In Florida, drug-related death was the leading cause of pregnancy-associated death (PAD) in 2017, accounting for one in four deaths. In order to reduce PAD, it is important to identify women at greatest risk of PAD itself and its leading causes, including substance use disorder and associated mental health conditions (e.g., postpartum anxiety and depression). Florida provides a unique opportunity to examine the feasibility of screening tools for PAD and severe maternal morbidity (SMM), as it is the only state that currently requires universal screening of all pregnant women and infants. The Healthy Start (HS) Risk Screen, administered prenatally and at birth, identifies those at highest risk of preterm birth, low birth weight, adverse health outcomes, and infant mortality. The screening questions focus on sociocultural issues, reflecting aspects of health disparities and adversity that affect pregnancy, health, and infant development. These HS Risk Screens, either in their current form or enhanced to include other individual or environmental factors, may also be useful in identifying women at high risk of PAD and SMM. The goal of this study is to utilize the HS Risk Screens, along with other readily available data on individual and environmental factors, to examine the ability to identify women at risk of PAD and SMM, particularly related to postpartum anxiety, depression, and substance use disorder. We will use available linked statewide administrative data as well as leverage ongoing efforts to link these administrative datasets to the OneFlorida Data Trust, a central data repository that hosts electronic health records (EHR) and geospatial information for over 15 million patients across Florida. We will work closely with key stakeholders, including obstetric providers, the association of Healthy Start coalitions across Florida, and pregnant women, to determine the feasibility of prenatal screening for PAD and/or substance-use related SMM. Knowledge gained from this study will inform the feasibility of PAD and/or SMM screening at a large scale amongst diverse populations.
In order to reduce pregnancy-associated death (PAD), it is important to identify women at greatest risk of PAD itself and its leading causes, including substance use disorder and associated mental health conditions (e.g., postpartum anxiety and depression). The goal of this study is to utilize the Florida Healthy Start Risk Screen, used to screen for adverse infant outcomes, along with other readily available data on individual and environmental factors, to examine the ability to identify women at risk of PAD and severe maternal morbidity. We will work closely with key stakeholders, including obstetric providers, the association of Healthy Start coalitions across Florida, and pregnant women, to determine the feasibility of prenatal screening for PAD and/or SMM.
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