Low Uptake of Human Papillomavirus Vaccine Among Postpartum Women, 2006–2012

Background: Young adult women find it acceptable to be offered the human papillomavirus (HPV) vaccine postpartum. Little is known about the practice of administering the HPV vaccine during the postpartum period

Nonurgent and urgent emergency department use during pregnancy: an observational study

Emergency department use is common among pregnant women. Non-urgent emergency department use may represent care that would be better provided by an established obstetric provider in an ambulatory setting

Health Literacy and Women's Reproductive Health: A Systematic Review

Background: Health literacy is thought to impact women's reproductive health, yet no comprehensive systematic reviews have been conducted on the topic. Our objective was to systematically identify, investigate, and summarize research on the relationship between health literacy and women's reproductive health knowledge, behaviors, and outcomes

Low Uptake of Human Papillomavirus Vaccine Among Postpartum Women, 2006–2012

Background: Young adult women find it acceptable to be offered the human papillomavirus (HPV) vaccine postpartum. Little is known about the practice of administering the HPV vaccine during the postpartum period. Materials and Methods: The Truven Health Analytics MarketScan Commercial Claims and Encounters database was used to develop a cohort of privately insured 18 to 26–year-old women with uncomplicated live-born pregnancies. Eligibility required no previous doses of HPV vaccine before delivery and continuous insurance enrollment from June 2006 through 1 year postpartum. Descriptive statistics were performed. Results: A total of 51,913 women meet age and enrollment criteria, with 3912 (7.5%) having received any doses of vaccine before their delivery, leaving 48,001 women in this cohort. In the year postpartum, 861 women (1.8%) received any HPV vaccine. Of the women initiating the vaccine, only 337 (39%) completed the three-vaccine series. Women who received the vaccine, compared with women who did not, were younger (21 vs. 23 years old), more often the dependent to the insurance beneficiary (56% vs. 30%), and were more likely to have had an abnormal pap smear in the year prior (19.6% vs. 9.1%) or postdelivery (16.4% vs. 4.9). More women completed the HPV vaccine series when initiated within 2 months postpartum compared with women initiating the vaccine series >2 months postpartum (44% vs. 38%). Conclusions: Postpartum women are eligible for the HPV vaccine, yet very few are receiving it. The postpartum period is a missed opportunity for administration of this cancer-preventing vaccine

Nonurgent and urgent emergency department use during pregnancy: an observational study

BACKGROUND: Emergency department use is common among pregnant women. Non-urgent emergency department use may represent care that would be better provided by an established obstetric provider in an ambulatory setting. OBJECTIVE: To identify socio-demographic factors associated with non-urgent emergency department use in pregnancy. STUDY DESIGN: This is a cross-sectional study of women recruited during their postpartum hospitalization. Data regarding prenatal care and emergency department visits was collected from medical records; participants completed a survey with questions regarding demographics and emergency department use. Urgency of an emergency department visit was pre-specified based on a-priori criteria abstracted from medical record review. Women with any non-urgent emergency department use were compared with women without non-urgent emergency department use. Logistic regression was performed to identify factors associated with non-urgent emergency department use. RESULTS: Two hundred and thirty-three women participated in this study; 197 (84%) received care in the emergency department during pregnancy. Eighty-three (35.6%) women had at least one visit to the emergency department that was non-urgent. In regression analysis, increased odds of non-urgent emergency department use was associated with a preferred language other than English (OR 2.02, 95% CI 1.01-4.05) and lack of private insurance (OR 5.55, 95% CI 2.54-12.12). The two most common reasons for presentation to the emergency department were concern that there was an emergency (45%) or being referred by a healthcare provider (36%). CONCLUSION: Women frequently use the emergency department during pregnancy, including visits for non-urgent indications. Identifying risk factors for non-urgent emergency department use in pregnancy is important for identifying women likely to use the emergency department, including for non-urgent visits, and the development of strategies to decrease non-urgent emergency department utilization in pregnancy

Health Literacy and Women's Reproductive Health: A Systematic Review

Background: Health literacy is thought to impact women's reproductive health, yet no comprehensive systematic reviews have been conducted on the topic. Our objective was to systematically identify, investigate, and summarize research on the relationship between health literacy and women's reproductive health knowledge, behaviors, and outcomes. Methods: PRISMA guidelines were used to guide this review. English language, peer-reviewed research articles indexed in MEDLINE as of February 2015 were searched, along with study results posted on Clinicaltrials.gov. Articles were included if they (1) described original data-driven research conducted in developed countries, (2) were published in a peer-reviewed journal, (3) measured health literacy using a validated assessment, (4) reported on the relationship between health literacy and reproductive health outcomes, related knowledge, or behaviors, and (5) consisted of a study population that included reproductive age women. Results: A total of 34 articles met eligibility criteria and were included in this review. Data were abstracted from articles by two study authors using a standardized form. Abstracted data were then reviewed and summarized in table format. Overall, health literacy was associated with reproductive health knowledge across a spectrum of topics. It was also related to certain health behaviors, such as prenatal vitamin use and breastfeeding. Its relationship with other reproductive behaviors and outcomes remains unclear. Conclusions: Health literacy plays an important role in reproductive knowledge and may impact behaviors and outcomes. While further research is necessary, healthcare providers should utilize health literacy best practices now to promote high-quality care for patients