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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 2

(544) Do maternal attributes including clinical risk and antenatal services predict postpartum care by 6 months?

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: Adequate postpartum care (PPC) is critical to overall maternal health, however rates of PPC utilization in the United States are suboptimal.  To better understand factors related PPC engagement, we sought to broadly examine maternal attributes including clinical risk, antenatal services, labor and delivery outcomes, and their association with 6-month PPC.

Study Design: Retrospective cohort analysis of patients delivering in a hospital system 2013-2022 with at least 1 documented prenatal care (PNC) visit.  We identified PPC visits by examining electronic medical record (EMR) data for ICD codes for any PPC engagement within 6 months across all specialty departments, and traditional PPC defined by ICD codes Z39 and V24.  Patient socio-demographics, antenatal clinical diagnoses, measures of PNC service utilization, and maternal/neonatal outcomes were examined by PPC engagement using chi-square or ANOVA.  Multivariable logistic regression was performed including all variables p< 0.05 in bivariate tests.   Adjusted odds ratios (aOR) and 95% CI are presented in Table 1.

Results: Among 60,933 deliveries, 90.3% and 78.3% had any PPC and traditional PPC, respectively. PPC engagement at 6 months varied by many patient attributes.  Following multivariable adjustment, significantly reduced odds of any PPC and traditional PPC were observed among patients with the following attributes: multiparous, smoking, single relationship status, public insurance, gestational diabetes (GDM), and substance use disorder (SUD). In contrast, significantly increased likelihood of PPC was demonstrated among patients with planned or intrapartum cesarean, preterm birth, chronic hypertension (cHTN), depression or anxiety, influenza vaccination, and higher number of PNC visits.

Conclusion: Although the overall rate of PPC is high in this diverse cohort, patients with disparity-related risk demonstrate significantly lower rates of PPC.  These data can inform targeted antenatal and delivery admission encounter interventions to optimize PPC with the goal of improving maternal health.