National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Adverse Drug Events (ADE) (1)
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- Asthma (1)
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- Comparative Effectiveness (1)
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- Obesity: Weight Management (2)
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- (-) Pregnancy (29)
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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 25 of 29 Research Studies DisplayedBurstein PD, Zalenski DM, Edwards JL
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
The researchers established a multifactorial shoulder dystocia response and management protocol to promote sustainable practice change. In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol.
AHRQ-funded; HS019608.
Citation: Burstein PD, Zalenski DM, Edwards JL .
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2472-86. doi: 10.1111/1475-6773.12589.
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Keywords: Labor and Delivery, Newborns/Infants, Adverse Events, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Outcomes, Guidelines, Evidence-Based Practice, Pregnancy, Teams
Metz TD, Rovner P, Hoffman MC
Maternal deaths from suicide and overdose in Colorado, 2004-2012.
This study ascertained demographic and clinical characteristics of maternal deaths from self-harm (accidental overdose or suicide) and to identify opportunities for prevention. It found that in seventeen percent (n=10) of maternal deaths there had been a known substance use disorder. Prior psychiatric diagnoses were documented in 54 percent (n=32) and prior suicide attempts in 10 percent (n=6).
AHRQ-funded; HS022143.
Citation: Metz TD, Rovner P, Hoffman MC .
Maternal deaths from suicide and overdose in Colorado, 2004-2012.
Obstet Gynecol 2016 Dec;128(6):1233-40. doi: 10.1097/aog.0000000000001695.
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Keywords: Behavioral Health, Pregnancy, Prevention, Maternal Care, Mortality
Goff SL, Youssef Y, Pekow PS
Successful strategies for practice-based recruitment of racial and ethnic minority pregnant women in a randomized controlled trial: the IDEAS for a healthy baby study.
The authors used strategies grounded in a health equity framework to address barriers to recruitment and retention in three domains: preparation, process, and patient-centeredness in the IDEAS (Information, Description, Education, Assistance, and Support) for a Healthy Baby study. They achieved higher recruitment (87.1 %) and retention rates (97.3 %) than anticipated, concluding that others seeking to recruit racial and ethnic minority pregnant women in similar settings may find the preparation, process, and patient-centered strategies used in this study applicable for their own studies.
AHRQ-funded; HS021864; HS021879.
Citation: Goff SL, Youssef Y, Pekow PS .
Successful strategies for practice-based recruitment of racial and ethnic minority pregnant women in a randomized controlled trial: the IDEAS for a healthy baby study.
J Racial Ethn Health Disparities 2016 Dec;3(4):731-37. doi: 10.1007/s40615-015-0192-x.
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Keywords: Racial and Ethnic Minorities, Pregnancy, Racial and Ethnic Minorities, Research Methodologies
Hinkle SN, Mumford SL, Grantz KL
AHRQ Author: Mitchell EM
Association of nausea and vomiting during pregnancy with pregnancy loss: a secondary analysis of a randomized clinical trial.
The researchers examined the association of nausea and vomiting during pregnancy with pregnancy loss. They found that nausea and nausea with vomiting were associated with a reduced risk for clinical pregnancy loss.
AHRQ-authored.
Citation: Hinkle SN, Mumford SL, Grantz KL .
Association of nausea and vomiting during pregnancy with pregnancy loss: a secondary analysis of a randomized clinical trial.
JAMA Intern Med 2016 Nov;176(11):1621-27. doi: 10.1001/jamainternmed.2016.5641.
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Keywords: Adverse Drug Events (ADE), Medication, Pregnancy, Risk, Women
Vo H, Cheng D, Cheng TL
AHRQ Author: Mistry KB
Health behaviors among women using fertility treatment.
The researchers described associated perinatal behaviors among women using fertility treatment. They concluded that a significant proportion of women using fertility treatments were not practicing recommended perinatal behaviors or receiving prenatal counseling on preventable risk factors.
AHRQ-authored.
Citation: Vo H, Cheng D, Cheng TL .
Health behaviors among women using fertility treatment.
Matern Child Health J 2016 Nov;20(11):2328-35. doi: 10.1007/s10995-016-2056-3.
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Keywords: Maternal Care, Pregnancy, Women
Kennedy-Hendricks A, McGinty EE, Barry CL
Effects of competing narratives on public perceptions of opioid pain reliever addiction during pregnancy.
The researchers tested the effects of narratives portraying a woman with opioid pain reliever addiction during pregnancy on beliefs about people addicted to opioid pain relievers, perceptions of treatment effectiveness, policy attitudes, and emotional responses. They found that the extent to which narratives portraying successfully treated addiction affected public attitudes depended on the socioeconomic status of the woman portrayed.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, McGinty EE, Barry CL .
Effects of competing narratives on public perceptions of opioid pain reliever addiction during pregnancy.
J Health Polit Policy Law 2016 Oct;41(5):873-916. doi: 10.1215/03616878-3632230.
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Keywords: Opioids, Pain, Pregnancy, Social Stigma, Substance Abuse
Yaghjyan L, Ghita GL, Dumont-Driscoll M
Maternal exposure to di-2-ethylhexylphthalate and adverse delivery outcomes: a systematic review.
This systematic review summarizes published studies that investigated the association of DEHP with preterm delivery, gestational age, and birthweight. identified important methodological concerns which could have resulted in selection bias and exposure misclassification and contributed to null findings and biased associations. Given limitations of the previous studies discussed in this review, more thorough investigation of these associations is warranted to advance scientific knowledge.
AHRQ-funded; HS022330.
Citation: Yaghjyan L, Ghita GL, Dumont-Driscoll M .
Maternal exposure to di-2-ethylhexylphthalate and adverse delivery outcomes: a systematic review.
Reprod Toxicol 2016 Oct;65:76-86. doi: 10.1016/j.reprotox.2016.07.002.
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Keywords: Outcomes, Patient Safety, Pregnancy
Upadhya KK, Jalazo ER, Connor KA
AHRQ Author: Mistry KB
Optimizing preconception health among young women: what are we missing?
This study evaluated whether receipt of specific preconception counseling topics differs between teen, young adult, and older mothers. It found that teen mothers were less than half as likely to be counseled about taking folic acid, 4 times more likely to be counseled about vaccines, and twice as likely to be counseled about mental health before pregnancy compared with adult mothers.
AHRQ-authored.
Citation: Upadhya KK, Jalazo ER, Connor KA .
Optimizing preconception health among young women: what are we missing?
J Pediatr Adolesc Gynecol 2016 Oct;29(5):464-6. doi: 10.1016/j.jpag.2016.02.010.
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Keywords: Children/Adolescents, Sexual Health, Maternal Care, Pregnancy, Women, Young Adults
Bommarito KM, Gross GA, Willers DM
The effect of clinical chorioamnionitis on cesarean delivery in the United States.
This study examined the association of clinical chorioamnionitis on cesarean delivery in a national sample of hospital discharges. It found that women with clinical chorioamnionitis were more likely to have cesarean delivery than those without clinical chorioamnionitis. The risk of cesarean delivery varied significantly by hospital location, teaching status, and U.S. region.
AHRQ-funded; HS019455.
Citation: Bommarito KM, Gross GA, Willers DM .
The effect of clinical chorioamnionitis on cesarean delivery in the United States.
Health Serv Res 2016 Oct;51(5):1879-95. doi: 10.1111/1475-6773.12447.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Pregnancy, Risk, Women
Haidari LA, Brown ST, Constenla D
The economic value of increasing geospatial access to tetanus toxoid immunization in Mozambique.
The researchers assessed how well tetanus toxoid (TT) immunization locations meet population demand in Mozambique. They found that TT immunization locations are not geographically accessible by a significant proportion of pregnant women, resulting in substantial healthcare and productivity costs that could potentially be averted by adding or reconfiguring TT immunization locations.
AHRQ-funded; HS023317.
Citation: Haidari LA, Brown ST, Constenla D .
The economic value of increasing geospatial access to tetanus toxoid immunization in Mozambique.
Vaccine 2016 Jul 29;34(35):4161-65. doi: 10.1016/j.vaccine.2016.06.065.
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Keywords: Access to Care, Healthcare Costs, Health Services Research (HSR), Pregnancy, Vaccination
Brown SD, Ehrlich SF, Kubo A
Lifestyle behaviors and ethnic identity among diverse women at high risk for type 2 diabetes.
The authors examined if ethnic identity could help account for variations in lifestyle behaviors within a diverse population at high risk for type 2 diabetes. Their findings suggest that ethnic group attachment is associated with some lifestyle behaviors, independent of acculturation indicators, among young women with gestational diabetes who are at high risk for type 2 diabetes. They suggest that prospective research is needed to clarify the temporal nature of associations between ethnic identity and modifiable diabetes risk factors.
AHRQ-funded; HS019367.
Citation: Brown SD, Ehrlich SF, Kubo A .
Lifestyle behaviors and ethnic identity among diverse women at high risk for type 2 diabetes.
Soc Sci Med 2016 Jul;160:87-93. doi: 10.1016/j.socscimed.2016.05.024.
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Keywords: Diabetes, Lifestyle Changes, Pregnancy, Racial and Ethnic Minorities, Women
Morales-Aleman MM, Scarinci IC
Correlates and predictors of sexual health among adolescent Latinas in the United States: a systematic review of the literature, 2004-2015.
The authors conducted a systematic literature review to better understand the correlates and predictors of sexual health among adolescent Latinas in the US. They found that results varied widely between studies, suggesting that the relationship between individual and proximal contextual variables and sexual health may be more complex than previously thought. They concluded that their review integrates the findings on correlates and predictors of sexual health among adolescent Latinas, and supports the need for strengths-based theoretically guided research on the mechanisms driving these associations.
AHRQ-funded; HS013852.
Citation: Morales-Aleman MM, Scarinci IC .
Correlates and predictors of sexual health among adolescent Latinas in the United States: a systematic review of the literature, 2004-2015.
Prev Med 2016 Jun;87:183-93. doi: 10.1016/j.ypmed.2016.03.005.
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Keywords: Children/Adolescents, Racial and Ethnic Minorities, Pregnancy, Racial and Ethnic Minorities, Sexual Health
Witt WP, Mandell KC, Wisk LE
Infant birthweight in the US: the role of preconception stressful life events and substance use.
The purpose of this study was to determine the relationships among preconception stressful life events (PSLEs), women's alcohol and tobacco use before and during pregnancy, and infant birthweight. It concluded that PSLEs and women's tobacco use before and during pregnancy are independent risk factors for having a lower birthweight baby.
AHRQ-funded; HS000063; HS000083.
Citation: Witt WP, Mandell KC, Wisk LE .
Infant birthweight in the US: the role of preconception stressful life events and substance use.
Arch Womens Ment Health 2016 Jun;19(3):529-42. doi: 10.1007/s00737-015-0595-z.
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Keywords: Newborns/Infants, Pregnancy, Stress, Substance Abuse, Women
Ehrlich SF, Sternfeld B, Krefman AE
Moderate and vigorous intensity exercise during pregnancy and gestational weight gain in women with gestational diabetes.
The researchers estimated the associations of exercise intensity during pregnancy with the rate of gestational weight gain (GWG) from gestational diabetes (GDM) diagnosis to delivery. Upon stratification by prepregnancy overweight/obesity, they found that significant associations were only observed for BMI greater than or equal to 25.0. There were no associations observed for moderate intensity exercise.
AHRQ-funded; HS019367.
Citation: Ehrlich SF, Sternfeld B, Krefman AE .
Moderate and vigorous intensity exercise during pregnancy and gestational weight gain in women with gestational diabetes.
Matern Child Health J 2016 Jun;20(6):1247-57. doi: 10.1007/s10995-016-1926-z.
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Keywords: Diabetes, Lifestyle Changes, Obesity, Obesity: Weight Management, Outcomes, Patient-Centered Outcomes Research, Pregnancy, Women
Smith W, Turan JM, White K
Social norms and stigma regarding unintended pregnancy and pregnancy decisions: a qualitative study of young women in Alabama.
The authors sought to describe the presence and manifestations of social norms and stigmas associated with unintended pregnancy and related decision making from the perspective of young women in the southern United States. They found that the community expected young women faced with unintended pregnancies to bear and raise their children, viewing them more positively than women who chose abortion or adoption. They concluded that there's a need to reduce stigma and create a social environment in which young women are empowered to make the best reproductive decisions for themselves.
AHRQ-funded; HS013852.
Citation: Smith W, Turan JM, White K .
Social norms and stigma regarding unintended pregnancy and pregnancy decisions: a qualitative study of young women in Alabama.
Perspect Sex Reprod Health 2016 Jun;48(2):73-81. doi: 10.1363/48e9016.
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Keywords: Shared Decision Making, Pregnancy, Social Stigma, Women, Young Adults
McCloskey LA
The effects of gender-based violence on women's unwanted pregnancy and abortion.
The authors sought to understand how gender-based violence across the life-course affects the likelihood of abortion and studied four different forms of gender-based abuse. They found that no single form of abuse predicted abortion; however, the cumulative effect of multiple forms of abuse did increase the odds of abortion. The authors suggested that priority in future research should be given to screening for multiple forms of victimization in reproductive healthcare settings.
AHRQ-funded; HS011088.
Citation: McCloskey LA .
The effects of gender-based violence on women's unwanted pregnancy and abortion.
Yale J Biol Med 2016 Jun;89(2):153-9.
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Keywords: Domestic Violence, Family Health and History, Pregnancy, Women
Maurer M, Firminger K, Dardees P
Understanding consumer perceptions and awareness of hospital-based maternity care quality measures.
This study explored factors that may influence use of comparative public reports for hospital maternity care. It found that, when describing high-quality maternity care, participants focused on interactions with providers, including respect for preferences and communication. The importance of quality measures was influenced by the extent to which they focused on babies' health, were perceived as the hospital's responsibility, and were perceived as representing "standard care."
AHRQ-funded; HS021873.
Citation: Maurer M, Firminger K, Dardees P .
Understanding consumer perceptions and awareness of hospital-based maternity care quality measures.
Health Serv Res 2016 Jun;51 Suppl 2:1188-211. doi: 10.1111/1475-6773.12472.
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Keywords: Maternal Care, Pregnancy, Patient Experience, Quality Measures, Quality of Care, Public Reporting
Reid AE, Rosenthal L, Earnshaw VA
Discrimination and excessive weight gain during pregnancy among Black and Latina young women.
The researchers examined the influence of discrimination, a culturally relevant stressor, on odds of gaining weight beyond Institute of Medicine recommendations during pregnancy. They found that ever experiencing discrimination was associated with a 71 percent increase in the odds of excessive weight gain.
AHRQ-funded; HS022986.
Citation: Reid AE, Rosenthal L, Earnshaw VA .
Discrimination and excessive weight gain during pregnancy among Black and Latina young women.
Soc Sci Med 2016 May;156:134-41. doi: 10.1016/j.socscimed.2016.03.012..
Keywords: Disparities, Obesity: Weight Management, Pregnancy, Racial and Ethnic Minorities, Social Stigma
Heberlein EC, Frongillo EA, Picklesimer AH
Effects of group prenatal care on food insecurity during late pregnancy and early postpartum.
The researchers compared the effects of group to individual prenatal care in late pregnancy and early postpartum on women's food security and psychosocial outcomes among food-insecure women. They found that group prenatal care provided health education and the opportunity for women to share experiences and knowledge, potentially improving food security through increasing confidence and skills in managing household food resources.
AHRQ-funded; HS021975.
Citation: Heberlein EC, Frongillo EA, Picklesimer AH .
Effects of group prenatal care on food insecurity during late pregnancy and early postpartum.
Matern Child Health J 2016 May;20(5):1014-24. doi: 10.1007/s10995-015-1886-8.
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Keywords: Pregnancy, Maternal Care, Nutrition, Education: Patient and Caregiver, Low-Income
Salemi JL, Pathak EB, Salihu HM
Infant outcomes after elective early-term delivery compared with expectant management.
The purpose of the study was to compare the risk of neonatal morbidity and infant mortality between elective early-term deliveries and those expectantly managed and delivered at 39 weeks of gestation or greater. It concluded that the issues surrounding the timing and reasons for delivery initiation are complicated and each pregnancy unique. Furthermore, it cautions against a general avoidance of all elective early-term deliveries.
AHRQ-funded - HS019997.
Citation: Salemi JL, Pathak EB, Salihu HM .
Infant outcomes after elective early-term delivery compared with expectant management.
Obstet Gynecol 2016 Apr;127(4):657-66. doi: 10.1097/aog.0000000000001331.
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Keywords: Newborns/Infants, Mortality, Pregnancy, Labor and Delivery, Adverse Events
Johnco C, Lewin AB, Salloum A
Adverse prenatal, perinatal and neonatal experiences in children with anxiety disorders.
The authors examined the incidence of adverse prenatal, perinatal, and neonatal experiences among children with anxiety disorders. They found several associations between neonatal complications and subsequent clinical symptomology, including attention deficit hyperactivity disorder and depressive comorbidity, anxiety severity and functional impairment.
AHRQ-funded; HS018665.
Citation: Johnco C, Lewin AB, Salloum A .
Adverse prenatal, perinatal and neonatal experiences in children with anxiety disorders.
Child Psychiatry Hum Dev 2016 Apr;47(2):317-25. doi: 10.1007/s10578-015-0569-4.
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Keywords: Anxiety, Children/Adolescents, Disabilities, Pregnancy
Cha S, Chapman DA, Wan W
Discordant pregnancy intentions in couples and rapid repeat pregnancy.
The researchers sought to examine the association between couple pregnancy intentions and Rapid repeat pregnancy (RRP) among women in the United States. Their findings highlight the important role of paternal intention in reproductive decisions. Study results suggest that RRP is strongly influenced by paternal rather than maternal pregnancy intentions. Clinicians and public health workers should involve partners in family planning discussions and counseling on optimal birth spacing.
AHRQ-funded; HS021504; HS023724.
Citation: Cha S, Chapman DA, Wan W .
Discordant pregnancy intentions in couples and rapid repeat pregnancy.
Am J Obstet Gynecol 2016 Apr;214(4):494.e1-94.e12. doi: 10.1016/j.ajog.2015.10.149.
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Keywords: Shared Decision Making, Pregnancy, Women
Horner-Johnson W, Darney BG, Kulkarni-Rajasekhara S
Pregnancy among US women: differences by presence, type, and complexity of disability.
The purpose of this study was to describe the occurrence of pregnancy among women with various types of disability and with differing levels of disability complexity, compared with women without disabilities, in a nationally representative sample. Women with the most complex disabilities (those that impact activities such as self-care and work) were less likely to have been pregnant, but women whose disabilities affected only basic actions did not differ significantly from women with no disabilities.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Darney BG, Kulkarni-Rajasekhara S .
Pregnancy among US women: differences by presence, type, and complexity of disability.
Am J Obstet Gynecol 2016 Apr;214(4):529.e1-9. doi: 10.1016/j.ajog.2015.10.929.
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Keywords: Disabilities, Medical Expenditure Panel Survey (MEPS), Pregnancy, Women
Heberlein EC, Picklesimer AH, Billings DL
The comparative effects of group prenatal care on psychosocial outcomes.
This study compared the psychosocial outcomes of the CenteringPregnancy (CP) model of group prenatal care to individual prenatal care. It used a prospective cohort study of women who chose CP group or individual prenatal care. Among women with high pregnancy-specific distress in early pregnancy, group participants had an 8.3 percent greater increase in prenatal planning-preparation coping strategies in late pregnancy and a 4.9 percent greater decrease in postpartum depressive symptom scores.
AHRQ-funded; HS021975.
Citation: Heberlein EC, Picklesimer AH, Billings DL .
The comparative effects of group prenatal care on psychosocial outcomes.
Arch Womens Ment Health 2016 Apr;19(2):259-69. doi: 10.1007/s00737-015-0564-6.
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Keywords: Pregnancy, Stress, Depression, Outcomes
Palmsten K, Schatz M, Chan PH
Validation of the pregnancy asthma control test.
The researchers sought to validate telephone administration of a modified version of the Asthma Control Test (ACT) during pregnancy. They found that the Pregnancy Asthma Control Test (p-ACT) demonstrated good internal consistency, varied in the expected direction by impairment level, and was responsive to changes in asthma course. Telephone administration of the p-ACT was reliable and valid for assessing asthma control during pregnancy.
AHRQ-funded; HS018474.
Citation: Palmsten K, Schatz M, Chan PH .
Validation of the pregnancy asthma control test.
J Allergy Clin Immunol Pract 2016 Mar-Apr;4(2):310-15.e1. doi: 10.1016/j.jaip.2015.11.019.
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Keywords: Pregnancy, Asthma, Diagnostic Safety and Quality, Patient-Centered Outcomes Research