![[ Visit Client Website ]](images/banner.gif)
Learning Objective 1: The learner will be able to compare health care utilization between women with previous perinatal loss and women with one or no perinatal losses.
Learning Objective 2: The learner will be able to discuss the potential relationship between fear and anxiety and health care utilization in pregnancy subsequent to perinatal loss.
Methods. We examined the effect of previous perinatal loss on health care utilization during a subsequent pregnancy in 2854 pregnant women ages 18-36 expecting their first live-born baby. Self-reported use of health resources during pregnancy were compared for women with a history of two or more perinatal losses and women with one or no perinatal loss, adjusting for maternal age, smoking status, and use of fertility treatment or advice.
Results. Women with two or more previous perinatal losses received their first prenatal care visit one week earlier than women with one or no previous losses (7.0 weeks vs. 8.2 weeks, respectively; p<0.001). Women with two or more previous perinatal losses also had twice the odds of third trimester emergency department visit (aOR=2.37, 95% CI 1.34, 4.19) and an increased odds of prenatal hospitalizations overall (aOR=1.70, 95% CI 1.04, 2.79). However, the two groups of women did not differ with respect to hospital admissions with an overnight stay, number of outpatient office visits in the final four weeks before delivery, or number of outpatient procedures (excluding ultrasound).
Conclusions. Women with two or more perinatal losses were twice as likely to use ED services in their third trimester, but did not have an increase in outpatient office visits, hospital overnight stays or outpatient procedures, suggesting that fear and anxiety may be related to increased utilization of certain health care resources.