Receipt of American Heart Association-Recommended Preconception Health Care Among Privately Insured Women With Congenital Heart Defects, 2007-2013
Receipt of American Heart Association-Recommended Preconception Health Care Among Privately Insured Women With Congenital Heart Defects, 2007-2013
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DOI：
10.1161/jaha.119.013608
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发表时间：
2019-09-17
影响因子：
5.4
通讯作者：
Oster, Matthew E.
中科院分区：
文献类型：
--
作者：
Farr, Sherry L.;Downing, Karrie F.;Oster, Matthew E.
背景-我们的目标是根据2017年美国心脏协会的建议，评估先天性心脏病(CHD)女性接受先天医疗保健的情况，作为评估建议实施情况的基线。方法和结果-使用2007至2013年的IBM MarketScan商业数据库，我们确定了年龄在15岁至44岁之间、怀孕并在估计受孕前一年参加医疗保险>；=11个月的CHD诊断代码的女性。我们评估了完整的血细胞计数、电解质、促甲状腺激素、肝功能、心电图、综合超声心动图和运动负荷测试的记录，使用程序代码和美国食品和药物管理局D类和X类心脏相关药物的门诊处方声明。根据CHD的严重程度、年龄、居住地区、受孕年份以及产科和心脏科的有记录的相遇来检验差异。在2003例冠心病患者中发现2524例妊娠，占重度冠心病的14.4%。在98.3%的怀孕前一年有过医疗保健的女性中，
Background-Our objective was to estimate receipt of preconception health care among women with congenital heart defects (CHD), according to 2017 American Heart Association recommendations, as a baseline for evaluating recommendation implementation.Methods and Results-Using 2007 to 2013 IBM MarketScan Commercial Databases, we identified women with CHD diagnosis codes ages 15 to 44 years who became pregnant and were enrolled in health insurance for >= 11 months in the year before estimated conception. We assessed documentation of complete blood count, electrolytes, thyroid-stimulating hormone, liver function, ECG, comprehensive echocardiogram, and exercise stress test, using procedural codes, and outpatient prescription claims for US Food and Drug Administration category D and X cardiac-related medications. Differences were examined according to CHD severity, age, region of residence, year of conception, and documented encounters at obstetric and cardiology practices. We found 2524 pregnancies among 2003 women with CHD (14.4% severe CHD). In the 98.3% of women with a healthcare encounter in the year before conception,