Brown University School of Public Health
Presentation Abstract
Postpartum Care Up to One Year After Delivery: A Systematic Review
Presentation Goals: I will summarize the methods and findings of our recent systematic review and meta-analysis (funded by the Agency for Healthcare Research and Quality [AHRQ] and Patient-Centered Outcomes Research Institute) on postpartum care up to 1 year after pregnancy.
Main Content: The research questions related to the comparative effectiveness and harms of: (1) alternative strategies for postpartum healthcare delivery, and (2) extension of postpartum health insurance coverage. We used standard AHRQ methodology for conducting systematic reviews, including stakeholder engagement, topic refinement, systematic searching, screening, data extraction, risk of bias assessment, evidence synthesis, and strength of evidence assessment.
Key Points: We included 54 studies on delivery strategies and 16 studies on health insurance coverage. Risk of bias was moderate to high for most studies. At the presentation, I will summarize various conclusions that were feasible based on the evidence. Regarding delivery strategies, I will summarize our conclusions regarding where care is provided (2 conclusions based on 10 studies), how care is provided (1 conclusion based on 7 studies), when care is provided (1 conclusion based on 8 studies), who provides care (1 conclusion based on 25 studies), and the use of information/communication technology (1 conclusion based on 7 studies). Because of sparse evidence, inconsistent results, and/or the lack of reporting of our prioritized outcomes, no conclusions are feasible related to care coordination or management (2 studies) and information targeting healthcare providers (2 studies). Regarding health insurance coverage, I will summarize our conclusion based on 16 studies.
Research Gaps and Future Directions: The findings listed above are based on the current status of the systematic review, which is about to undergo public review and an updated search of the literature. At the Pathways to Prevention workshop, I will present updated findings, research gaps, and future directions.
About Dr. Saldanha
Dr. Ian Saldanha is an Associate Professor of Health Services, Policy, and Practice, and of Epidemiology, at the Brown University School of Public Health in Providence, Rhode Island. He is an epidemiologist and evidence-based health researcher with a background in medicine. He works at the Brown University Center for Evidence Synthesis in Health, where he is Assistant Director of the Brown Evidence-based Practice Center. His research focuses on comparative effectiveness research (systematic reviews, clinical trials, and other studies), methods and technology for research synthesis, and methods for research prioritization. Clinical area-wise, Dr. Saldanha’s work has addressed various women’s health topics (including postpartum health), ophthalmology (especially ocular surface disease), and other areas. He serves as an evidence synthesis expert for the Practice Pattern (Guidelines) Development Committee of the American Academy of Gynecologic and Laparoscopic Surgeons and for the Tear Film and Ocular Surface Society Lifestyle Epidemic Workshop. His systematic reviews and methodological work have directly informed guidelines developed by various clinical professional organizations. He served on two National Academies of Sciences, Engineering, and Medicine committees that informed Dietary Reference Intakes.
Dr. Saldanha disclosed the following conflict of interest: Partial salary support from an AHRQ contract.