Evidence map›Paper›PMID 35248782›Full record

ArticleAmerican journal of obstetrics & gynecology MFM2022

A population-based analysis of postpartum acute care use among women with disabilities.

Hilary K Brown, Simon Chen, Simone N Vigod, Astrid Guttmann, Susan M Havercamp, Susan L Parish, Lesley A Tarasoff, Yona Lunsky

Abstract read
In one paragraph

Article in American journal of obstetrics & gynecology MFM, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Hilary K BrownDepartment of Health & Society, University of Toronto Scarborough, Toronto, Canada (Drs Brown and Tarasoff); Dalla Lana School of Public Health, University of Toronto, Toronto, Canada (Drs Brown, Vigod, and Guttmann); Women's College Research Institute, Women's College Hospital, Toronto, Canada (Drs Brown and Vigod); Institute for Clinical Evaluative Sciences, Toronto, Canada (Drs Brown, Chen, Vigod, Guttmann, and Lunsky). Electronic address: hk.brown@utoronto.ca.
Simon ChenInstitute for Clinical Evaluative Sciences, Toronto, Canada (Drs Brown, Chen, Vigod, Guttmann, and Lunsky).
Simone N VigodDalla Lana School of Public Health, University of Toronto, Toronto, Canada (Drs Brown, Vigod, and Guttmann); Women's College Research Institute, Women's College Hospital, Toronto, Canada (Drs Brown and Vigod); Institute for Clinical Evaluative Sciences, Toronto, Canada (Drs Brown, Chen, Vigod, Guttmann, and Lunsky); Department of Psychiatry, University of Toronto, Toronto, Canada (Drs Vigod and Lunsky).
Astrid GuttmannDalla Lana School of Public Health, University of Toronto, Toronto, Canada (Drs Brown, Vigod, and Guttmann); Institute for Clinical Evaluative Sciences, Toronto, Canada (Drs Brown, Chen, Vigod, Guttmann, and Lunsky); Hospital for Sick Children, Toronto, Canada (Dr Guttmann); Department of Pediatrics, University of Toronto, Toronto, Canada (Dr Guttmann).
Susan M HavercampCenter for Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, Columbus, OH (Dr Havercamp).
Susan L ParishCollege of Health Professions, Virginia Commonwealth University, Richmond, VA (Dr Parish).
Lesley A TarasoffDepartment of Health & Society, University of Toronto Scarborough, Toronto, Canada (Drs Brown and Tarasoff); Azrieli Adult Neurodevelopmental Centre, Centre for Addiction & Mental Health, Toronto, Canada (Drs Tarasoff and Lunsky).
Yona LunskyInstitute for Clinical Evaluative Sciences, Toronto, Canada (Drs Brown, Chen, Vigod, Guttmann, and Lunsky); Department of Psychiatry, University of Toronto, Toronto, Canada (Drs Vigod and Lunsky); Azrieli Adult Neurodevelopmental Centre, Centre for Addiction & Mental Health, Toronto, Canada (Drs Tarasoff and Lunsky).

Funding

Pregnancy in Women with Disabilities: Using Novel Methods to Characterize RiskR01HD092326 · NICHD · UNIVERSITY OF TORONTO · PI BROWN, HILARY, LUNSKY, YONA · 2017 to 2020
$590k
NICHD NIH HHS R01 HD092326
6 · The paper itself

Abstract

backgroundDisability is common in reproductive-aged women, and as many as 1 in 8 pregnancies occur in women with a disability. Women with disabilities experience significant social and health disparities, and are at greater risk than their nondisabled counterparts for perinatal complications. Yet, few studies have examined their postpartum acute care use.

objectiveTo examine risks of postpartum emergency department visits and hospital admissions among women with and without physical, sensory, and intellectual/developmental disabilities. STUDY

designIn this population-based study in Ontario, Canada, women with a singleton obstetrical delivery from 2003 to 2019 were classified into those with physical (n=155,500), sensory (n=49,338), intellectual/developmental (n=2650), and multiple disabilities (≥2 disabilities; n=9904), and women without disabilities (n=1,701,574). Primary outcomes were emergency department visits and hospital admissions 0 to 365 days after index delivery hospital discharge. Secondary outcomes were emergency department visits and hospital admissions by primary diagnosis (medical, psychiatric) and by timing (0-7, 8-42, 43-365 days postpartum). Adjusted relative risks comparing each disability group to those without disabilities were adjusted for age; parity; income quintile; rurality; immigrant/refugee status; prepregnancy chronic medical conditions, mental illness, and substance use disorders; and prenatal care provider type.

resultsAny postpartum emergency department visit occurred in 23.5% of women without a disability, with risks elevated in women with physical (32.9%; adjusted relative risk, 1.27; 95% confidence interval, 1.26-1.28), sensory (30.0%; adjusted relative risk, 1.16; 95% confidence interval, 1.15-1.18), intellectual/developmental (48.8%; adjusted relative risk, 1.38; 95% confidence interval, 1.33-1.44), and multiple disabilities (42.0%; adjusted relative risk, 1.44; 95% confidence interval, 1.41-1.48) compared with women without disabilities. Similarly, any postpartum hospital admission occurred in 3.0% of women without a disability, with elevated risks in women with physical (4.8%; adjusted relative risk, 1.37; 95% confidence interval, 1.34-1.40), sensory (4.0%; adjusted relative risk, 1.19; 95% confidence interval, 1.14-1.24), intellectual/developmental (9.6%; adjusted relative risk, 1.96; 95% confidence interval, 1.73-2.21), and multiple disabilities (7.3%; adjusted relative risk, 1.77; 95% confidence interval, 1.64-1.90). Results were consistent by primary diagnosis and timing in the postpartum period.

conclusionWomen with disabilities have elevated risk of emergency department visits and hospital admissions in the postpartum period, indicating greater postpartum morbidity, which requires attention through enhanced and extended follow-up across the postpartum period.

Indexed as

Persons with DisabilitiesPregnancy ComplicationsAdultEmergency Service, HospitalFemaleHumansOntarioPostpartum PeriodPregnancydisabled personsemergency servicehospitalmaternal healthmaternal health servicespostnatal carepostpartum periodsupport for persons with disabilities

Identifiers

PMID35248782
PMCPMC9703340

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.