Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA.
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA.
Matern Child Health J. 2024 Sep;28(9):1506-1516. doi: 10.1007/s10995-024-03929-z. Epub 2024 May 25.
To understand differences in the relationship between parental leave duration and postpartum care across sociodemographic and income groups.
We used data from six states participating in the Center for Disease Control and Prevention's yearly PRAMS study from 2016 to 2019 with a total sample of 12,442 people. Bivariable analyses assessed demographics among those who took more or less parental leave and estimated the prevalence of not accessing postpartum care by demographics, stratified by leave length. We used propensity score weighting to estimate the predicted risk and risk ratios of not accessing postpartum care with < 7 as compared to > = 7 weeks of leave, stratified by income.
There were significant differences in the prevalence of not accessing care stratified by leave duration, and disparities in utilization by race, ethnicity, and income. A shorter leave duration was associated with a higher risk of not accessing care (RR: 1.98 [CI 1.25-3.20] in higher income group, RR: 1.45 [CI 1.08, 1.99] in lower). The absolute risk of not accessing care was highest in the lower income group regardless of leave duration, though patterns of increased utilization with longer leave duration were consistent in both groups.
While shorter leave durations increased the risk of not attending postpartum care, those with lower incomes had the highest absolute risk of not attending care. Policies to support paid leave and extended leave duration are necessary, along with additional supports to increase postpartum care utilization, particularly among low-income families.
了解父母休假时长与产后护理在社会人口统计学和收入群体间的关系差异。
我们使用了 2016 年至 2019 年来自六个参与疾病控制与预防中心年度 PRAMS 研究的州的数据，总样本量为 12442 人。双变量分析评估了休假时间长短不同的人群的人口统计学特征，并按休假时长分层，估计了不同人口统计学特征的人未接受产后护理的比例。我们使用倾向评分加权法，按收入分层，估计了休假时间<7 周与≥7 周的人未接受产后护理的风险和风险比。
按休假时长分层，未接受护理的比例存在显著差异，不同种族、族裔和收入的利用率存在差异。较短的休假时长与未接受护理的风险增加相关（高收入组的 RR：1.98 [CI 1.25-3.20]，低收入组的 RR：1.45 [CI 1.08, 1.99]）。无论休假时长如何，低收入群体未接受护理的绝对风险最高，尽管在两个群体中，随着休假时长的延长，利用率增加的模式是一致的。
虽然较短的休假时长增加了未接受产后护理的风险，但收入较低的人群未接受护理的绝对风险最高。需要制定带薪休假和延长休假时长的政策，同时还需要增加额外的支持，以提高产后护理的利用率，尤其是在低收入家庭中。
