Association of Pregnancy Documentation with Radiological Imaging in the Emergency Department

Area of Science:

• Medical imaging
• Public health
• Health equity

Background:

• Emergency department (ED) visits are frequent for pregnant individuals in the U.S.
• Radiological imaging is often avoided during pregnancy due to potential risks.
• This study investigates missed pregnancy documentation in EDs and its link to imaging use.

Purpose of the Study:

• To determine the frequency of missed pregnancy documentation in ED encounters.
• To assess the association between undocumented pregnancies and the use of radiological imaging.
• To identify potential disparities in care for pregnant individuals in the ED.

Main Methods:

• Retrospective cohort study of pregnant individuals with live births in Indiana (2022-2023).
• Included 4,597 ED encounters between 42-279 days of gestation, excluding those near delivery.
• Analyzed pregnancy documentation status and receipt of chest, abdomen, or spine radiological imaging using logistic regression.

Main Results:

• Pregnancy was undocumented in 5.9% (273/4,597) of encounters.
• Missed documentation was higher among non-Hispanic Black patients (OR 1.70).
• Undocumented pregnancies were associated with significantly increased odds of receiving radiological imaging (OR 2.11).

Conclusions:

• Missed pregnancy documentation in 5.9% of ED encounters is a significant issue.
• This omission is strongly associated with increased use of radiological imaging.
• Addressing documentation gaps is crucial for equitable maternal care and outcomes.