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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.

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1 to 10 of 10 Research Studies Displayed
Reid LD, Weiss AJ, Fingar KR
AHRQ Author: Reid LD
Contributors to disparities in postpartum readmission rates between safety-net and non-safety-net hospitals: a decomposition analysis.
The authors assessed how patient, hospital, and community characteristics explain the safety-net hospital (SNH)/non-SNH disparity in postpartum readmission rates. Using HCUP data, they found that higher postpartum readmission rates at SNHs versus non-SNHs were largely due to differences in the patient mix rather than hospital factors. They recommended hospital initiatives to reduce the risk of postpartum readmissions among SNH patients. They concluded that improving factors that contribute to the disparity, including underlying health conditions and health inequities associated with race, will require enduring investments in public health.
AHRQ-authored; AHRQ-funded; 290201800001C.
Citation: Reid LD, Weiss AJ, Fingar KR . Contributors to disparities in postpartum readmission rates between safety-net and non-safety-net hospitals: a decomposition analysis. J Hosp Med 2022 Feb;17(2):77-87. doi: 10.1002/jhm.2769..
View abstract on the National Library of Medicine site.
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Safety Net, Hospital Readmissions, Pregnancy, Labor and Delivery, Women, Maternal Care
Williams D, Stout MJ, Rosenbloom JI
Preeclampsia predicts risk of hospitalization for heart failure with preserved ejection fraction.
Preeclampsia is associated with increased risk of future heart failure (HF), but the relationship between preeclampsia and HF subtypes are not well-established. The objective of this analysis was to identify the risk of HF with preserved ejection fraction (HFpEF) following a delivery complicated by preeclampsia/eclampsia. The investigators concluded that preeclampsia/eclampsia was an independent risk factor for future hospitalizations for HFpEF.
AHRQ-funded; HS019455.
Citation: Williams D, Stout MJ, Rosenbloom JI . Preeclampsia predicts risk of hospitalization for heart failure with preserved ejection fraction. J Am Coll Cardiol 2021 Dec 7;78(23):2281-90. doi: 10.1016/j.jacc.2021.09.1360..
View abstract on the National Library of Medicine site.
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Risk, Labor and Delivery, Pregnancy, Women
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..
View abstract on the National Library of Medicine site.
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Health Insurance, Healthcare Costs, Labor and Delivery, Pregnancy, Women, Outcomes
Guglielminotti J, Rosenberg H, Li G
Prevalence of malignant hyperthermia diagnosis in obstetric patients in the United States, 2003 to 2014.
The goal of this study was to assess the prevalence of malignant hyperthermia (MH) diagnosis and associated factors in obstetric patients. Using data from the Nationwide Inpatient Sample, results showed that the prevalence of MH-susceptibility is about 1 in 125,000 in cesarean deliveries, similar to the prevalence reported in non-obstetrical surgery inpatients. The findings of this study suggest that stocking dantrolene in maternity units is justified.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Rosenberg H, Li G . Prevalence of malignant hyperthermia diagnosis in obstetric patients in the United States, 2003 to 2014. BMC Anesthesiol 2020 Jan 20;20(1):19. doi: 10.1186/s12871-020-0934-0..
View abstract on the National Library of Medicine site.
Keywords: Healthcare Cost and Utilization Project (HCUP), Pregnancy, Maternal Care, Women, Diagnostic Safety and Quality, Labor and Delivery
Lewkowitz AK, Rosenbloom JI, Keller M
Association between stillbirth >/=23 weeks gestation and acute psychiatric illness within 1 year of delivery.
This study analyzed whether women experiencing a stillbirth had a higher risk of psychiatric morbidity and/or substance misuse within 1 year of delivery compared to women having a live birth. Higher risk was found for both using data from the Florida State Inpatient and State Emergency Department databases from 2005-2014. Women with an ICD-9 classification of stillbirth at or greater than 23 weeks gestation were included. Emergency department encounters or admissions with a diagnosis code of a psychiatric disorder were used.
AHRQ-funded; HS019455.
Citation: Lewkowitz AK, Rosenbloom JI, Keller M . Association between stillbirth >/=23 weeks gestation and acute psychiatric illness within 1 year of delivery. Am J Obstet Gynecol 2019 Nov;221(5):491.e1-91.e22. doi: 10.1016/j.ajog.2019.06.027..
View abstract on the National Library of Medicine site.
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Pregnancy, Behavioral Health, Women, Labor and Delivery
Guglielminotti J, Landau R, Li. G
Adverse events and factors associated with potentially avoidable use of general anesthesia in cesarean deliveries.
Compared with neuraxial anesthesia, general anesthesia for cesarean delivery is associated with increased risk of maternal adverse events. Reducing avoidable general anesthetics for cesarean delivery may improve safety of obstetric anesthesia care. This study examined adverse events, trends, and factors associated with potentially avoidable general anesthetics for cesarean delivery. The investigators concluded that compared with neuraxial anesthesia, avoidable general anesthetics are associated with increased risk of adverse maternal outcomes.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Landau R, Li. G . Adverse events and factors associated with potentially avoidable use of general anesthesia in cesarean deliveries. Anesthesiology 2019 Jun;130(6):912-22. doi: 10.1097/aln.0000000000002629..
View abstract on the National Library of Medicine site.
Keywords: Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Surgery, Pregnancy, Adverse Drug Events (ADE), Adverse Events, Women, Medication, Medication: Safety, Patient Safety, Maternal Care
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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View abstract on the National Library of Medicine site.
Keywords: Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Pregnancy, Risk, 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.
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View abstract on the National Library of Medicine site.
Keywords: Adverse Events, Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Pregnancy, Risk
Henke RM, Wier LM, Marder WD
AHRQ Author: Friedman BS, Wong HS
Geographic variation in cesarean delivery in the United States by payer.
This study aimed (1) to determine whether the geographic variation in cesarean delivery rate is consistent for private insurance and Medicaid, and (2) to identify the patient, population, and market factors associated with cesarean rate and determine if these factors vary by payer. It concluded that factors associated with geographic variation in cesarean delivery, a frequent and high-resource inpatient procedure, vary somewhat by payer.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Henke RM, Wier LM, Marder WD . Geographic variation in cesarean delivery in the United States by payer. BMC Pregnancy Childbirth 2014 Nov 19;14:387. doi: 10.1186/s12884-014-0387-x.
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View abstract on the National Library of Medicine site.
Keywords: Healthcare Cost and Utilization Project (HCUP), Health Insurance, Labor and Delivery, Medicaid, Pregnancy
Bardenheier BH, Elixhauser A, Imperatore G
AHRQ Author: Elixhauser A
Variation in prevalence of gestational diabetes mellitus among hospital discharges for obstetric delivery across 23 states in the United States.
The authors examined variability in diagnosed gestational diabetes mellitus (GDM) prevalence at delivery by race/ethnicity and state. Their results suggest that GDM rates differ by state, with this variation attributable to differences in obesity at the population level, age, race/ethnicity, hospital, and insurance.
AHRQ-authored.
Citation: Bardenheier BH, Elixhauser A, Imperatore G . Variation in prevalence of gestational diabetes mellitus among hospital discharges for obstetric delivery across 23 states in the United States. Diabetes Care 2013 May;36(5):1209-14. doi: 10.2337/dc12-0901.
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View abstract on the National Library of Medicine site.
Keywords: Diabetes, Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Labor and Delivery, Pregnancy

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