of life and psychosocial well-being in young breast cancer survivors.
JAMA Surg 2020 Nov;155(11):1035-42. doi: 10.1001/jamasurg.2020.3325..
Keywords: Cancer: Breast Cancer, Cancer, Women, Quality of Life, Surgery
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