Pre-pregnancy and Early Prenatal Care are Associated with Lower Risk of Ectopic Pregnancy Complications in the Medicaid Population: 2004-08
| Autor: | Irma Dahlquist, Debra B. Stulberg, Diane S. Lauderdale, Loretta Cain |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty Blood transfusion Adolescent Epidemiology medicine.medical_treatment Population Obstetric Surgical Procedures Prenatal care Lower risk Preconception Care Insurance Coverage Young Adult 03 medical and health sciences 0302 clinical medicine Pregnancy Humans Medicine Blood Transfusion 030212 general & internal medicine Healthcare Disparities education Retrospective Studies Medically Uninsured education.field_of_study 030219 obstetrics & reproductive medicine Ectopic pregnancy Medicaid business.industry Obstetrics Incidence Prenatal Care Length of Stay medicine.disease United States Pregnancy Ectopic Socioeconomic Factors Pediatrics Perinatology and Child Health Female business |
| Zdroj: | Paediatric and Perinatal Epidemiology. 31:4-10 |
| ISSN: | 0269-5022 |
| DOI: | 10.1111/ppe.12327 |
| Popis: | Background Ectopic pregnancy causes significant maternal morbidity and mortality. Complications are more common among women with Medicaid or no insurance compared to those with private insurance. It is unknown whether preventive care prior to pregnancy and prenatal care, which are covered by Medicaid, would decrease complications if they were more fully utilised. Methods Medicaid claims were used to identify a clinical cohort of women who experienced an ectopic pregnancy during 2004–08 among all female Medicaid enrolees from a large 14-state population, ages 15–44. Diagnosis and procedure codes were used to identify ectopic pregnancies and associated complications. The primary outcomes were complications associated with ectopic pregnancy: blood transfusion, sterilisation, or hospitalisation with length of stay greater than 2 days. Independent variables were documentation of preventive care within 1 year prior to the ectopic pregnancy and prenatal care within 4 months prior. Results Controlling for race, age, and state of residence, women's risks of any ectopic pregnancy complication were independently higher among those who did not receive any Medicaid-covered preventive care within 1 year before the ectopic pregnancy compared to those who did (RR 1.12, 95% confidence interval (CI) 1.09, 1.16), and among those who did not receive any Medicaid-covered prenatal care within 4 months prior, compared to those who did (RR 1.89, 95% CI 1.83, 1.96). Conclusions Pre-pregnancy and prenatal care are independently associated with decreased risk of ectopic pregnancy complications among Medicaid beneficiaries. |
| Databáze: | OpenAIRE |
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