National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (3)
- Antibiotics (2)
- Asthma (1)
- Cardiovascular Conditions (1)
- Centers for Education and Research on Therapeutics (CERTs) (1)
- Children/Adolescents (2)
- Chronic Conditions (1)
- Comparative Effectiveness (1)
- Decision Making (1)
- Depression (1)
- Diagnostic Safety and Quality (1)
- Education: Patient and Caregiver (1)
- Evidence-Based Practice (2)
- Healthcare-Associated Infections (HAIs) (1)
- Health Status (1)
- Heart Disease and Health (1)
- Hospitalization (2)
- Infectious Diseases (2)
- Injuries and Wounds (2)
- Labor and Delivery (3)
- Lifestyle Changes (1)
- Maternal Care (1)
- Medication (4)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Mortality (1)
- Neonatal Intensive Care Unit (NICU) (2)
- (-) Newborns/Infants (23)
- Obesity (1)
- Outcomes (3)
- Patient-Centered Outcomes Research (1)
- Patient Safety (1)
- Pregnancy (7)
- Prevention (1)
- Racial and Ethnic Minorities (2)
- Respiratory Conditions (2)
- (-) Risk (23)
- Sepsis (1)
- Substance Abuse (1)
- Vaccination (1)
- Women (1)
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 DisplayedFlannery DD, Mukhopadhyay S, Morales KH
Delivery characteristics and the risk of early-onset neonatal sepsis.
This retrospective cohort study identified term and preterm infants at lowest risk of culture-confirmed early-onset sepsis (EOS) using delivery characteristics and also determined antibiotic use among them. The study cohort included term and preterm infants born 2009 to 2014 with blood culture with or without cerebrospinal fluid culture obtained ≤72 hours after birth. Low EOS risk criteria included: cesarean delivery, without labor or membrane rupture before delivery, and no antepartum concern for intraamniotic infection or nonreassuring fetal status. Among 53,575 births, 7549 (14.1%) were evaluated and 41 (0.5%) of those infants had EOS. For 1121 evaluated infants there were low-risk delivery characteristics and none had EOS. Duration of antibiotics administered to infants born with and without low-risk characteristics was not different.
AHRQ-funded; HS027468.
Citation: Flannery DD, Mukhopadhyay S, Morales KH .
Delivery characteristics and the risk of early-onset neonatal sepsis.
Pediatrics 2022 Feb;149(2). doi: 10.1542/peds.2021-052900..
Keywords: Newborns/Infants, Sepsis, Risk, Labor and Delivery, Antibiotics, Medication
Oster NV, Williams EC, Unger JM
A risk prediction model to identify newborns at risk for missing early childhood vaccinations.
Approximately 30% of US children aged 24 months have not received all recommended vaccines. This retrospective cohort study aimed to develop a prediction model to identify newborns at high risk for missing early childhood vaccines. The investigators concluded that their prediction model using information readily available in birth hospitalization records consistently identified newborns at high risk for undervaccination.
AHRQ-funded; HS025470.
Citation: Oster NV, Williams EC, Unger JM .
A risk prediction model to identify newborns at risk for missing early childhood vaccinations.
J Pediatric Infect Dis Soc 2021 Dec 31;10(12):1080-86. doi: 10.1093/jpids/piab073..
Keywords: Newborns/Infants, Vaccination, Risk
Moza R, Truong DT, Lambert LM
Poor weight recovery between stage 1 palliation and hospital discharge for infants with single ventricle physiology: an analysis of the NPC-QIC Phase II dataset.
The purpose of this study was to investigate change in weight-for-age z-scores (WAZ) and risk factors for impaired weight gain between stage 1 palliation (S1P) for single ventricle physiology and discharge. Data from the National Pediatric Cardiology Quality Improvement Collaborative Phase II database was analysed. Findings showed that nearly all infants lost weight after S1P, with little recovery by hospital discharge. At discharge, three-quarters of the infants were at-risk for impaired weight gain or had failure to thrive. Most risk factors associated with change in WAZ were unmodifiable or surrogates of disease severity.
AHRQ-funded; HS021114.
Citation: Moza R, Truong DT, Lambert LM .
Poor weight recovery between stage 1 palliation and hospital discharge for infants with single ventricle physiology: an analysis of the NPC-QIC Phase II dataset.
J Pediatr 2021 Jul;234:20-26.e2. doi: 10.1016/j.jpeds.2021.03.035..
Keywords: Newborns/Infants, Centers for Education and Research on Therapeutics (CERTs), Heart Disease and Health, Cardiovascular Conditions, Health Status, Risk
Michelson KA, Neuman MI, Pruitt CM
Height of fever and invasive bacterial infection.
This study evaluated the association of higher fevers with invasive bacterial infection (IBI) among febrile infants ≤60 days of age. Maximum temperatures of febrile infants with IBI were compared to infants without IBI. The median temperature was higher for infants with IBI (38.8°C) compared to those without IBI (38.4°C). Temperatures ranges of 39°C-39.4°C and 39.5°C-39.9°C were associated with a higher likelihood of IBI, although 30.4% of febrile infants with IBI had maximum temperatures <38.5°C.
AHRQ-funded; HS026006; HS026503.
Citation: Michelson KA, Neuman MI, Pruitt CM .
Height of fever and invasive bacterial infection.
Arch Dis Child 2021 Jun;106(6):594-96. doi: 10.1136/archdischild-2019-318548..
Keywords: Newborns/Infants, Infectious Diseases, Diagnostic Safety and Quality, Risk
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
Donovan BM, Abreo A, Ding T
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
This study examined the association between dose, timing and type of infant antibiotic use and the risk of childhood asthma. The study examined a cohort of 152,622 children enrolled in the Tennessee Medicaid Program. At least 79% had at least one antibiotic prescription fill during infancy. There was a 20% increase in odds of childhood asthma for each additional antibiotic filled. There was no significant association between timing, formulation, anaerobic coverage and class of antibiotics and childhood asthma. However, broad spectrum antibiotic fills increased the odds of development of childhood asthma compared to narrow spectrum only fills.
AHRQ-funded; HS018454.
Citation: Donovan BM, Abreo A, Ding T .
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
Clin Infect Dis 2020 Apr 10;70(8):1658-65. doi: 10.1093/cid/ciz448..
Keywords: Newborns/Infants, Children/Adolescents, Antibiotics, Medication, Asthma, Respiratory Conditions, Risk, Chronic Conditions
Cruz AT, Nigrovic LE, Xie J
Predictors of invasive herpes simplex virus infection in young infants.
This study’s objective was to identify independent predictors of invasive herpes simplex virus (HSV) infection in infants aged 60 days or less. This 23-center nested case-control study matched 149 infants with HSV to 1340 controls. All were 60 days or less old and had cerebrospinal fluid obtained within 24 hours of presentation or had HSV detected. Of the 149 infants with HSV, 90 had invasive and 59 had skin, eyes, and mouth disease. Predictors independently associated with invasive HSV included younger age (<28 days), prematurity, seizure at home, ill appearance, abnormal triage temperature, vesicular rash, thrombocytopenia, and cerebrospinal fluid pleocytosis. Infants with invasive HSV had a higher median risk score than those without invasive HSV.
AHRQ-funded; HS026006; HS025138.
Citation: Cruz AT, Nigrovic LE, Xie J .
Predictors of invasive herpes simplex virus infection in young infants.
Pediatrics 2021 Sep;148(3). doi: 10.1542/peds.2021-050052..
Keywords: Newborns/Infants, Infectious Diseases, Risk
Akinboyo IC, Voskertchian A, Gorfu G
Epidemiology and risk factors for recurrent Staphylococcus aureus colonization following active surveillance and decolonization in the NICU.
In this single center retrospective cohort study, the investigators sought to examine neonatal risk factors associated with recurrent Staphylococcus aureus colonization and to determine the genetic relatedness of S. aureus strains cultured from neonates before and after decolonization.
AHRQ-funded; HS022872.
Citation: Akinboyo IC, Voskertchian A, Gorfu G .
Epidemiology and risk factors for recurrent Staphylococcus aureus colonization following active surveillance and decolonization in the NICU.
Infect Control Hosp Epidemiol 2018 Nov;39(11):1334-39. doi: 10.1017/ice.2018.223..
Keywords: Healthcare-Associated Infections (HAIs), Neonatal Intensive Care Unit (NICU), Newborns/Infants, Risk
Wu P, Escobar GJ, Gebretsadik T
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
This retrospective cohort study examined the effectiveness of respiratory syncytial virus (RSV) prophylaxis for infants born between 1996 and 2008. The infants were enrolled in the Kaiser Permanente Northern California integrated health system. Infants who ever received RSV immunoprophylaxis had a 32% decreased risk of bronchiolitis hospitalization and finants with chronic lung disease (CLD) had a 52% decreased risk. The 2014 American Academy of Pediatrics (AAP) guidelines changed recommendations for RSV immunoprophylaxis which made 48% of infants no longer eligible but nearly all infants with CLD would remain eligible.
AHRQ-funded; HS018454.
Citation: Wu P, Escobar GJ, Gebretsadik T .
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
Am J Epidemiol 2018 Jul;187(7):1490-500. doi: 10.1093/aje/kwy008..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Hospitalization, Newborns/Infants, Outcomes, Patient-Centered Outcomes Research, Prevention, Respiratory Conditions, Risk
Hefele JG, Santos P, Ritter G
Risk factors for shoulder dystocia: the impact of mother's race and ethnicity.
The purpose of this observational study was to examine shoulder dystocia risk factors by race and ethnicity using a 19,236 sample of pregnant women who presented for labor and delivery. Results found that, for White non-Hispanic mothers, the strongest risk factors were delivering past 40 weeks' gestation and use of epidural anesthesia during delivery. Among Black non-Hispanic mothers, the risk factors with the greatest impact were use of epidural and having gestational diabetes and controlling the condition with insulin. Additionally, among Hispanic mothers, having Spanish as the primary language increased shoulder dystocia likelihood compared to those who did not cite it as their primary language. This study provides evidence that risk factors for a labor and delivery condition can vary significantly across racial and ethnic subgroups.
AHRQ-funded; HS019608.
Citation: Hefele JG, Santos P, Ritter G .
Risk factors for shoulder dystocia: the impact of mother's race and ethnicity.
J Racial Ethn Health Disparities 2018 Apr;5(2):333-41. doi: 10.1007/s40615-017-0374-9..
Keywords: Adverse Events, Labor and Delivery, Injuries and Wounds, Newborns/Infants, Pregnancy, Risk
Santos P, Hefele JG, Ritter G
Population-based risk factors for shoulder dystocia.
This retrospective observational study examined population-based risk factors for infant shoulder dystocia during labor. Five hospitals in 5 states were used and over 19,000 births evaluated between April 2011 and July 2013. An increased risk for dystocia was found for women who were prescribed insulin, indicating gestational diabetes. However this was not true of women with gestational diabetes who were not prescribed insulin. Other risk factors included being Black, Hispanic, covered by Medicaid or no insurance, infant gestational age of 41 weeks or greater, and chronic diabetes.
AHRQ-funded; HS019608.
Citation: Santos P, Hefele JG, Ritter G .
Population-based risk factors for shoulder dystocia.
J Obstet Gynecol Neonatal Nurs 2018 Jan;47(1):32-42. doi: 10.1016/j.jogn.2017.11.011..
Keywords: Labor and Delivery, Newborns/Infants, Risk, Pregnancy, Injuries and Wounds, Adverse Events
Chang PW, Kuzniewicz MW, McCulloch CE
A clinical prediction rule for rebound hyperbilirubinemia following inpatient phototherapy.
The American Academy of Pediatrics provides little guidance on when to discontinue phototherapy in newborns treated for hyperbilirubinemia. In this study, the investigators sought to develop a prediction rule to estimate the probability of rebound hyperbilirubinemia after inpatient phototherapy. They concluded that the risk of rebound hyperbilirubinemia can be quantified according to an infant's gestational age, age at phototherapy initiation, and total serum bilirubin relative to the treatment threshold at phototherapy termination.
AHRQ-funded; HS020618.
Citation: Chang PW, Kuzniewicz MW, McCulloch CE .
A clinical prediction rule for rebound hyperbilirubinemia following inpatient phototherapy.
Pediatrics 2017 Mar;139(3):1-9. doi: 10.1542/peds.2016-2896..
Keywords: Decision Making, Evidence-Based Practice, Newborns/Infants, Risk
Joyner BL, Oden RP, Moon RY
Reasons for pacifier use and non-use in African-Americans: does knowledge of reduced SIDS risk change parents' minds?
The authors sought to investigate African-American parental reasons for pacifier use or non-use. They recommended that providers supply information about the benefits of pacifiers and concluded that establishing for parents any plausible link between the protective mechanism of pacifiers and SIDS pathophysiology may be important in promoting pacifier use.
AHRQ-funded; HS016892.
Citation: Joyner BL, Oden RP, Moon RY .
Reasons for pacifier use and non-use in African-Americans: does knowledge of reduced SIDS risk change parents' minds?
J Immigr Minor Health 2016 Apr;18(2):402-10. doi: 10.1007/s10903-015-0206-0.
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Keywords: Education: Patient and Caregiver, Newborns/Infants, Newborns/Infants, Racial and Ethnic Minorities, Risk
Ericson JE, Popoola VO, Smith PB
Burden of invasive staphylococcus aureus infections in hospitalized infants.
This study compared demographics and mortality of inf ants with invasive methicillin-resistant S aureus (MRSA) and methicillin-susceptible S aureus (MSSA), to determine the annual proportion of S aureus infections that were MRSA. It found that infant mortality after invasive MRSA and MSSA infections was similar, but MSSA caused more infections and more deaths in infants than MRSA.
AHRQ-funded; HS022872.
Citation: Ericson JE, Popoola VO, Smith PB .
Burden of invasive staphylococcus aureus infections in hospitalized infants.
JAMA Pediatr 2015 Dec;169(12):1105-11. doi: 10.1001/jamapediatrics.2015.2380..
Keywords: Newborns/Infants, Methicillin-Resistant Staphylococcus aureus (MRSA), Mortality, Hospitalization, Risk
Chang AL, Hurwitz E, Miyamura J
Maternal risk factors and perinatal outcomes among pacific islander groups in Hawaii: a retrospective cohort study using statewide hospital data.
This study compared perinatal outcomes between Pacific Islander and White women who delivered a singleton liveborn in any Hawaii hospital from January 2010 to December 2011. Significant differences in perinatal outcomes between Pacific Islander and White women and newborns were noted. All Pacific Islander groups had an increased risk of hypertension. Native Hawaiians had the highest risk of low birthweight infants.
AHRQ-funded; HS021903.
Citation: Chang AL, Hurwitz E, Miyamura J .
Maternal risk factors and perinatal outcomes among pacific islander groups in Hawaii: a retrospective cohort study using statewide hospital data.
BMC Pregnancy Childbirth 2015 Oct 05;15:239. doi: 10.1186/s12884-015-0671-4.
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Keywords: Maternal Care, Risk, Racial and Ethnic Minorities, Outcomes, Newborns/Infants
Wickremasinghe AC, Risley RJ, Kuzniewicz MW
Risk of sensorineural hearing loss and bilirubin exchange transfusion thresholds.
The researchers sought to quantify the risk of sensorineural hearing loss (SNHL) in newborns who had bilirubin levels at or above American Academy of Pediatrics exchange transfusion thresholds (ETT). They found that only bilirubin levels 10 mg/dL above ETT were associated with a statistically significant increased risk of SNHL.
AHRQ-funded; HS020618.
Citation: Wickremasinghe AC, Risley RJ, Kuzniewicz MW .
Risk of sensorineural hearing loss and bilirubin exchange transfusion thresholds.
Pediatrics 2015 Sep;136(3):505-12. doi: 10.1542/peds.2014-3357..
Keywords: Newborns/Infants, Newborns/Infants, Risk
Huybrechts KF, Bateman BT, Palmsten K
Antidepressant use late in pregnancy and risk of persistent pulmonary hypertension of the newborn.
This study examined the risk of persistent pulmonary hypertension of the Newborn (PPHN) associated with exposure to different antidepressant medication classes late in pregnancy. Its findings suggest that the risk of PPHN associated with late pregnancy exposure to selective serotonin reuptake inhibitor antidepressants—if present—is smaller than previous studies.
AHRQ-funded; HS018533.
Citation: Huybrechts KF, Bateman BT, Palmsten K .
Antidepressant use late in pregnancy and risk of persistent pulmonary hypertension of the newborn.
JAMA 2015 Jun 2;313(21):2142-51. doi: 10.1001/jama.2015.5605..
Keywords: Medication, Newborns/Infants, Pregnancy, Risk
Desai RJ, Huybrechts KF, Hernandez-Diaz S
Exposure to prescription opioid analgesics in utero and risk of neonatal abstinence syndrome: population based cohort study.
The study’s objective was to provide risk estimates of neonatal abstinence syndrome (NAS) based on prescription opioid duration and timing of use during pregnancy in the presence or absence of additional risk factors for NAS. It found that the risk of NAS is higher in women using long term prescription opioids when there is a history of drug or alcohol misuse and smoking.
AHRQ-funded; HS018533.
Citation: Desai RJ, Huybrechts KF, Hernandez-Diaz S .
Exposure to prescription opioid analgesics in utero and risk of neonatal abstinence syndrome: population based cohort study.
BMJ 2015 May 14;350:h2102. doi: 10.1136/bmj.h2102..
Keywords: Newborns/Infants, Substance Abuse, Pregnancy, Risk
Bateman BT, Hernandez-Diaz S, Fischer MA
Statins and congenital malformations: cohort study.
The researchers undertook an epidemiologic study to assess the association between statin use in the first trimester and the risk of congenital malformations, using data derived from a large cohort of Medicaid beneficiaries. They found that women taking statins during the first trimester of pregnancy were at an increased risk of delivering an infant with malformations. The association was explained by underlying characteristics of users, mainly pre-existing diabetes.
AHRQ-funded; HS018533.
Citation: Bateman BT, Hernandez-Diaz S, Fischer MA .
Statins and congenital malformations: cohort study.
BMJ 2015 Mar 17;350:h1035. doi: 10.1136/bmj.h1035..
Keywords: Pregnancy, Medication, Risk, Newborns/Infants
Wu YW, Kuzniewicz MW, Wickremasinghe AC
Risk for cerebral palsy in infants with total serum bilirubin levels at or above the exchange transfusion threshold: a population-based study.
The researchers sought to quantify the risks for cerebral palsy (CP) and CP consistent with kernicterus that are associated with high with total serum bilirubin (TSB) levels based on the 2004 American Academy of Pediatrics exchange transfusion threshold (ETT) guidelines. They condcluded that CP consistent with kernicterus occurred only in infants with 2 or more risk factors for neurotoxicity and TSB levels of more than 5 mg/dL above the ETT.
AHRQ-funded; HS020618.
Citation: Wu YW, Kuzniewicz MW, Wickremasinghe AC .
Risk for cerebral palsy in infants with total serum bilirubin levels at or above the exchange transfusion threshold: a population-based study.
JAMA Pediatr 2015 Mar;169(3):239-46. doi: 10.1001/jamapediatrics.2014.3036.
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Keywords: Newborns/Infants, Risk, Children/Adolescents
Foglia EE, Ades A, Napolitano N
Factors associated with adverse events during tracheal intubation in the NICU.
This study sought to determine the incidence of adverse tracheal intubation-associated events (TIAEs and to identify factors associated with TIAEs in the NICU. It found that adverse TIAEs occurred in 153 of 701 (22 percent) tracheal intubation encounters. Modifiable risk factors associated with TIAEs identified include intubator training level and use of paralytic medications.
AHRQ-funded; HS021583.
Citation: Foglia EE, Ades A, Napolitano N .
Factors associated with adverse events during tracheal intubation in the NICU.
Neonatology 2015;108(1):23-9. doi: 10.1159/000381252..
Keywords: Patient Safety, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Risk, Adverse Events
Fleisch AF, Rifas-Shiman SL, Koutrakis P
Prenatal exposure to traffic pollution: associations with reduced fetal growth and rapid infant weight gain.
The authors explored air pollution exposure implications for postnatal growth. They found that infants exposed to the highest quartile of neighborhood traffic density had lower fetal growth, more rapid 0- to 6-month weight-for-length gain, and higher odds of weight-for-length ≥95th percentile at 6 months. Neighborhood traffic density was additionally associated with an infant being in both the lowest quartile of fetal growth and the highest quartile of 0- to 6-month weight-for-length gain.
AHRQ-funded; HS000063.
Citation: Fleisch AF, Rifas-Shiman SL, Koutrakis P .
Prenatal exposure to traffic pollution: associations with reduced fetal growth and rapid infant weight gain.
Epidemiology 2015 Jan;26(1):43-50. doi: 10.1097/ede.0000000000000203.
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Keywords: Newborns/Infants, Newborns/Infants, Obesity, Pregnancy, Risk
Anand V, Downs SM, Bauer NS
Prevalence of infant television viewing and maternal depression symptoms.
This study evaluated how the risk of very early TV viewing by infants relates to the mother’s reported symptoms of depression. It found that TV viewing by infants increased by almost 50 percent with maternal report of depression symptoms.
AHRQ-funded; HS018453; HS017939
Citation: Anand V, Downs SM, Bauer NS .
Prevalence of infant television viewing and maternal depression symptoms.
J Dev Behav Pediatr. 2014 Apr;35(3):216-24. doi: 10.1097/dbp.0000000000000035..
Keywords: Newborns/Infants, Depression, Risk, Lifestyle Changes