ArticleJournal of women's health (2002)2015
Emergency Room Utilization After Medically Complicated Pregnancies: A Medicaid Claims Analysis.
Article in Journal of women's health (2002), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Care of the Postpartum Patient in the Emergency Department: A Systematic Review with Implications for Maternal Mortality.American journal of perinatology · 2023Pooled it
- A Systematic Review of Patient-, Provider-, and Health System-Level Predictors of Postpartum Health Care Use by People of Color and Low-Income and/or Uninsured Populations in the United States.Journal of women's health (2002) · 2021Pooled it
- Antihypertensive therapy and unplanned maternal postpartum healthcare utilization in patients with mild chronic hypertension.American journal of obstetrics & gynecology MFM · 2024Trial
- Perinatal insult dimensions and developmental trajectories of psychotic-like experiences.Schizophrenia (Heidelberg, Germany) · 2025Article
- Severe Postpartum Maternal Morbidity: How Medicaid Coverage for 365 Days Can Make a Difference.Cureus · 2025Article
- Postpartum Acute Care Utilization in a Health Care System in the Southeastern United States.Journal of women's health (2002) · 2025Article
- Postpartum Emergency Care Visits Among North Carolina Medicaid Beneficiaries, 2013-2019.Journal of women's health (2002) · 2024Article
- Acute health care utilization in the first 24 months postpartum by rurality and pregnancy complications: A prospective cohort study.Health services research · 2024Article
- Postpartum Hospital Readmissions and Emergency Department Visits Among High-Risk, Medicaid-Insured Women in New York City.Journal of women's health (2002) · 2022Article
- Improving Postpartum Care: Identifying Opportunities to Reduce Postpartum Emergency Room Visits Among Publicly-Insured Women of Color.Maternal and child health journal · 2022Article
- Characterizing Hypertensive Disorders of Pregnancy Among Medicaid Recipients in a Nonexpansion State.Journal of women's health (2002) · 2022Article
- Perinatal morbidity and health utilization among mothers of medically fragile infants.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- Obstetrics and Gynecology Emergency Department Activity during Lockdown in a Teaching Hospital, Hub Center, for COVID-19.Obstetrics and gynecology international · 2022Article
- Postpartum visits in the gynecological emergency room: How can we improve?BMC pregnancy and childbirth · 2020Article
- Risk Factors for Postpartum Emergency Department Visits in an Urban Population.Maternal and child health journal · 2019Article
- Emergency Department Visits for Postpartum Complications.Journal of women's health (2002) · 2018Article
- Identifying Key Intervention Opportunities During a Pregnancy Complicated by Diabetes: a Review of Acute Complications of Diabetes During Pregnancy.Current diabetes reports · 2016Review
- Delivery Complications and Postpartum Hospital Use in California.Women's health issues : official publication of the Jacobs Institute of Women's HealthArticle
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundWomen with pregnancy complications benefit from closer monitoring postpartum and beyond. Increased postpartum emergency room (ER) use may indicate unmet need for outpatient obstetrics and primary care. The purpose of this study was to evaluate whether women with pregnancy complications (gestational diabetes [GDM], gestational hypertension, and preeclampsia) have increased ER use in the first 6 months postpartum, compared with women without these complications.
methodsWe conducted a retrospective population-based cohort study using a 2003-2010 Maryland Medicaid managed care claims data set, linked with U.S. Census data. Data included claims for outpatient and ER visits for women aged 12-45 years who were continuously enrolled in Medicaid for at least 100 days of pregnancy and 90 days postpartum. We used logistic regression to calculate the association between pregnancy complications and having ≥1 ER visit in the 6 months postpartum.
resultsWe identified 26,074 pregnancies, of which 20% were complicated by GDM, gestational hypertension, or preeclampsia. Of these complicated pregnancies, 42.1% had GDM, 35.4% had gestational hypertension, and 42.5% had preeclampsia (diagnoses were not mutually exclusive). In the 6 months postpartum, 25% of women had ≥1 ER visits. Of the complicated pregnancy group, 27.7% had ≥1 ER visit, versus 23.6% of the comparison group (p<0.0001). In adjusted analyses, women with a pregnancy complication were more likely to have ≥1 ER visit compared with women without these complications (odds ratio [OR]1.14, 95% confidence interval [CI] 1.05-1.23). The strength of association was highest in women under age 25 (OR 1.20, 95% CI 1.09-1.33). Preconception medical comorbidities (type 2 diabetes, chronic hypertension, obesity, asthma, mental health, and substance abuse diagnoses) were also strongly associated with postpartum ER use (OR 1.61, 95% CI 1.51-1.73).
conclusionsPregnancy complications increased ER utilization during the 6 months postpartum, especially among women under age 25 years. Interventions that improve discharge planning and early postpartum care may decrease ER use.
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Registered trials
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