Emergency Department Visits During Pregnancy.

Area of Science:

• Obstetrics and Gynecology
• Emergency Medicine
• Public Health

Background:

• Pregnant women frequently access emergency department (ED) services.
• Understanding the patterns and predictors of ED visits during pregnancy is crucial for optimizing maternal care.
• Previous research has not fully elucidated the factors associated with increased ED utilization in this population.

Purpose of the Study:

• To determine the frequency and characteristics of emergency department visits among pregnant women.
• To identify sociodemographic and clinical factors associated with increased ED utilization during pregnancy.

Main Methods:

• A retrospective cohort study was conducted using administrative health data from Alberta, Canada (2011-2017).
• Included were pregnancies resulting in live births at ≥20 weeks gestation.
• Random-effect negative binomial regression was used to analyze associations between various factors and ED visits, adjusting for multiple pregnancies.

Main Results:

• The study analyzed 255,929 pregnancies; 37.3% had at least one ED visit.
• The overall ED visit rate was 94.0 per 100 pregnancies, with most visits being nonobstetric and resulting in discharge.
• Increased ED visits were linked to rural/remote residence, younger maternal age, intensive prenatal care, and pre-existing major/moderate, mental health conditions, and high antepartum risk.

Conclusions:

• Approximately one in three pregnant women utilized emergency department services.
• Factors such as rural/remote location, younger maternal age, and concurrent health issues significantly increased the likelihood of ED visits during pregnancy.
• These findings highlight specific populations and conditions associated with higher ED use, informing targeted healthcare strategies.