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Am J Perinatol
DOI: 10.1055/a-2053-7439
Original Article

Antenatal Hospital Use among Deaf and Hard of Hearing Women

Michael M. McKee
1   Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
,
Jianying Zhang
2   The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
,
Ilhom Akobirshoev
2   The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
,
Kimberly McKee 
1   Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
,
Monika Mitra
2   The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
› Author Affiliations Funding Research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health (grant no.: R01HD090104). Drs. M.M. and M.M.M. are also supported by grant no.: 90DPGRE0001-05. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agency.
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Abstract

Objective Hearing loss is increasingly prevalent among younger adults, impacting health and health care use. Deaf and hard of hearing (DHH) women have a higher risk of chronic diseases, pregnancy complications, and adverse birth outcomes compared with hearing women. Health care utilization patterns during the perinatal period remain not well understood. The objective of this study was to examine differences in antenatal emergency department and inpatient utilization among DHH and non-DHH women.

Study Design We conducted a retrospective cohort study design to analyze 2002 to 2013 Massachusetts Pregnancy to Early Life Longitudinal data to compare antenatal inpatient and emergency department use between DHH (N = 925) and hearing (N = 2,895) women with singleton deliveries. Matching was done based on delivery year, age at delivery, and birth parity in 1:3 case–control ratio. Demographic, socioeconomic, clinical, and hospital characteristics were first compared for DHH mothers and the matched control group using chi-squared tests and t-tests. Multivariable models were adjusted for sociodemographic and clinical characteristics.

Results Among DHH women (N = 925), 49% had at least one emergency department visit, 19% had an observational stay, and 14% had a nondelivery hospital stay compared with 26, 14, and 6%, respectively, among hearing women (N = 28,95) during the antenatal period (all ps < 0.001). The risk of nondelivery emergency department visits (risk ratio [RR] 1.58; p < 0.001) and inpatient stays (RR = 1.89; p < 0.001) remained higher among DHH women compared with hearing women even after adjustment. Having four or more antenatal emergency department visits (7 vs. 2%) and two or more nondelivery hospital stays (4 vs. 0.4%) were more common among pregnant DHH women compared with their controls (all p-values < 0.001).

Conclusion The findings demonstrate that DHH women use emergency departments and inpatient services at a significantly higher rate than their hearing controls during the antenatal period. A systematic investigation of the mechanisms for these findings are needed.

Key Points

  • Antenatal emergency department use is significantly higher among deaf and hard of hearing women.

  • Antenatal hospitalizations are significantly higher among deaf and hard of hearing women.

  • Hearing loss screening may identify those at risk for adverse pregnancy and birth outcomes.

Keywords

deaf and hard of hearing mothers - health care barriers - pregnant deaf mothers - deaf health

Authors' Contributions

M.M.M. and M.M. provided the study conceptualization. M.M.M., M.M., J.Z., K.M., and I.A. analyzed and interpreted the data. M.M.M. was a major contributor in writing the manuscript. All authors interpreted the findings and contributed to writing the manuscript, as well as reading and approving the final manuscript.




Publication History

Received: 19 August 2022

Accepted: 24 February 2023

Accepted Manuscript online:
14 March 2023

Article published online:
10 April 2023

© 2023. Thieme. All rights reserved.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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