Together: Transforming and Translating Discovery to Improve Health

在佛罗里达州，与毒品有关的死亡是2017年妊娠相关死亡(PAD)的主要原因， 占死亡人数的四分之一。为了减少PAD，重要的是在以下方面识别女性 PAD本身的最大风险及其主要原因，包括物质使用障碍和相关 精神健康状况(例如产后焦虑和抑郁)。 佛罗里达州提供了一个独特的机会来研究PAD和PAD筛查工具的可行性 严重孕产妇发病率(SMM)，因为它是目前唯一需要普遍 对所有孕妇和婴儿进行筛查。健康开始(HS)风险筛查，管理 在产前和出生时，确定那些早产风险最高的人，低出生体重， 不利的健康后果和婴儿死亡率。筛选问题集中在社会文化方面。 问题，反映了健康差距和逆境影响怀孕、健康和 婴儿发育。这些HS风险筛选，无论是当前形式的还是增强的，包括 其他个人或环境因素，也可能有助于确定高危妇女 PAD和SMM。 这项研究的目标是利用HS风险筛查以及其他现成的数据 关于个人和环境因素，以检查识别有PAD风险的妇女的能力 和SMM，尤其与产后焦虑、抑郁和物质使用障碍有关。我们 将使用全州范围内可用的链接管理数据，并利用持续的努力将 这些管理数据集存储到One佛罗里达数据信托，这是一个中央数据存储库 电子健康记录(EHR)和地理空间信息 佛罗里达。我们将与主要利益攸关方密切合作，包括产科提供者、协会 佛罗里达州各地的健康起步联盟和孕妇，以确定 产前筛查PAD和/或与物质使用相关的SMM。从这项研究中获得的知识将 告知在不同人群中进行大规模PAD和/或SMM筛查的可行性。

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.