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Postpartum Primary Care in the United States: A Scoping Review of the Evidence Base and Opportunities.

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Název: Postpartum Primary Care in the United States: A Scoping Review of the Evidence Base and Opportunities.
Autoři: Gordon RD; Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA., Hatab J; Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA.; Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA., Voisin CE; Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA., Gillespie SL; Pitzer Center for Women, Children, and Youth, College of Nursing, The Ohio State University, Columbus, Ohio, USA., Bunger A; Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA., Rodriguez Miranda M; Department of Clinical Psychology, Albizu University, San Juan, Florida, USA., Piersaint TP; Department of Clinical Psychology, Albizu University, San Juan, Florida, USA., Mitchell R; Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, Howard University College of Medicine, Washington, District of Columbia, USA., Bose Brill S; Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA.
Zdroj: Journal of women's health (2002) [J Womens Health (Larchmt)] 2025 Sep; Vol. 34 (9), pp. 1140-1165. Date of Electronic Publication: 2025 May 27.
Způsob vydávání: Journal Article; Scoping Review; Review
Jazyk: English
Informace o časopise: Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 101159262 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1931-843X (Electronic) Linking ISSN: 15409996 NLM ISO Abbreviation: J Womens Health (Larchmt) Subsets: MEDLINE
Imprint Name(s): Original Publication: Larchmont, NY : Mary Ann Liebert, Inc., [2002]-
Výrazy ze slovníku MeSH: Primary Health Care*/organization & administration , Postnatal Care* , Postpartum Period* , Maternal Health Services*, Humans ; Female ; United States ; Pregnancy ; Maternal Health ; Health Services Accessibility
Abstrakt: Background: The United States is experiencing a maternal health crisis that continues to worsen in the face of racial/ethnic disparities, rising chronic disease burden among birthing patients, and policy barriers to health care access. Longitudinal postpartum primary care is critical to mitigating these trends, but current rates of use are low, and evidence-based interventions are limited. This scoping review aims to understand the current literature and components of the Chronic Care Model (CCM) used in postpartum primary care and its impact on maternal health outcomes. Methods: We identified 74 studies published between 2000 and 2023 through comprehensive searches of four databases. Extracted data was synthesized for their impact on maternal health, including equity considerations and the primary CCM element. Results: The studies were collated based on their primary maternal health priority (general health n = 13, depression and anxiety n = 34, diabetes n = 3, hypertension n = 5, adolescent parents n = 6, and substance use disorder n = 13). The most common CCM elements were Delivery System Design and Self-Management Support. The least common CCM element was Clinical Information Systems, with electronic health record challenges noted as a barrier. We identified successful interventions that increased depression screening, postpartum hypertension follow-up via telehealth, and integrated contraceptive education within shared parent-child medical homes for adolescent parents. Interventions were largely feasible and acceptable for both patients and clinicians. Conclusions: This review highlights several potential strategies to improve and scale longitudinal postpartum primary care. Further work is needed to ensure equitable delivery, improved connection with community resources, and to expand informatics in postpartum care.
Contributed Indexing: Keywords: health care disparities; maternal health; mental health; postpartum; primary care
Entry Date(s): Date Created: 20250527 Date Completed: 20250910 Latest Revision: 20250911
Update Code: 20250912
DOI: 10.1089/jwh.2024.0813
PMID: 40421711
Databáze: MEDLINE
Popis
Abstrakt:Background: The United States is experiencing a maternal health crisis that continues to worsen in the face of racial/ethnic disparities, rising chronic disease burden among birthing patients, and policy barriers to health care access. Longitudinal postpartum primary care is critical to mitigating these trends, but current rates of use are low, and evidence-based interventions are limited. This scoping review aims to understand the current literature and components of the Chronic Care Model (CCM) used in postpartum primary care and its impact on maternal health outcomes. Methods: We identified 74 studies published between 2000 and 2023 through comprehensive searches of four databases. Extracted data was synthesized for their impact on maternal health, including equity considerations and the primary CCM element. Results: The studies were collated based on their primary maternal health priority (general health n = 13, depression and anxiety n = 34, diabetes n = 3, hypertension n = 5, adolescent parents n = 6, and substance use disorder n = 13). The most common CCM elements were Delivery System Design and Self-Management Support. The least common CCM element was Clinical Information Systems, with electronic health record challenges noted as a barrier. We identified successful interventions that increased depression screening, postpartum hypertension follow-up via telehealth, and integrated contraceptive education within shared parent-child medical homes for adolescent parents. Interventions were largely feasible and acceptable for both patients and clinicians. Conclusions: This review highlights several potential strategies to improve and scale longitudinal postpartum primary care. Further work is needed to ensure equitable delivery, improved connection with community resources, and to expand informatics in postpartum care.
ISSN:1931-843X
DOI:10.1089/jwh.2024.0813