National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (2)
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Comparative Effectiveness (2)
- Diabetes (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Hospitalization (1)
- Hospitals (2)
- (-) Labor and Delivery (13)
- Maternal Care (5)
- Medical Errors (1)
- Medical Liability (1)
- Medication (1)
- Mortality (1)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (2)
- Outcomes (2)
- Patient-Centered Outcomes Research (2)
- Patient Safety (3)
- Practice Patterns (1)
- Pregnancy (4)
- Racial and Ethnic Minorities (1)
- Risk (3)
- Social Determinants of Health (1)
- Training (2)
- Women (5)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedKorst LM, Feldman DS, Bollman DL
Cross-sectional survey of California childbirth hospitals: implications for defining maternal levels of risk-appropriate care.
The researchers examined the extent to which hospitals could be classified by increasingly sophisticated maternal levels of care. They concluded that childbirth services varied widely across California hospitals, and most hospitals did not fit easily into proposed levels. Cognizance of this existing variation is critical to determining the optimal configuration of services for basic, intermediate, and regional maternal levels of care.
AHRQ-funded; HS020915.
Citation: Korst LM, Feldman DS, Bollman DL .
Cross-sectional survey of California childbirth hospitals: implications for defining maternal levels of risk-appropriate care.
Am J Obstet Gynecol 2015 Oct;213(4):527.e1-27.e12. doi: 10.1016/j.ajog.2015.07.014..
Keywords: Labor and Delivery, Maternal Care, Hospitals, Access to Care
Feldman DS, Bollman DL, Fridman M
Do laborists improve delivery outcomes for laboring women in California community hospitals?
The researchers sought to determine the impact of the laborists staffing model on cesarean rates and maternal morbidity in California community hospitals. They were unable to demonstrate differences in cesarean and maternal childbirth complication rates in community hospitals with and without laborists.
AHRQ-funded; HS020915.
Citation: Feldman DS, Bollman DL, Fridman M .
Do laborists improve delivery outcomes for laboring women in California community hospitals?
Am J Obstet Gynecol 2015 Oct;213(4):587.e1-87.e13. doi: 10.1016/j.ajog.2015.05.051..
Keywords: Labor and Delivery, Outcomes, Patient Safety, Women
Korst LM, Feldman DS, Bollman DL
Variation in childbirth services in California: a cross-sectional survey of childbirth hospitals.
The objective of the study was to describe the resources and activities associated with childbirth services. It concluded that childbirth services varied widely across California hospitals. Cognizance of this variation and linkage of these data to childbirth outcomes should assist in the identification of key resources and activities that optimize the hospital environment for pregnant women.
AHRQ-funded; HS020915.
Citation: Korst LM, Feldman DS, Bollman DL .
Variation in childbirth services in California: a cross-sectional survey of childbirth hospitals.
Am J Obstet Gynecol 2015 Oct;213(4):523.e1-8. doi: 10.1016/j.ajog.2015.08.013..
Keywords: Labor and Delivery, Maternal Care, Hospitals, Access to Care
Tilden EL, Lee VR, Allen AJ
Cost-effectiveness analysis of latent versus active labor hospital admission for medically low-risk, term women.
The purpose of this study was to assess the outcomes and costs of hospital admission during the latent versus active phase of labor. It found that delaying admission until active labor would result in 672,000 fewer epidurals, 67,232 fewer cesarean deliveries, and 9.6 fewer maternal deaths in our theoretic cohort as compared to admission during latent labor.
AHRQ-funded; HS017582.
Citation: Tilden EL, Lee VR, Allen AJ .
Cost-effectiveness analysis of latent versus active labor hospital admission for medically low-risk, term women.
Birth 2015 Sep;42(3):219-26. doi: 10.1111/birt.12179..
Keywords: Labor and Delivery, Comparative Effectiveness, Healthcare Costs, Patient-Centered Outcomes Research, Hospitalization
Andrews SE, Alston MJ, Allshouse AA
Does the number of forceps deliveries performed in residency predict use in practice?
The researchers aimed to determine whether a threshold number of forceps deliveries in residency predicts use of forceps in independent practice. They concluded that, although exceeding 13 forceps deliveries made it highly likely that obstetricians would use them in practice, further study is necessary to set goals for a number of resident forceps deliveries that translate into use in practice.
AHRQ-funded; HS022143.
Citation: Andrews SE, Alston MJ, Allshouse AA .
Does the number of forceps deliveries performed in residency predict use in practice?
Am J Obstet Gynecol 2015 Jul;213(1):93.e1-4. doi: 10.1016/j.ajog.2015.03.025..
Keywords: Labor and Delivery, Patient-Centered Outcomes Research, Practice Patterns, Training, Women
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.
.
.
Keywords: Adverse Events, Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, 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
Huesch M, Doctor JN
Factors associated with increased cesarean risk among African American women: evidence from California, 2010.
The researchers studied the association of maternal health in African American women in hospitals or communities with the rates of cesarean delivery of infants. They found that cesarean rates were significantly higher overall for African American women than other women (unadjusted rate 36.8 percent vs 32.7 percent), as were both elective and emergency primary cesarean rates.
AHRQ-funded; HS021868.
Citation: Huesch M, Doctor JN .
Factors associated with increased cesarean risk among African American women: evidence from California, 2010.
Am J Public Health 2015 May;105(5):956-62. doi: 10.2105/ajph.2014.302381..
Keywords: Labor and Delivery, Maternal Care, Racial and Ethnic Minorities
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
Marshall NE, Vanderhoeven J, Eden KB
Impact of simulation and team training on postpartum hemorrhage management in non-academic centers.
The researchers conducted a multi-center study to evaluate in situ simulation and team training for postpartum hemorrhage management (PPH) among experienced clinical teams in non-academic hospitals in urban and rural communities. They found that team training significantly improved response times in the management of PPH, including the recognition of PPH, time to administer first medication, performance of uterine massage and time to administer second medication.
AHRQ-funded; HS015800; HS016673.
Citation: Marshall NE, Vanderhoeven J, Eden KB .
Impact of simulation and team training on postpartum hemorrhage management in non-academic centers.
J Matern Fetal Neonatal Med 2015 Mar;28(5):495-9. doi: 10.3109/14767058.2014.923393..
Keywords: Training, Patient Safety, Labor and Delivery, Women
Santos P, Ritter GA, Hefele JL
Decreasing intrapartum malpractice: targeting the most injurious neonatal adverse events.
The researchers conducted a case study of a risk reduction labor and delivery model at 5 demonstration sites. After 27 months post implementation, reporting of unintended events increased significantly (43 vs 84 per 1000 births), while high-risk malpractice events decreased significantly (14 vs 7 per 1000 births).
AHRQ-funded; HS019608.
Citation: Santos P, Ritter GA, Hefele JL .
Decreasing intrapartum malpractice: targeting the most injurious neonatal adverse events.
J Healthc Risk Manag 2015;34(4):20-7. doi: 10.1002/jhrm.21168..
Keywords: Labor and Delivery, Patient Safety, Risk, Medical Liability, Medical Errors
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
Kastenberg ZJ, Lee HC, Profit J
Effect of deregionalized care on mortality in very low-birth-weight infants with necrotizing enterocolitis.
The study’s aims were to describe the current trend toward deregionalization and to test the hypothesis that infants with necrotizing enterocolitis represent a particularly high-risk subgroup of the VLBW population that would benefit from early identification, increased intensity of early management, and possible targeted triage to tertiary hospitals. It found that outcomes for VLBW infants continue to be suboptimal when they are not born into high-level, high-volume centers.
AHRQ-funded; HS000028.
Citation: Kastenberg ZJ, Lee HC, Profit J .
Effect of deregionalized care on mortality in very low-birth-weight infants with necrotizing enterocolitis.
JAMA Pediatr 2015 Jan;169(1):26-32. doi: 10.1001/jamapediatrics.2014.2085..
Keywords: Newborns/Infants, Labor and Delivery, Mortality, Neonatal Intensive Care Unit (NICU), Healthcare Delivery