Show simple item record

dc.contributor.authorClements, Karen M.
dc.contributor.authorMitra, Monika
dc.contributor.authorZhang, Jianying
dc.contributor.authorIezzoni, Lisa I.
dc.date2022-08-11T08:08:07.000
dc.date.accessioned2022-08-23T15:43:17Z
dc.date.available2022-08-23T15:43:17Z
dc.date.issued2016-09-01
dc.date.submitted2017-01-04
dc.identifier.citationWomens Health Issues. 2016 Sep-Oct;26(5):504-10. doi: 10.1016/j.whi.2016.06.001. Epub 2016 Jul 28. <a href="http://dx.doi.org/10.1016/j.whi.2016.06.001">Link to article on publisher's site</a>
dc.identifier.issn1049-3867 (Linking)
dc.identifier.doi10.1016/j.whi.2016.06.001
dc.identifier.pmid27477954
dc.identifier.urihttp://hdl.handle.net/20.500.14038/27054
dc.description.abstractBACKGROUND: Women with disabilities are at risk for poor birth outcomes. Little is known about specific potentially disabling health conditions and their effects on pregnancies. Using hospital claims, we identified women at risk for disability and evaluated the relationship between disability risk and demographic characteristics, pregnancy risks, and infant and maternal outcomes. METHODS: The 2006 through 2009 Massachusetts Pregnancy to Early Life Longitudinal data system linked birth certificate and hospital claims one year pre-pregnancy through delivery. Access Risk Classification System categorized International Classification of Diseases, Ninth Revision, Clinical Modification/Current Procedural Terminology codes into disability risk groups (no/limited vs. medium/high). Generalized estimating equations evaluated the association between disability risk and infant and maternal outcomes. RESULTS: Of 221,867 women, 14,701 (6.6%) were at medium or high risk of disability. Health conditions were classified as circulatory (23%), musculoskeletal (10%), nervous system/sensory (13%), other physical (19%), two or more physical (5%), mental illness (24%), and comorbid mental/physical (6%). Women at risk of disability were more likely than others to have socioeconomic and pregnancy risks, and adverse infant and maternal outcomes. Socioeconomic and risk profile varied by health condition category. Adjusted risk ratios for preterm birth ranged from 1.2 (95% confidence interval [CI], 1.1-1.4) for women with nervous system/sensory diagnoses to 1.6 (95% CI, 1.4-1.9) for women with two or more physical diagnoses; risk ratios for maternal delivery hospitalization for more than 5 days ranged from 1.5 (95% CI, 1.2-1.9) for women with musculoskeletal diagnoses to 3.0 (95% CI, 2.5-3.6) for women with comorbid mental/physical diagnoses. CONCLUSIONS: Disability risk identified through claims is associated with poor infant and maternal outcomes. Risk profiles vary by underlying health condition.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=27477954&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1016/j.whi.2016.06.001
dc.subjectdisabilities
dc.subjectpregnancy
dc.subjectinfant and maternal outcomes
dc.subjectClinical Epidemiology
dc.subjectEpidemiology
dc.subjectFemale Urogenital Diseases and Pregnancy Complications
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.subjectMaternal and Child Health
dc.subjectObstetrics and Gynecology
dc.subjectWomen's Health
dc.titlePregnancy Characteristics and Outcomes among Women at Risk for Disability from Health Conditions Identified in Medical Claims
dc.typeJournal Article
dc.source.journaltitleWomen's health issues : official publication of the Jacobs Institute of Women's Health
dc.source.volume26
dc.source.issue5
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/commed_pubs/6
dc.identifier.contextkey9510781
html.description.abstract<p>BACKGROUND: Women with disabilities are at risk for poor birth outcomes. Little is known about specific potentially disabling health conditions and their effects on pregnancies. Using hospital claims, we identified women at risk for disability and evaluated the relationship between disability risk and demographic characteristics, pregnancy risks, and infant and maternal outcomes.</p> <p>METHODS: The 2006 through 2009 Massachusetts Pregnancy to Early Life Longitudinal data system linked birth certificate and hospital claims one year pre-pregnancy through delivery. Access Risk Classification System categorized International Classification of Diseases, Ninth Revision, Clinical Modification/Current Procedural Terminology codes into disability risk groups (no/limited vs. medium/high). Generalized estimating equations evaluated the association between disability risk and infant and maternal outcomes.</p> <p>RESULTS: Of 221,867 women, 14,701 (6.6%) were at medium or high risk of disability. Health conditions were classified as circulatory (23%), musculoskeletal (10%), nervous system/sensory (13%), other physical (19%), two or more physical (5%), mental illness (24%), and comorbid mental/physical (6%). Women at risk of disability were more likely than others to have socioeconomic and pregnancy risks, and adverse infant and maternal outcomes. Socioeconomic and risk profile varied by health condition category. Adjusted risk ratios for preterm birth ranged from 1.2 (95% confidence interval [CI], 1.1-1.4) for women with nervous system/sensory diagnoses to 1.6 (95% CI, 1.4-1.9) for women with two or more physical diagnoses; risk ratios for maternal delivery hospitalization for more than 5 days ranged from 1.5 (95% CI, 1.2-1.9) for women with musculoskeletal diagnoses to 3.0 (95% CI, 2.5-3.6) for women with comorbid mental/physical diagnoses.</p> <p>CONCLUSIONS: Disability risk identified through claims is associated with poor infant and maternal outcomes. Risk profiles vary by underlying health condition.</p>
dc.identifier.submissionpathcommed_pubs/6
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.contributor.departmentCommonwealth Medicine, Center for Health Policy and Research
dc.source.pages504-10


Files in this item

Thumbnail
Name:
Publisher version

This item appears in the following Collection(s)

Show simple item record