Pregnant individuals who make frequent visits to the hospital may be at a higher risk of experiencing life-threatening complications during or after pregnancy, as indicated by a recent study conducted by Boston University School of Public Health (BUSPH) and Cityblock Health. Published in JAMA Network Open, the study analyzed data from nearly 775,000 pregnant patients in Massachusetts and found that 31% of them had at least one unscheduled emergency visit to the hospital, with 3.3% having four or more unscheduled visits. This latter group was almost 50% more likely to experience severe maternal morbidity (SMM), which includes complications such as aneurysms, eclampsia, kidney and heart failure, and sepsis.
Of particular concern was the fact that nearly half of the pregnant individuals who had four or more emergency visits during their pregnancy sought care at multiple hospitals. This lack of continuity in treatment makes it challenging for hospital-based pregnancy programs to fully understand and address the prenatal and postpartum challenges faced by these high-risk patients. The study highlighted the importance of early identification of high-risk cases to prevent severe maternal morbidity and ensure better outcomes for mothers and infants.
The researchers also observed disparities in emergency care utilization among pregnant patients, with young women under 25, Hispanic and non-Hispanic Black individuals, and those with additional health conditions or opioid-related hospitalizations being more likely to make multiple emergency visits. These findings underscore the need for targeted interventions to address the structural racism and systemic barriers that contribute to maternal morbidity in these populations.
Dr. Eugene Declercq, the lead author of the study, emphasized the importance of proactive community-based support for high-risk pregnant patients to prevent adverse outcomes. By identifying and addressing the root causes of frequent emergency care visits during pregnancy, healthcare providers, policymakers, and advocates can work together to improve maternal health outcomes and reduce disparities in care.
The study, which utilized data from a statewide database in Massachusetts, sheds light on the significant impact of emergency care utilization on maternal health outcomes. By bringing attention to this public health issue and advocating for comprehensive and timely interventions, the researchers hope to drive meaningful change in the way prenatal care is delivered to high-risk pregnant patients. This study serves as a call to action for stakeholders across the healthcare system to address the unmet needs of pregnant individuals and ensure better maternal health outcomes for all.
