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Supplement to Annals of IM discusses key considerations, strategies to address maternal mortality

Embargoed News from Annals of Internal Medicine

American College of Physicians

Research News

Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.

Supplement to Annals of Internal Medicine discusses key considerations and strategies to address maternal mortality and morbidity in the United States
Editorial abstract: https://www.acpjournals.org/doi/10.7326/M19-3259
URLs go live when the embargo lifts

A special supplement to Annals of Internal Medicine discusses evidence-based approaches and innovative solutions to decreasing maternal mortality and morbidity rates in the United States. Supplement articles stemmed from sessions at the Health Resources and Services Administration (HRSA) Maternal Mortality Summit.

In the United States, it is estimated that 2 women die every 3 days because of pregnancy. The absolute numbers may appear to be small, but any maternal death is unacceptable, the authors say. To address this issue, the HRSA of the U.S. Department of Health and Human Services convened the HRSA Maternal Health Summit in June 2018. During the summit, countries shared openly on the challenges of measuring and documenting maternal deaths and to discuss realistic strategies for moving forward with the goal of reducing deaths to no more than 70 per 100,000 live births worldwide.

Focusing on discussions related specifically to the United States, the HRSA Maternal Mortality Summit highlighted essential areas to address. These include the general health among women and the effects of inequities and disparities. Additional concerns discussed were the availability of a robust health workforce and the relevant policies and financial implications that drive the overall U.S. health agenda. Specific papers in the supplement include:

  • Timing of Prenatal Care Initiation in the Health Resources and Services Administration Health Center Program in 2017: This paper from authors at the HRSA discusses health center characteristics associated with the initiation of prenatal care in the first trimester, as well as actionable steps policymakers, providers, and health centers can take to promote early initiation of prenatal care.
    Link: https://www.acpjournals.org/doi/10.7326/M19-3248.

  • Trends in Opioid and Psychotropic Prescription in Pregnancy in the United States From 2001 to 2015 in a Privately Insured Population: This paper from Ohio State University finds that opioids are frequently co-prescribed with psychotropic medication during pregnancy at doses that increase overdose risk and exceed daily recommendations.
    Link: https://www.acpjournals.org/doi/10.7326/M19-3249.

  • Rural-Urban Differences in Health Care Access Among Women of Reproductive Age: A 10-Year Pooled Analysis: Among other differences, this paper from the Oak Ridge Institute for Science and Education finds that rural women may less often visit obstetrician-gynecologists, which might have relevance for maternal mortality.
    Link: https://www.acpjournals.org/doi/10.7326/M19-3250.

  • Rural-Urban Differences in Delivery Hospitalization Costs by Severe Maternal Morbidity Status: This paper from authors at the HRSA found that women residing in rural areas have higher hospitalization costs than those in urban areas among deliveries both with and without severe maternal morbidity.
    Link: https://www.acpjournals.org/doi/10.7326/M19-3251.

  • Health Needs of Mothers of Infants in a Neonatal Intensive Care Unit: This paper from authors at the University of North Carolina at Chapel Hill found that NICU mothers not only had a greater burden of chronic disease and perinatal complications, but also faced multiple barriers to addressing their physical and emotional needs.
    Link: https://www.acpjournals.org/doi/10.7326/M19-3252.

  • Association of Maternal Comorbidity With Severe Maternal Morbidity: This study from Stanford Medical School examines the association of maternal comorbid conditions, age, body mass index, and previous cesarean birth with occurrence of severe maternal morbidities, which are on the rise since 1997.
    Link: https://www.acpjournals.org/doi/10.7326/M19-3253.

  • Regional Variations in Maternal Mortality and Health Workforce Availability in the United States: This paper from authors at the HRSA finds that regional variations in maternal mortality rates may relate to the availability of birth-attending and primary care providers.
    Link: https://www.acpjournals.org/doi/10.7326/M19-3254.

  • Initiatives to Reduce Maternal Mortality and Severe Maternal Morbidity in the United States: This narrative review from the HRSA briefly describes the epidemiology of maternal mortality and severe maternal morbidity in the United States and discusses selected initiatives to reduce maternal mortality and severe maternal morbidity in the areas of data and surveillance; clinical workforce training and patient education; telehealth; comprehensive models and strategies; and clinical guidelines, protocols, and bundles.
    Link: https://www.acpjournals.org/doi/10.7326/M19-3258.

Media contacts:
For an embargoed PDF or to be connected with an author(s), please contact Lauren Evans at
laevans@acponline.org.

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