Women's Preferences for Maternal and Neonatal Morbidity and Mortality in Childbirth.

08:00 EDT 26th September 2019 | BioPortfolio

Summary of "Women's Preferences for Maternal and Neonatal Morbidity and Mortality in Childbirth."

To measure utility values that describe women's willingness to tradeoff maternal morbidity for fetal benefit among pregnant and nonpregnant women of reproductive age. We recruited English-speaking women aged 18 to 45 years in clinical and community-based settings. Eight health states were studied: 4 maternal (healthy, stroke, hysterectomy, death) and 4 neonatal (healthy, severe cerebral palsy [CP], severe mental retardation [MR], death). Utilities were assessed on a subset of 9 pairs of mom/baby delivery outcomes. Participants ranked the 9 pairs of outcomes in order of preference, then standard gamble methods were used to calculate utilities. Numeracy skills were assessed. Utilities were obtained from 477 participants (recruitment rate = 94%). Twenty-one percent were pregnant, 63% were parents, and 54% were African American. Utilities did not differ significantly between pregnant and nonpregnant women or based on numeracy score. The highest (nonhealthy) values were assigned to baby healthy/mom hysterectomy (0.999), baby healthy/mom stroke (0.946), and baby CP/mom healthy (0.940). The lowest values were assigned to baby death/mom hysterectomy (0.203), baby MR/mom death (0.150), and baby death/mom stroke (0.087). Nonwhite participants assigned a significantly higher value to baby MR/mom death ( = 0.01), baby MR/mom stroke ( = 0.02), baby MR/mom healthy ( < 0.01), and baby MR/mom hysterectomy ( = 0.02) than white participants. When asked to value pairs of maternal/fetal outcomes that required a tradeoff of morbidity and mortality, women tended to assign the highest utility to combinations that resulted in a "healthy baby." They assigned the lowest values to combinations that resulted in a baby's death or MR. Our findings highlight the importance of 1) assessing individual preferences and goals of care for pregnancy outcomes and 2) measuring utilities among reproductive-aged women when modeling obstetric decision making.


Journal Details

This article was published in the following journal.

Name: Medical decision making : an international journal of the Society for Medical Decision Making
ISSN: 1552-681X
Pages: 272989X19869910


DeepDyve research library

PubMed Articles [13904 Associated PubMed Articles listed on BioPortfolio]

Association between advanced maternal age and maternal and neonatal morbidity: A cross-sectional study on a Spanish population.

Over recent decades, a progressive increase in the maternal age at childbirth has been observed in developed countries, posing a health risk for both women and infants. The aim of this study was to an...

Preferences for formal and traditional sources of childbirth and postnatal care among women in rural Africa: A systematic review.

The underutilization of formal, evidence-based maternal health services continues to contribute to poor maternal outcomes among women living in rural Africa. Women's choice of the type of maternal car...

Severe maternal morbidity among women with a history of cesarean section at a tertiary referral teaching hospital in the southeast of Iran.

Although the cesarean section (C-section) is known as a lifesaving procedure, it can also increase the risk of maternal mortality and morbidity. This study was conducted to achieve two objectives: (1)...

Advanced maternal age and factors associated with neonatal near miss in nulliparous and multiparous women.

The early neonatal period accounts for approximately half of the deaths of young children under one year of age, and the neonatal near miss can recognize factors causing this high number of deaths. Th...

Rural-Urban Differences In Severe Maternal Morbidity And Mortality In The US, 2007-15.

In the United States, severe maternal morbidity and mortality is climbing-a reality that is especially challenging for rural communities, which face declining access to obstetric services. refers to ...

Clinical Trials [11793 Associated Clinical Trials listed on BioPortfolio]

Lack of Antenatal Care in Primiparas

Antenatal care is a key strategy for reducing maternal and neonatal morbidity and mortality rate because adequate utilization of antenatal health care services is associated with improved ...

Measuring Preferences for Childbirth After Cesarean

The objective of this proposed 18-month exploratory research study is to help pregnant women weigh risks and benefits in a childbirth decision using the Preferences-Assessment Computer Mod...

Azithromycin-Prevention in Labor Use Study (A-PLUS)

Maternal and neonatal infections are among the most frequent causes of maternal and neonatal deaths, and current antibiotic strategies have not been effective in preventing many of these d...

Reducing Fear of Childbirth Among Pregnant Women

Pregnant women often experience fear of childbirth or anxiety toward the labor pain or uncertainties associated with labor process. To develop and evaluate the efficacy of childbirth educa...

Assessment of Maternal and Perinatal Morbidity and Mortality in Vaginal and Cesarean Delivery

This study will be done at Ain Shams university maternity hospital to identify the significant risk of maternal intensive care unit admission, need for advanced surgery, postpartum hemorrh...

Medical and Biotech [MESH] Definitions

Maternal deaths resulting from complications of pregnancy and childbirth in a given population.

Pregnancy in which the mother and/or FETUS are at greater than normal risk of MORBIDITY or MORTALITY. Causes include inadequate PRENATAL CARE, previous obstetrical history (ABORTION, SPONTANEOUS), pre-existing maternal disease, pregnancy-induced disease (GESTATIONAL HYPERTENSION), and MULTIPLE PREGNANCY, as well as advanced maternal age above 35.

The health of women during PREGNANCY; childbirth and the POSTPARTUM PERIOD.

The nursing specialty that deals with the care of women throughout their pregnancy and childbirth and the care of their newborn children.

Postnatal deaths from BIRTH to 365 days after birth in a given population. Postneonatal mortality represents deaths between 28 days and 365 days after birth (as defined by National Center for Health Statistics). Neonatal mortality represents deaths from birth to 27 days after birth.

Quick Search

DeepDyve research library

Relevant Topics

Women's Health
Women's Health - key topics include breast cancer, pregnancy, menopause, stroke Follow and track Women's Health News on BioPortfolio: Women's Health News RSS Women'...

Pediatrics is the general medicine of childhood. Because of the developmental processes (psychological and physical) of childhood, the involvement of parents, and the social management of conditions at home and at school, pediatrics is a specialty. With ...

Obstetrics and gynaecology
Fertility Menopause Obstetrics & Gynaecology Osteoporosis Women's Health Obstetrics and gynaecology comprises the care of the pregnant woman, her unborn child and the management of diseases specific to women. Most consultant...

Searches Linking to this Article