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Published on: August 25, 2014
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A multi-level explanatory-sequential mixed-methods study of perinatal toxicology practices in New York State:
Sugy Choi1, Elizabeth Knopf1, Erin Kim1
1Department of Population Health, New York University Grossman School of Medicine, New York, New York, United States of America.
Plos One
|December 31, 2025
Summary
Maternal drug overdose deaths are rising, particularly in pregnant women. This study examines toxicology testing variations and outcomes to improve care access and reduce disparities for pregnant and postpartum individuals.
Area of Science:
- Public Health
- Health Services Research
- Maternal Health
Background:
- Rising maternal morbidity and mortality (MMM) from drug overdoses impacts pregnant and postpartum women aged 35-44.
- Current toxicology testing practices in hospitals lack clear understanding regarding their effectiveness in linking patients to care.
- Disparities in care access persist for vulnerable maternal populations.
Purpose of the Study:
- To investigate variations in toxicology testing for pregnant and postpartum women.
- To explore hospital- and individual-level factors influencing testing practices.
- To assess the impact of testing on linkage to care and health outcomes.
Main Methods:
- Mixed-methods study using the Socio-cultural Framework for the Study of Health Service Disparities (SCF-HSD) in New York State.
- Multilevel statistical models with New York State Medicaid claims data (2021-2024) to identify testing predictors and hospital variation.
- Qualitative interviews with hospital staff and focus groups with individuals with lived experience to inform policy.
Main Results:
- Predictors of perinatal toxicology testing will be identified.
- Hospital-level variations in testing policies and practices will be characterized.
- Diverse perspectives on testing rationales, attitudes, and adherence will be captured.
Conclusions:
- Findings will guide improvements in toxicology testing disparities for pregnant and postpartum women.
- Emphasis on standardized, evidence-based protocols and supportive service pathways is crucial.
- Policy reforms are needed to reduce stigma and inequities in maternal care.
