Currently submitted to: JMIR Preprints
Date Submitted: Dec 26, 2022
Open Peer Review Period: Dec 26, 2022 - Dec 11, 2023
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Prevalence and Characteristics of Emergency Department Visits by Pregnant People: an analysis of a national emergency department sample (2010-2020)
ABSTRACT
Background:
Complications of pregnancy are common emergency department (ED) complaints. Care for pregnant patients will be significantly impacted by the increasing individual state level restrictions on reproductive healthcare following the repeal of Roe v. Wade. To address these changes, the population of pregnant patients must be clearly understood, but this population is not well-described in the literature.
Objective:
We aimed to estimate the number of ED visits for pregnant patients in the United States and determine the characteristics of this population using a national sample.
Methods:
We conducted a secondary analysis of the 2010-2020 National Hospital Ambulatory Medical Care Survey (NHAMCS), a survey designed to capture a nationally representative sample of ED visits. We evaluated visits for female patients 15-44 years old in this sample and identified visits with pregnant patients based on discharge diagnosis codes. We compared the characteristics of pregnant to non-pregnant patients and estimated the number of new pregnancies diagnosed in the ED. Using multivariable logistic regression, we determined visit characteristics associated with visits for pregnant patients versus non-pregnant patients.
Results:
The 2010-2020 NHAMCS database included 255,963 visits (weighted n = 1,502,215,000), and 59,080 visits among women ages 15-44 (weighted n=353,012,00). Pregnant patients accounted for 3.0% (95% CI 2.7-3.2) of all ED visits and 8.6% (95% CI, 8-9.3) of visits for female patients ages 15-44. This is equivalent to approximately 2.77 million visits for pregnant patients annually. Pregnant patients presenting for care were more likely to be publicly insured, Hispanic, or Black. We estimated that pregnancy was first diagnosed during 13.3% (95% CI 11.8-14.9) of ED visits for pregnant patients.
Conclusions:
A large number for pregnant patients present for care in the ED annually. Given the potential effects of the overturn of Roe v. Wade on pregnant patients, ED-based interventions should be considered to address changes in availability of healthcare resources.
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