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01-11-2016

Predictors of Non-Attendance to the Postpartum Follow-up Visit

Authors: Annemieke Wilcox, Erika E. Levi, Joanne M. Garrett

Published in: Maternal and Child Health Journal | Special Issue 1/2016

Abstract

Objectives This study aimed to measure the incidence and identify predictors of postpartum visit non-attendance, using medical records of women who received prenatal care and went on to deliver live births at Montefiore Hospital in 2013. Methods Pearson’s Chi square tests were used to assess the association between maternal demographics, insurance status, and delivery information with non-attendance of a postpartum visit. Logistic regression and modified Poisson regression models were then used to identify statistically significant predictors of postpartum visit non-attendance. Results We found that one-third of all women who attended a prenatal visit at Montefiore Hospital did not return for a postpartum visit. Variables significantly associated with non-attendance include having Medicaid or no insurance (RR 1.4, 95 % CI 1.2–1.6), being Hispanic or Latino (RR 1.2, 95 % CI 1.1–1.3), having a vaginal delivery (RR 1.2, 95 % CI 1.1–1.4), and age <20 years (RR 0.77, 95 % CI 0.64–0.92). Conclusions for Practice We conclude that the risk of postpartum visit non-attendance disproportionately impacts socially and economically vulnerable patients who are: younger, part of a minority ethnic background, and depend on state funded health insurance. Our results highlight the disparity in access to postpartum care and the importance of identifying barriers to attendance as well as developing creative strategies of providing postpartum care outside of the traditional postpartum visit framework.

American College of Obstetricians and Gynecologists (ACOG). (2016). Committee opinion: Optimizing postpartum care. ACOG practice bulletin 666. Washington, DC, The College.

Baby-friendly USA, Designated Facilities by State. (2012). Retrieved July 24, 2016, from https://www.babyfriendlyusa.org/find-facilities.

Berger, E., Wu, A., Smulian, E. A., Quinones, J. N., Curet, S., Marraccini, R. L., & Smulian, J. C. (2014). Universal versus risk factor-targeted early inpatient postpartum depression screening. The Journal of Maternal-fetal and Neonatal Medicine. doi:10.3109/14767058.2014.932764.PubMed

Bryant, A. S., Haas, J. S., McElrath, T. F., & McCormick, M. C. (2006). Predictors of compliance with the postpartum visit among women living in healthy start project areas. Maternal and Child Health Journal, 10(6), 511–516. doi:10.1007/s10995-006-0128-5.CrossRefPubMed

Centers for Medicare and Medicaid Services (CMS). (2015). Resources on strategies to improve postpartum care among Medicaid and CHIP populations. Retrieved July 26, 2016, from https://www.medicaid.gov/medicaid-chip-program-information/by-topics/quality-of-care/downloads/strategies-to-improve-postpartum-care.pdf.

Conde-Agudelo, A., Rosas-Bermúdez, A., & Kafury-Goeta, A. (2006). Birth spacing and risk of adverse perinatal outcomes: A meta-analysis. The Journal of the American Medical Association, 295(15), 1809–1823. doi:10.1001/jama.295.15.1809.CrossRefPubMed

DiGirolamo, A. M., Grummer-Strawn, L. M., & Fein, S. B. (2008). Effect of maternity-care practices on breastfeeding. Pediatrics, 122(Suppl 2), S43–S49.CrossRefPubMed

Frost, J. J., & Darroch, J. E. (2008). Factors associated with contraceptive choice and inconsistent method use, US, 2004. Perspectives on Sexual and Reproductive Health, 40(2), 94–104. doi:10.1363/4009408.CrossRefPubMed

Gilson, L., Doherty, J., Loewenson, R., & Francis, V. (2007). Challenging inequity through health systems. Final Report of the Knowledge Network on Health Systems.

Glasier, A. F., Logan, J., & McGlew, T. J. (1996). Who gives advice about postpartum contraception? Contraception, 53(4), 217–220.CrossRefPubMed

Healthcare Effectiveness Data and Information Set (HEDIS). (2009). Healthcare effectiveness data and information set. Washington DC: NCQA.

Henderson, V. (2015). Understanding factors associated with postpartum visit attendance and contraception choices: Listening to low-income postpartum women and health care providers. In 2015 APHA annual meeting and exposition (October 31–November 4, 2015). APHA.

Jackson, B., & Goodman, E. (2011). Low social status markers: Do they predict depressive symptoms in adolescence? Race and Social Problems, 3(2), 119–128.CrossRefPubMedPubMedCentral

Kirby, J. B., Taliaferro, G., & Zuvekas, S. H. (2006). Explaining racial and ethnic disparities in health care. Medical Care, 44(5), I–64.CrossRef

Lu, M. C., & Prentice, J. (2002). The postpartum visit: Risk factors for nonuse and association with breast-feeding. American Journal of Obstetrics and Gynecology, 187(5), 1329–1336.CrossRefPubMedPubMedCentral

McLachlan, H. L., Forster, D. A., Amir, L. H., Small, R., Cullinane, M., Watson, L. F., & Shafiei, T. (2014). Supporting breastfeeding In Local Communities (SILC): Protocol for a cluster randomised controlled trial. BMC Pregnancy and Childbirth, 14(1), 346. doi:10.1186/1471-2393-14-346.CrossRefPubMedPubMedCentral

Merewood, A., Mehta, S. D., Chamberlain, L. B., Philipp, B. L., & Bauchner, H. (2005). Breastfeeding rates in US Baby-Friendly hospitals: Results of a national survey. Pediatrics, 116(3), 628–634. doi:10.1542/peds.2004-1636.CrossRefPubMed

National Committee for Quality Assurance, The State of Health Care Quality. (2010). http://www.ncqa.org/.

Ogburn, J. A., Espey, E., & Stonehocker, J. (2005). Barriers to intrauterine device insertion in postpartum women. Contraception, 72(6), 426–429. doi:10.1016/j.contraception.2005.05.016.CrossRefPubMed

Rose, G. (2001). Sick individuals and sick populations. International Journal of Epidemiology, 30(3), 427–432.CrossRefPubMed

Shi, L., Stevens, G. D., & Politzer, R. M. (2007). Access to care for US health center patients and patients nationally: How do the most vulnerable populations fare? Medical Care, 45(3), 206–213.CrossRefPubMed

Siddiqui, R., Bell, T., Sangi-Haghpeykar, H., Minard, C., & Levison, J. (2014). Predictive factors for loss to postpartum follow-up among low income HIV-infected women in Texas. AIDS Patient Care and STDs, 28(5), 248–253. doi:10.1089/apc.2013.0321.CrossRefPubMed

Sit, D. K., & Wisner, K. L. (2009). The identification of postpartum depression. Clinical Obstetrics and Gynecology, 52(3), 456.CrossRefPubMedPubMedCentral

Sonalkar, S., Mody, S., & Gaffield, M. E. (2014). Outreach and integration programs to promote family planning in the extended postpartum period. International Journal of Gynaecology and Obstetrics, 124(3), 193–197. doi:10.1016/j.ijgo.2013.09.021.CrossRefPubMed

Stevens-Simon, C., Kelly, L., & Singer, D. (1999). Preventing repeat adolescent pregnancies with early adoption of the contraceptive implant. Family Planning Perspectives, 31(2), 88–93.CrossRefPubMed

Thiel de Bocanegra, H., Chang, R., Howell, M., & Darney, P. (2014). Interpregnancy intervals: Impact of postpartum contraceptive effectiveness and coverage. American Journal of Obstetrics and Gynecology, 210(4), 311.e1–e18. doi:10.1016/j.ajog.2013.12.020.CrossRef

Tocce, K. M., Sheeder, J. L., & Teal, S. B. (2012). Rapid repeat pregnancy in adolescents: Do immediate postpartum contraceptive implants make a difference? American Journal of Obstetrics and Gynecology, 206(6), 481.e81–87. doi:10.1016/j.ajog.2012.04.015.CrossRef

U.S. Department of Health and Human Services, Social Determinants of Health. (2014). Retreived July 25, 2016, from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health#two.

U.S. Department of Health and Human Services, Healthy People 2020, Objective FP5 and MICH-19. Washingtion, DC. Retrieved July 2, 2014, from http://www.healthypeoplegov/2020/topicsobjectives2020.

Weinick, R. M., Zuvekas, S. H., & Cohen, J. W. (2000). Racial and ethnic differences in access to and use of health care services, 1977 to 1996. Medical Care Research and Review, 57(suppl 1), 36–54.CrossRefPubMed

Weir, S., Posner, H. E., Zhang, J., Willis, G., Baxter, J. D., & Clark, R. E. (2011). Predictors of prenatal and postpartum care adequacy in a Medicaid managed care population. Women’s Health Issues, 21(4), 277–285.CrossRefPubMed

World Health Organization. (1998). Postpartum care of the mother and newborn: a practical guide. Geneva: WHO. Retrieved July 13, 2016, from http://apps.who.int/iris/bitstream/10665/66439/1/WHO_RHT_MSM_98.3.pdf.

Zhu, B. P., Rolfs, R. T., Nangle, B. E., & Horan, J. M. (1999). Effect of the interval between pregnancies on perinatal outcomes. The New England Journal of Medicine, 340(8), 589–594. doi:10.1056/nejm199902253400801.CrossRefPubMed

Zou, G. (2004). A modified poisson regression approach to prospective studies with binary data. American Journal of Epidemiology, 159(7), 702–706.CrossRefPubMed

Title: Predictors of Non-Attendance to the Postpartum Follow-up Visit
Authors: Annemieke Wilcox
Erika E. Levi
Joanne M. Garrett
Publication date: 01-11-2016
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue Special Issue 1/2016
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-016-2184-9

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Predictors of Non-Attendance to the Postpartum Follow-up Visit

Abstract

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Abstract

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