Emergency Department Visits During Pregnancy - 19/01/23
Abstract |
Study objective |
Pregnant women often seek care in an emergency department (ED). We sought to describe the frequency, characteristics, and factors associated with increased ED visits during pregnancy.
Methods |
We conducted a retrospective cohort study using administrative health data of all pregnancies resulting in a live birth at 20 or more weeks of gestation in Alberta, Canada, from 2011 to 2017. The primary outcome was the occurrence of any ED visit during pregnancy. The secondary outcomes were ED visit characteristics and discharge disposition. We calculated rate ratios (RRs) and 95% confidence intervals (CIs) for associations between sociodemographic and clinical factors and increased ED visits during pregnancy using random-effect negative binomial regression adjusting for multiple pregnancies per person during the study period.
Results |
We included 255,929 pregnancies from 193,965 women. Of all the pregnancy episodes followed, 37.3% (95% CI 37.1 to 37.5) had at least 1 ED visit, resulting in a total of 226,811 ED visits and an overall ED visit rate of 94.0 visits per 100 pregnancies (95% CI 93.6 to 94.3). Most visits were nonobstetric (46.4%) and resulted in ED discharge (85.3%). Increased ED visits were associated with living in remote (RR 6.9; 95 %CI 6.7 to 7.1) or rural (RR 3.4; 95% CI 3.4 to 3.5) areas, younger age (RR 1.9; 95% CI 1.8 to 2.0), intensive prenatal care (RR 1.5; 95% CI 1.5 to 1.5), major/moderate health conditions (RR 1.6; 95% CI 1.6 to 1.6), mental health conditions (RR 1.6; 95% CI 1.5 to 1.6), and high antepartum risk score (RR 1.1; 95% CI 1.1 to 1.1).
Conclusion |
Approximately 1 in 3 women in our sample visited the ED during pregnancy. A higher number of visits occurred in those with rural/remote residence, younger maternal age, and concomitant health conditions.
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| Please see page 198 for the Editor’s Capsule Summary of this article. |
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| Supervising editor: Daniel A. Handel, MD, MBA. Specific detailed information about possible conflicts of interest for individual editors is available at editors. |
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| Author contributions: MBO, RJR, BHR, AM, RC, SC, and SJ conceptualized and designed the study. SC and SJ acquired the data. BAM, RJR, JSL, and MBO analyzed and interpreted the data. BAM and MBO drafted the manuscript. MBO, BAM, RJR, BHR, AM, RC, SC, SJ, and JSL critically revised the manuscript for important intellectual content. RJR provided statistical expertise. MBO acquired funding for the study. MBO takes responsibility for the paper as a whole. |
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| All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist. Supported by a Health Outcomes Improvement Fund Operating Grant and the Alberta Women's Health Foundation (Edmonton, Alberta) through a Women and Children's Health Research Institute Recruitment Award to Dr. Ospina. Dr. Rowe's research is supported by a Scientific Director's Grant (SOP 168483) from the Canadian Institutes of Health Research (CIHR) through the Government of Canada (Ottawa, Ontario), which supported the statistical analysis. Dr. Ospina is supported by CIHR as a Canada Research Chair in Life Course, Social Environments and Health through the Government of Canada (950-232833). |
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Vol 81 - N° 2
P. 197-208 - février 2023 Retour au numéro
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