Journal of women's health
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Journal of women's health · Jun 2022
A County Hospital Experience with Reproductive Travelers to the United States for Obstetric Care: Maternal and Neonatal Outcomes.
Objective: To describe the maternal and neonatal outcomes, health care utilization, and cost to reproductive travelers for obstetric care (RTOC) at a single institution. Materials and Methods: A retrospective chart review was conducted of women identified as reproductive travelers who delivered at Stroger Hospital in Chicago, IL when a self-pay package of obstetrical services was offered. Data included maternal characteristics and obstetric and neonatal outcomes. ⋯ Extra charges beyond those covered by the financial package were incurred by 230 (55.7%) of the women. Conclusion: Reproductive travelers have better obstetric outcomes and fewer NICU admissions than non-travelers who delivered at the same institution. However, the care of RTOC in this manner is fraught with challenges, including late presentation for care, lack of medical records, providers at times managing unfamiliar conditions, and unforeseen financial obligations assumed by patients.
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Journal of women's health · Jun 2022
Effects of Stress and Nativity on Maternal Antenatal Substance Use and Postnatal Mental Disorders.
Background: Maternal substance use and common mental disorders (CMDs) during or after pregnancy can lead to negative health outcomes among mothers and infants. We examined whether nativity (US-born versus foreign-born) and stress levels during pregnancy were associated with antenatal substance use and postnatal CMDs. Methods: We analyzed the Boston Birth Cohort, a racially diverse cohort recruited at birth with rolling enrollment since 1998. ⋯ In analyses combining nativity and stress, being US-born with high stress was associated with increased odds of antenatal substance use (adjusted odds ratio [aOR] = 14.91, 95% confidence interval [CI]: 12.09-18.39) and postnatal CMDs (aOR = 4.09, 95% CI: 2.72-6.15) compared with foreign-born mothers with low stress. The results of the subanalyses limited to black and Hispanic women separately were similar; high stress alone was associated with fourfold increased odds of CMDs among foreign-born Hispanic mothers (aOR = 4.27, 95% CI: 1.96-9.33). Conclusions: Findings suggest that identifying and alleviating high stress among pregnant women may reduce their risk of antenatal substance use and postnatal CMDs.
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Journal of women's health · Jun 2022
Interconception Preventive Care and Recurrence of Pregnancy Complications for Medicaid-Insured Women.
Background: Pregnancy complications may recur and are associated with potentially modifiable risks. The role of interconception preventive care in reducing repeat pregnancy complications is understudied. Materials and Methods: This retrospective cohort used 2007-2012 Medicaid claims from 12 states. ⋯ Preventive visits were associated with reduced hypertension in the subsequent pregnancy (OR 0.88, 95% CI 0.82-0.97) but not reduced preterm birth or diabetes. Conclusions: Preventive visits after an index birth complicated by prematurity, hypertension, or diabetes were associated with 10% lower odds of hypertension in a subsequent pregnancy, but not with reductions in diabetes or prematurity. Some complications may be more amenable to interconception preventive services than others.