Study objective

Pregnant women often seek care in an emergency department (ED). We sought to describe the frequency, characteristics, and factors associated with increased ED visits during pregnancy.

Methods

We conducted a retrospective cohort study using administrative health data of all pregnancies resulting in a live birth at 20 or more weeks of gestation in Alberta, Canada, from 2011 to 2017. The primary outcome was the occurrence of any ED visit during pregnancy. The secondary outcomes were ED visit characteristics and discharge disposition. We calculated rate ratios (RRs) and 95% confidence intervals (CIs) for associations between sociodemographic and clinical factors and increased ED visits during pregnancy using random-effect negative binomial regression adjusting for multiple pregnancies per person during the study period.

Results

We included 255,929 pregnancies from 193,965 women. Of all the pregnancy episodes followed, 37.3% (95% CI 37.1 to 37.5) had at least 1 ED visit, resulting in a total of 226,811 ED visits and an overall ED visit rate of 94.0 visits per 100 pregnancies (95% CI 93.6 to 94.3). Most visits were nonobstetric (46.4%) and resulted in ED discharge (85.3%). Increased ED visits were associated with living in remote (RR 6.9; 95 %CI 6.7 to 7.1) or rural (RR 3.4; 95% CI 3.4 to 3.5) areas, younger age (RR 1.9; 95% CI 1.8 to 2.0), intensive prenatal care (RR 1.5; 95% CI 1.5 to 1.5), major/moderate health conditions (RR 1.6; 95% CI 1.6 to 1.6), mental health conditions (RR 1.6; 95% CI 1.5 to 1.6), and high antepartum risk score (RR 1.1; 95% CI 1.1 to 1.1).

Conclusion

Approximately 1 in 3 women in our sample visited the ED during pregnancy. A higher number of visits occurred in those with rural/remote residence, younger maternal age, and concomitant health conditions.

中文翻译：

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怀孕期间急诊就诊

学习目标

孕妇经常在急诊室 (ED) 寻求护理。我们试图描述与怀孕期间急诊就诊增加相关的频率、特征和因素。

方法

我们使用 2011 年至 2017 年加拿大艾伯塔省所有妊娠 20 周或以上活产的妊娠管理健康数据进行了一项回顾性队列研究。主要结果是妊娠期间任何急诊就诊的发生率。次要结果是急诊就诊特征和出院处置。我们计算了社会人口学和临床因素之间关联的比率 (RR) 和 95% 置信区间 (CI)，并使用随机效应负二项式回归调整研究期间每人的多胎妊娠来计算怀孕期间增加的急诊就诊次数。

结果

我们纳入了 193,965 名女性的 255,929 次怀孕。在随后发生的所有妊娠事件中，37.3%（95% CI 37.1 至 37.5）至少进行了 1 次急诊就诊，总计 226,811 次急诊就诊，总急诊就诊率为每 100 次妊娠 94.0 次就诊（95% CI 93.6 至 37.5） 94.3）。大多数就诊是非产科的 (46.4%)，并导致急诊出院 (85.3%)。急诊就诊次数增加与居住在偏远地区 (RR 6.9；95% CI 6.7 至 7.1) 或农村地区 (RR 3.4；95% CI 3.4 至 3.5)、年龄较小 (RR 1.9；95% CI 1.8 至 2.0)、密集产前护理（RR 1.5；95% CI 1.5 至 1.5）、严重/中度健康状况（RR 1.6；95% CI 1.6 至 1.6）、心理健康状况（RR 1.6；95% CI 1.5 至 1.6）和高产前风险评分（RR 1.1；95% CI 1.1 至 1.1）。

结论

在我们的样本中，大约三分之一的女性在怀孕期间访问了急诊室。居住在农村/偏远地区、产妇年龄较小和伴随健康状况的人的就诊次数较多。