Oluwasegun Akinyemi, Temitope Ogundare, Mojisola Fasokun, Vania Nwokolo, Terhas Weldeslase, Vanesa McDonald, Lyanne Colon-Santos, Guoyang Luo
Introduction
The Affordable Care Act (ACA) aims to broaden health care access and significantly impacts obstetric practices. Yet, its effect on maternal and neonatal outcomes among women with gestational diabetes across diverse demographics is underexplored.
Objective
This study examines the impact of the implementation of the ACA on maternal and neonatal health in Maryland with ACA implementation and Georgia without ACA implementation.
Methodology
We used data from the Maryland State Inpatient Database and US Vital Statistics System to assess the ACA’s influence on maternal and neonatal outcomes in Maryland, with Georgia serving as a nonexpansion control state. Outcomes compared include cesarean section (CS) rates, low Apgar scores, neonatal intensive care unit (NICU) admissions, and assisted ventilation 7 h postdelivery. We adjusted for factors including women’s age, race, insurance type, preexisting conditions, prior CS, prepregnancy obesity, weight gain during pregnancy, birth weight, labor events, and antenatal practices.
Results
The study included 52 479 women: 55.8% from Georgia and 44.2% from Maryland. Post-ACA, CS rates were 45.1% in Maryland versus 48.2% in Georgia (P = 0.000). Maryland demonstrated better outcomes, including lower rates of low Agar scores (odds ratio [OR], 0.74 [95% confidence interval (CI), 0.63–0.86]), assisted ventilation (OR, 0.79 [95% CI, 0.71–0.82]), and NICU admissions (OR, 0.76 [95% CI, 0.71–0.82]), but no significant change in CS rates (OR, 0.96 [95% CI, 0.92–1.01]).
Conclusion
After ACA implementation, Maryland showed improved maternal and neonatal outcomes compared with Georgia, a nonexpansion state.
Fascinating insights! The creative potential you discuss is beautifully realized in Sprunki Game‘s revolutionary platform. The way Sprunki Game empowers users to explore and create unique soundscapes is truly groundbreaking.
Your writing is so impactful; it has the power to change perspectives.
Your blog quickly became my go-to place for motivation. I cannot thank you enough!
Great site you have here.. It’s hard to find good quality writing like yours
these days. I really appreciate individuals like you!
Take care!!
This site is always a great source of information and inspiration. Thanks for sharing your thoughts and ideas.
There is certainly a great deal to find out about this issue.
I love all of the points you’ve made.
I have read so many articles or reviews on the topic of the blogger lovers however this paragraph is in fact a
fastidious paragraph, keep it up.
Engaging and informative; your blog offers unique and valuable.
Your commitment and enthusiasm radiate through every section. It’s truly inspiring.