干旱区生态环境知识资源中心(Arid): Maternity Care Deserts and Pregnancy-Associated Mortality in Louisiana

Arid

DOI	10.1016/j.whi.2020.09.004
	Maternity Care Deserts and Pregnancy-Associated Mortality in Louisiana
	Wallace, Maeve; Dyer, Lauren; Felker-Kantor, Erica; Benno, Jia; Vilda, Dovile; Harville, Emily; Theall, Katherine
通讯作者	Wallace, M (corresponding author), Tulane Univ, Sch Publ Hlth & Trop Med, Mary Amelia Douglas Whited Community Womens Hlth, Dept Global Community Hlth & Behav Sci, 1440 Canal St,Suite 2210,Mailcode 8319, New Orleans, LA 70117 USA.
来源期刊	WOMENS HEALTH ISSUES
ISSN	1049-3867
EISSN	1878-4321
出版年	2021
卷号	31 期号:2 页码:122-129
英文摘要	Background: Maternal mortality is an issue of growing concern in the United States, where the incidence of death during pregnancy and postpartum seems to be increasing. The purpose of this analysis was to explore whether residing in a maternity care desert (defined as a county with no hospital offering obstetric care and no OB/GYN or certified nurse midwife providers) was associated with risk of death during pregnancy and up to 1 year postpartum among women in Louisiana from 2016 to 2017. Methods: Data provided by the March of Dimes were used to classify Louisiana parishes by level of access to maternity care. Using data on all pregnancy-associated deaths verified by the Louisiana Department of Health (n = 112 from 2016 to 2017) and geocoded live births occurring in Louisiana during the same time period (n = 101,484), we fit adjusted modified Poisson regression models with generalized estimating equations and exploratory spatial analysis to identify significant associations between place of residence and risk of death. Results: We found that the risk of death during pregnancy and up to 1 year postpartum owing to any cause (pregnancy associated mortality) and in particular death owing to obstetric causes (pregnancy-related mortality) was significantly elevated among women residing in maternity care deserts compared with women in areas with greater access (adjusted risk ratio [aRR] for pregnancy-associated mortality, 1.91; 95% confidence interval [CI], 1.15-3.18; aRR for pregnancy related mortality, 3.37; 95% CI, 1.71-6.65). A large racial inequity in risk persisted above and beyond differences in geographic access to maternity care (non-Hispanic Black vs. non-Hispanic White aRR for pregnancy-associated mortality, 2.22; 95% CI, 1.39-3.56; aRR for pregnancy-related mortality, 2.66; 95% CI, 1.16-6.12). Conclusions: Ensuring access to maternity care may be an important step toward maternal mortality prevention, but may alone be insufficient for achieving maternal health equity. (c) 2020 Jacobs Institute of Women's Health. Published by Elsevier Inc.
类型	Article
语种	英语
收录类别	SSCI
WOS记录号	WOS:000632777400006
WOS关键词	ETHNIC DISPARITIES ; OBSTETRIC SERVICES ; HEALTH ; CLOSURES ; ACCESS ; HOSPITALS ; RACISM ; IMPACT
WOS类目	Public, Environmental & Occupational Health ; Women's Studies
WOS研究方向	Public, Environmental & Occupational Health ; Women's Studies
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/352005
作者单位	[Wallace, Maeve; Dyer, Lauren; Felker-Kantor, Erica; Vilda, Dovile; Theall, Katherine] Tulane Univ, Sch Publ Hlth & Trop Med, Mary Amelia Community Womens Hlth Educ Ctr, Dept Global Community Hlth & Behav Sci, New Orleans, LA 70117 USA; [Benno, Jia] Louisiana Dept Hlth, Bur Family Hlth, New Orleans, LA USA; [Harville, Emily] Tulane Univ, Sch Publ Hlth & Trop Med, Dept Epidemiol, New Orleans, LA 70117 USA
推荐引用方式 GB/T 7714	Wallace, Maeve,Dyer, Lauren,Felker-Kantor, Erica,et al. Maternity Care Deserts and Pregnancy-Associated Mortality in Louisiana[J],2021,31(2):122-129.
APA	Wallace, Maeve.,Dyer, Lauren.,Felker-Kantor, Erica.,Benno, Jia.,Vilda, Dovile.,...&Theall, Katherine.(2021).Maternity Care Deserts and Pregnancy-Associated Mortality in Louisiana.WOMENS HEALTH ISSUES,31(2),122-129.
MLA	Wallace, Maeve,et al."Maternity Care Deserts and Pregnancy-Associated Mortality in Louisiana".WOMENS HEALTH ISSUES 31.2(2021):122-129.