Infections, Maternal Sepsis
Conditions
Keywords
Post Partum Period, Pregnancy, Maternal Health, Electronic Health Record
Brief summary
Sepsis is the second leading cause of maternal death in the U.S. For racial and ethnic minoritized birthing people, especially those who are Black, living in poverty, and from underserved communities, labor and postpartum are particularly vulnerable risk periods. The goal of this multi-center, multidisciplinary observational study is to establish a novel maternal care continuity model to reduce sepsis- related death and disability and increase maternal health equity.
Detailed description
Maternal sepsis is the second leading cause of maternal death, major cause of morbidity, and preventable in most cases. Labor, birth, and postpartum are periods of increased sepsis risk, particularly for racial and ethnic minoritized birthing people. With extensive community partnerships and community organized leadership advisory board (CoLAB), EnCoRe MoMS: Engaging Communities to Reduce Morbidity from Maternal Sepsis (Aim 3) Conduct a co-design process and qualitative study to explore the experiences, needs, and perceived solutions for maternal care continuity, sepsis prevention, and promotion of equity in postpartum. In the UG3 phase, robust community engagement and research infrastructures were established to: 3a. (3a.1) Refine the CoLAB and co-design process; (3a.2) Conduct in-depth individual patient interviews (IDIs) and focus group discussions (FGDs) with community and hospital stakeholders from one site to explore the lived experiences and perspectives of SDOH on care access/quality, outcome disparities, and solutions for care continuity. In the UH3 phase, the investigators will engage the community toAim 3b. (3b.1) Complete qualitative patient IDIs and stakeholder FGDs for the three additional hospital sites; (3b.2) Co-design an integrative supportive care model, with our community partner co-lead, CoLAB, and results from other aims, that entails maternal sepsis community engagement, care linkages, education, services, and policy efforts. The resulting model can be scaled to hospitals and communities with lesser resources and applied to other preventable causes of severe maternal morbidity.
Interventions
None listed
Sponsors
Columbia University
Northern Manhattan Perinatal Partnership
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Study design
Observational model
ECOLOGIC_OR_COMMUNITY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patient Interviews: * Speak Spanish or English * Be 18 years or older * Have a birthing experience in Columbia, Allen, Lincoln, or Harlem Hospitals within the past 8 weeks of enrollment * Have had at least one early warning sign or risk factor for infection present during their pregnancy, delivery, or postpartum Community Stakeholder Focus Groups: * Speak English or Spanish * Be 18 years or older * Have academic/professional background relevant to maternal health in New York City.
Exclusion criteria
Patient Interviews * Under 18 years old * Speaks a language other than Spanish or English * Gave birth in a hospital other than Columbia, Allen, Lincoln, or Harlem Hospitals * Did not have had at least one early warning sign or risk factor for infection present during their pregnancy, delivery, or postpartum Community Stakeholder Focus Groups * Under 18 years old * Speaks a language other than Spanish or English * Does not have a academic/professional background relevant to maternal health in New York City.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Integrative Supportive Care Model | 2023-2025 | Patient and community stakeholder feedback regarding lived experiences and perspectives of the impact of SDOH on care access and quality will be assessed by questionnaire. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORDena Goffman, MD
Columbia University
Outcome results
None listed