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      Reducing Maternal Mortality Rates in Alabama Through Patient Education: A Scoping Review

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          Abstract

          Maternal mortality continues to rise in the United States and disproportionately affects those in Alabama. Lack of patient education on warning signs is a preventable cause of maternal mortality. This article aims to systematically quantify existing research investigating the effect of patient education on maternal outcomes. The inclusion criteria required an article to be (a) original research, (b) conducted within the United States, (c) in English, and (d) published between January 2012 and September 2022. PubMed® and Embase® databases were searched using key words and filters. Rayyan®, a systematic review research tool, was utilized to assess articles in a blinded two-person review process. A blinded third researcher resolved conflicts. A total of 3,139 articles were compiled; 3,115 articles did not meet inclusion criteria, and 24 articles were retrieved after an abstract review. Ultimately, 11 articles were included after a full-text review. None of these articles were specific to Alabama. However, they did contain evidence for patient education improving maternal mortality. More research is required in Alabama to demonstrate the effect of educating patients on maternal mortality. These articles contain evidence for education as a tool to improve maternal outcomes.

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          Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions.

          Ai-ris Collier, Rose Molina (2019)
          The rising trend in pregnancy-related deaths during the past 2 decades in the United States stands out among other high-income countries where pregnancy-related deaths are declining. Cardiomyopathy and other cardiovascular conditions, hemorrhage, and other chronic medical conditions are all important causes of death. Unintentional death from violence, overdose, and self-harm are emerging causes that require medical and public health attention. Significant racial/ethnic inequities exist in pregnancy care with non-Hispanic black women incurring 3 to 4 times higher rates of pregnancy-related death than non-Hispanic white women. Varied terminology and lack of standardized methods for identifying maternal deaths in the United States have resulted in nuanced data collection and interpretation challenges. State maternal mortality review committees are important mechanisms for capturing and interpreting data on cause, timing, and preventability of maternal deaths. Importantly, a thorough standardized review of each maternal death leads to recommendations to prevent future pregnancy-associated deaths. Key interventions to improve maternal health outcomes include 1) integrating multidisciplinary care for women with high-risk comorbidities during preconception care, pregnancy, postpartum, and beyond; 2) addressing structural racism and the social determinants of health; 3) implementing hospital-wide safety bundles with team training and simulation; 4) providing patient education on early warning signs for medical complications of pregnancy; and 5) regionalizing maternal levels of care so that women with risk factors are supported when delivering at facilities with specialized care teams.
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            The Maternal Early Warning Criteria: A Proposal from the National Partnership for Maternal Safety

            Jill Mhyre, Robyn D'Oria, Afshan B. Hameed … (2014)
            Case reviews of maternal death have revealed a concerning pattern of delay in recognition of hemorrhage, hypertensive crisis, sepsis, venous thromboembolism, and heart failure. Early-warning systems have been proposed to facilitate timely recognition, diagnosis, and treatment for women developing critical illness. A multidisciplinary working group convened by the National Partnership for Maternal Safety used a consensus-based approach to define The Maternal Early Warning Criteria, a list of abnormal parameters that indicate the need for urgent bedside evaluation by a clinician with the capacity to escalate care as necessary in order to pursue diagnostic and therapeutic interventions. This commentary reviews the evidence supporting the use of early-warning systems, describes The Maternal Early Warning Criteria, and provides considerations for local implementation.
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              Improving patient understanding of preeclampsia: a randomized controlled trial.

              Whitney You, Michael Wolf, Stacy Bailey … (2012)
              We developed a standardized educational tool to inform women about preeclampsia. The objective of this study was to assess whether exposure to this tool led to superior understanding of the syndrome. This was a randomized controlled trial in which 120 women were assigned to (1) a newly developed preeclampsia educational tool, (2) a standard pamphlet addressing preeclampsia that had been created by the American College of Obstetricians and Gynecologists, or (3) no additional information. Preeclampsia knowledge was assessed with the use of a previously validated questionnaire. There were no demographic differences among the groups. Patients who received the tool scored significantly better on the preeclampsia questionnaire than those who received the American College of Obstetricians and Gynecologists pamphlet or no additional information (71%, 63%, 49%, respectively; P .05). Patients who were exposed to a graphics-based educational tool demonstrated superior preeclampsia-related knowledge, compared with those patients who were exposed to standard materials or no education. Published by Mosby, Inc.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 8 August 2023
                Publication date (Electronic, collection): August 2023
                Volume: 15
                Issue: 8
                Electronic Location Identifier: e43172
                Affiliations
                [1 ] Research, Alabama College of Osteopathic Medicine, Dothan, USA
                [2 ] Internal Medicine, Southeast Health Medical Center, Dothan, USA
                Author notes
                Article
                DOI: 10.7759/cureus.43172
                PMC ID: 10484635
                PubMed ID: 37692638
                SO-VID: 6e9b25b5-a904-4566-b3c2-715b5635cef2
                Copyright © Copyright © 2023, Telese et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 5 July 2023
                Date accepted : 8 August 2023
                Categories
                Subject: Family/General Practice
                Subject: Internal Medicine
                Subject: Obstetrics/Gynecology

                Keywords: united states of america,alabama,health education & awareness,prevention in primary care,patient education,maternal mortality
                Data availability:
                Keywords: united states of america, alabama, health education & awareness, prevention in primary care, patient education, maternal mortality

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