Pregnancy and Emergency Department Utilization in North Carolina, 2016–2021: A Population-Based Surveillance Study

Autor: Elizabeth M. Nazzal, BS, Anna E. Waller, ScD, Michelle L. Meyer, PhD, MPH, Amy I. Ising, PhD, Kathleen Jones-Vessey, MS, Eugene Urrutia, PhD, Rachel P. Urrutia, MD, MS
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: AJPM Focus, Vol 2, Iss 4, Pp 100142- (2023)
Druh dokumentu: article
ISSN: 2773-0654
DOI: 10.1016/j.focus.2023.100142
Popis: Introduction: Pregnancy-associated complaints are a common reason for emergency department visits for women of reproductive age. Emergency department utilization during pregnancy is associated with worse birth outcomes for both mothers and infants. We used statewide North Carolina emergency department surveillance data between 2016 and 2021 to describe the sociodemographic factors associated with the use of emergency department for pregnancy-associated problems and subsequent hospital admission. Methods: North Carolina Disease Event Tracking and Epidemiologic Collection Tool is a syndromic surveillance system that includes all emergency department encounters at civilian acute-care facilities in North Carolina. We analyzed all emergency department visits between January 1, 2016 and December 31, 2021 for female patients aged 15–44 years residing in North Carolina with at least 1 ICD-10-CM code (analysis occurred in July 2021–October 2022). Each emergency department visit was categorized as pregnancy-associated if assigned ICD-10-CM code(s) indicated pregnancy. We stratified visits by age, race, ethnicity, county of residence, and insurance and compared them with estimated pregnant population proportions using 1-sample t-tests. We used multivariable logistic regression to determine whether pregnancy-associated visits were more likely to be associated with hospital admission and then to determine sociodemographic predictors of admission among pregnancy-associated emergency department visits. Results: More than 6.4 million emergency department visits were included (N=6,471,197); 10.1% (n=655,476) were pregnancy-associated, significantly higher than the proportion of women estimated to be pregnant at any given time in North Carolina (4.6%, p
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