Emergency consultations in obstetrics : identification of decisive, contributing and associated factors

PURPOSE: Psychosocial and biological factors influence the perception of physical changes during pregnancy. Some pregnant women present to the obstetric emergency department (ED) with diverse symptoms not requiring urgent medical action. These visits result in over-consultation, tying up resources and inflating health care expenses. This study outlines factors associated with multiple ED visits during pregnancy, measures the prevalence of anxiety and depression, and explores the choice of maternity clinic for delivery aiming to elucidate options for care strategies.

METHODS: This prospective, cross-sectional, questionnaire-based bicentric study was performed in the obstetric outpatient departments of two university hospitals in Germany and recruited pregnant women between 12/2016 and 11/2017. The questionnaire included socio-demographics, obstetric history, anxiety (GAD-7), depression (PHQ-9), and health status (WHO-5, SF-12).

RESULTS: This analysis included 496 women and showed that women with numerous ED visits were significantly younger (p < 0.0001), less educated (p = 0.0002), and more likely to be unemployed and single. Different prevalences for anxiety and depression were detected correlating with the number of ED visits although each showing only low effect sizes (0.024 resp. 0.015).

CONCLUSIONS: Pregnant women attending the ED more often might benefit from health education, psychosomatic interventions, and social support to overcome their depression and anxiety to avoid non-urgent ED consultations. Further prospective studies are needed to support these findings.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:302

Enthalten in:

Archives of gynecology and obstetrics - 302(2020), 4 vom: 01. Okt., Seite 821-828

Sprache:

Englisch

Beteiligte Personen:

Schramm, Katharina [VerfasserIn]
Nees, Juliane [VerfasserIn]
Hoffmann, Janine [VerfasserIn]
Bruckner, Thomas [VerfasserIn]
Haun, Markus W [VerfasserIn]
Maatouk, Imad [VerfasserIn]
Stepan, Holger [VerfasserIn]
Schott, Sarah [VerfasserIn]

Links:

Volltext

Themen:

Emergency visit
Fetal monitoring
Journal Article
Maternal fetal medicine
Non-urgent emergency department use
Prenatal care
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 17.11.2020

Date Revised 17.11.2020

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s00404-020-05662-8

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM31185737X