Stegman Molly M, Lucarelli-Baldwin Elizabeth, Ural Serdar H
College of Medicine, The Pennsylvania State University, Hershey, PA, United States.
Department of Obstetrics and Gynecology, College of Medicine, The Pennsylvania State University, Hershey, PA, United States.
Front Glob Womens Health. 2023 Jul 25;4:1151362. doi: 10.3389/fgwh.2023.1151362. eCollection 2023.
The term "high-risk pregnancy" describes a pregnancy at increased risk for complications due to various maternal or fetal medical, surgical, and/or anatomic issues. In order to best protect the pregnant patient and the fetus, frequent prenatal visits and monitoring are often recommended. Unfortunately, some patients are unable to attend these appointments for various reasons. Moreover, it has been documented that patients from ethnically and racially diverse backgrounds are more likely to miss medical appointments than are Caucasian patients. For instance, a case-control study retrospectively identified the race/ethnicity of patients who no-showed for mammography visits in 2018. Women who no-showed were more likely to be African American than patients who kept their appointments, with an odds ratio of 2.64 (4). Several other studies from several other primary care and specialty disciplines have shown similar results. However, the current research on high-risk obstetric no-shows has focused primarily on patients miss their appointments rather than are missing appointments. This is an area of opportunity for further research. Given disparities in health outcomes among underrepresented racial/ethnic groups and the importance of prenatal care, especially in high-risk populations, targeted attempts to increase patient participation in prenatal care may improve maternal and infant morbidity/mortality in these populations.
“高危妊娠”一词描述的是由于各种母体或胎儿的医学、外科和/或解剖学问题而导致并发症风险增加的妊娠。为了最好地保护孕妇和胎儿,通常建议进行频繁的产前检查和监测。不幸的是,一些患者由于各种原因无法参加这些预约。此外,有记录表明,来自不同种族和民族背景的患者比白人患者更有可能错过医疗预约。例如,一项病例对照研究回顾性地确定了2018年未按预约进行乳房X光检查的患者的种族/民族。未按预约就诊的女性比按时就诊的患者更有可能是非裔美国人,优势比为2.64(4)。其他几个初级保健和专科领域的研究也显示了类似的结果。然而,目前关于高危产科未就诊患者的研究主要集中在患者错过预约,而不是正在错过预约。这是一个有待进一步研究的领域。鉴于在代表性不足的种族/民族群体中健康结果存在差异,以及产前护理的重要性,特别是在高危人群中,有针对性地努力提高患者对产前护理的参与度可能会改善这些人群的母婴发病率/死亡率。