Maternal Mortality in the United States and the HOPE Registry

Grodzinsky, Anna; Florio, Karen; Spertus, John A.; Daming, Tara; Schmidt, Laura; Lee, John; Rader, Valerie; Nelson, Lynne; Gray, Rebecca A.; White, Darcy; Swearingen, Kate; Magalski, Anthony

doi:10.1007/s11936-019-0745-0

Cited by 16 publications

(9 citation statements)

References 17 publications

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“…Different scholars thought that various factors hindering the pregnant women make ANC dropout rate. Several studies suggested that socioeconomic factors such as poverty, accessibility of the health centers, lack of information about ANC, service quality, age at first birth, educational background, place of living, sociocultural, and individual factors directly affected the utilization of antenatal care follow-up services (15)(16)(17)(18)(19). Adequate utilization of the recommended antenatal care visits is a key to protecting both the mother and newborn from the adverse complications of pregnancy and childbirth.…”

mentioning

confidence: 99%

More Than One-Third of Pregnant Women in Ethiopia Had Dropped Out From Their ANC Follow-Up: Evidence From the 2019 Ethiopia Mini Demographic and Health Survey

Tariku

Tusa²,

Weldesenbet³

et al. 2022

Front. Glob. Womens Health

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BackgroundIn Ethiopia, the magnitude of antenatal care (ANC) practice and institutional delivery is low as compared with developed countries. The majority of the pregnant women have not completed their ANC follow-up and only 43% of women have reached the four and above ANC. This study was conducted to determine the magnitude of ANC dropout and associated factors among pregnant women in Ethiopia.MethodsSecondary data analysis was conducted using the 2019 Ethiopia Mini Demographic and Health Survey 2019 (2019 EMDHS). The sample was selected using a stratified, two-stage cluster sampling design and the data were analyzed using the binary logistic regression model to identify factors associated with ANC dropout. Adjusted odds ratio (AOR) with 95% CI was reported to declare significance and strength of association. A total weighted sample of 2,143 women who had antenatal care follow-up during pregnancy was included. In the multivariate logistic regression analysis, variables having a p-value < 0.05 were considered to have a significant association with ANC dropout.ResultThe magnitude of ANC dropout was 39.12% (95% CI: 37.07 and 41.20%) among women who had ANC follow-up in Ethiopia. Aged 30–49 years [AOR = 0.71; 95% CI: (0.54, 0.94)], attended primary [AOR = 0.79; 95% CI: (0.62, 0.99)], secondary [AOR = 0.63; 95% CI: (0.44, 0.87)], and higher education [AOR = 0.39; 95% CI: (0.25, 0.62)], were in first trimesters [AOR = 0.49; 95% CI: (0.40, 0.60)] at the time of first ANC visit, and had access to laboratory service [AOR = 0.25; 95% CI: (0.13, 0.51)] were found to be a negative significant associated factors of ANC dropouts, whereas being rural resident [AOR = 1.53; 95% CI: (1.11, 2.10)] has a positive significant association with ANC dropouts.ConclusionMore than one-third of the pregnant women in Ethiopia had dropped out from their ANC follow-up in the study period. Being old-aged, educated, urban resident, having a first ANC visit in the first trimester, and having access to laboratory service were negatively associated with ANC dropouts. Therefore, we recommended encouraging women to have ANC visit at an early stage of pregnancy and conducting basic laboratory investigations during their visit. When undertaking that, due attention should be given to young, uneducated, and rural dweller women.

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confidence: 99%

More Than One-Third of Pregnant Women in Ethiopia Had Dropped Out From Their ANC Follow-Up: Evidence From the 2019 Ethiopia Mini Demographic and Health Survey

Tariku

Tusa²,

Weldesenbet³

et al. 2022

Front. Glob. Womens Health

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“…Some of these include the Nulliparous Pregnancy Outcomes (nuMoM2b-Heart Healthy Study), the Heart Outcomes in Pregnancy Expectations (HOPE) Registry, and the Registry of Pregnancy and Cardiac Disease (ROPAC). 23 24 25 26 …”

Section: Core Components Of Cardio-obstetrics Trainingmentioning

confidence: 99%

“…Interventions focused on women with APOs to reduce future cardiovascular risk are also an active area of investigation. Epidemiologic and population health studies using large databases—such as the National Inpatient Sample, 19 22 27 administrative claims databases, and cohort studies such as the HOPE registry, 24 —facilitate understanding. Basic science, translational research, and personalized medicine offer the opportunity to elucidate disease mechanisms and the impact of pregnancy-related CVD on long-term health.…”

Section: Core Components Of Cardio-obstetrics Trainingmentioning

confidence: 99%

Instituting a Curriculum for Cardio-Obstetrics Subspecialty Fellowship Training

Minhas

Goldstein

Vaught

et al. 2022

Methodist DeBakey Cardiovascular Journal

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Maternal mortality is rising in the United States, and cardiovascular disease is the leading cause. Adverse pregnancy outcomes such as preeclampsia and gestational diabetes heighten the risk of cardiovascular complications during pregnancy and the peripartum period and are associated with long-term cardiovascular risks. The field of cardio-obstetrics is a subspecialty within adult cardiology that focuses on the management of women with or at high risk for heart disease who are considering pregnancy or have become pregnant. There is growing recognition of the need for more specialists with dedicated expertise in cardio-obstetrics to improve the cardiovascular care of this high-risk patient population. Current recommendations for cardiovascular fellowship training programs accredited by the Accreditation Council for Graduate Medical Education involve establishing core competency in the knowledge of managing heart disease in pregnancy. However, little granular detail is available of what such training should entail, which can lead to knowledge gaps. Additionally, dedicated advanced subspecialty training in this area is not commonly offered. Multidisciplinary collaborative teams have been shown to improve outcomes in cardiac patients during pregnancy, and cardiovascular fellows-in-training interested in cardio-obstetrics should have the opportunity to participate in and contribute to a pregnancy heart team. In this document, we describe a proposed specialized cardio-obstetrics training pathway that could serve to adequately prepare trainees to competently and comprehensively care for women with cardiovascular disease before, during, and after pregnancy.

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“…The research collaborative, HOPE (Heart Outcomes in Pregnancy: Expectations for Mom and Baby) Registry, aims to gather data on both mothers affected by HF and other cardiac conditions and their babies. 97 This multi‐institutional prospective registry would provide insights into delivery approaches, management plans, and contraception counseling practices for this patient population and provide a better understanding of all aspects related to maternal and neonatal outcomes through to 5 years postpartum. Other opportunities for progress lie in State Perinatal Quality Collaboratives, which are networks of multidisciplinary teams, striving to improve measurable outcomes for maternal and neonatal health by examining evidence‐based clinical practices and processes using quality improvement principles.…”

Section: Future Directions and Researchmentioning

confidence: 99%

Maternal Heart Failure

Bright

Lima

Avila

et al. 2021

JAHA

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Heart failure (HF) remains the most common major cardiovascular complication arising in pregnancy and the postpartum period. Mothers who develop HF have been shown to experience an increased risk of death as well as a variety of adverse cardiac and obstetric outcomes. Recent studies have demonstrated that the risk to neonates is significant, with increased risks in perinatal morbidity and mortality, low Apgar scores, and prolonged neonatal intensive care unit stays. Information on the causal factors of HF can be used to predict risk and understand timing of onset, mortality, and morbidity. A variety of modifiable, nonmodifiable, and obstetric risk factors as well as comorbidities are known to increase a patient's likelihood of developing HF, and there are additional elements that are known to portend a poorer prognosis beyond the HF diagnosis. Multidisciplinary cardio‐obstetric teams are becoming more prominent, and their existence will both benefit patients through direct care and increased awareness and educate clinicians and trainees on this patient population. Detection, access to care, insurance barriers to extended postpartum follow‐up, and timely patient counseling are all areas where care for these women can be improved. Further data on maternal and fetal outcomes are necessary, with the formation of State Maternal Perinatal Quality Collaboratives paving the way for such advances.

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Maternal Mortality in the United States and the HOPE Registry

Cited by 16 publications

References 17 publications

More Than One-Third of Pregnant Women in Ethiopia Had Dropped Out From Their ANC Follow-Up: Evidence From the 2019 Ethiopia Mini Demographic and Health Survey

More Than One-Third of Pregnant Women in Ethiopia Had Dropped Out From Their ANC Follow-Up: Evidence From the 2019 Ethiopia Mini Demographic and Health Survey

Instituting a Curriculum for Cardio-Obstetrics Subspecialty Fellowship Training

Maternal Heart Failure

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