A Retrospective Analysis of Postpartum Adherence to Follow-up in High-risk Obstetric Patients in Primary Care

Abstract

Background and Objectives: Texas is a state with a well-documented statistical rate of the nation’s highest maternal mortality rates. Maternal mortality has a multiplicity of risk factors including gestational complications, not limited to diabetes mellitus, hypertension, and preeclampsia. The high-risk obstetrics (HROB) initiative was created at CommuniCare Health Centers in San Antonio, TX, to provide resources to obstetric (OB) patients identified as high risk for perinatal and postpartum complications. The goal of this analysis is to assess the consistency with which HROB patients enrolled present to the first and second OB postpartum follow-up visits and subsequently family medicine follow-up visits. Methods: The patients were enrolled in this initiative based on a criterion for being considered high risk for obstetrical complications including hypertensive disease, preeclampsia, eclampsia, and diabetes mellitus. One hundred ninety-two patient charts were reviewed and 180 were included in this retrospective analysis. Results: A multivariate analysis revealed that an adjusted odds ratio for postpartum follow-up among HROB patients was 1.65 (95% confidence interval = 0.71–3.83). A positive trend was observed for HROB patients’ OB postpartum follow-up visits, whereas a negative trend was observed for family medicine postpartum follow-up visits. Conclusion: Prevention strategies aimed at reducing postpartum loss to follow-up identified in this study could promote better health outcomes among HROB patients in San Antonio, TX.