Structured Abstract

Contents

• Preface
• Acknowledgments
• Key Informants
• Technical Expert Panel
• Peer Reviewers
• Executive Summary
  • Main Points
  • Background and Purpose
  • Methods
  • Results
  • Limitations
  • Implications and Conclusions
• 1. Introduction
  • 1.1. Background
  • 1.2. Purpose of the Review
• 2. Methods
  • 2.1. Review Approach
  • 2.2. Key Questions
  • 2.3. Analytic Framework
  • 2.4. Study Selection
  • 2.5. Data Extraction and Data Management
  • 2.6. Assessment of Risk of Bias in Individual Studies
  • 2.7. Data Synthesis
  • 2.8. Grading the Strength of Evidence for Major Comparisons and Outcomes
• 3. Results
  • 3.1. Description of Included Evidence
  • 3.2. Literature Search Results
  • 3.3. KQ 1: What healthcare delivery strategies affect postpartum healthcare utilization and improve maternal outcomes within 1 year postpartum?
  • 3.4. KQ 2: Does extension of health insurance coverage or improvements in access to healthcare affect postpartum healthcare utilization and improve maternal outcomes within 1 year postpartum?
• 4. Discussion
  • 4.1. Findings in Relation to the Decisional Dilemmas
  • 4.2. Strengths and Limitations
  • 4.3. Applicability
  • 4.4. Implications for Clinical Practice
  • 4.5. Implications for Research
  • 4.6. Conclusions
• References
• Appendixes
  • Appendix A. Methods
  • Appendix B. List of Excluded Studies
  • Appendix C. Results: Design, Arm, and Sample Details
  • Appendix D. Results: Risk of Bias
  • Appendix E. Results: Evidence Tables
  • Appendix F. Patient-Centered Outcomes Research Institute (PCORI) Methodology Standards
  • Appendix G. References

Suggested citation:

Saldanha IJ, Adam GP, Kanaan G, Zahradnik ML, Steele DW, Danilack VA, Peahl AF, Chen KK, Stuebe AM, Balk EM. Postpartum Care up to 1 Year After Pregnancy: A Systematic Review and Meta-Analysis. Comparative Effectiveness Review No. 261. (Prepared by the Brown Evidence-based Practice Center under Contract No. 75Q80120D00001.) AHRQ Publication No. 23-EHC010. PCORI Publication No. 2023-SR-01. Rockville, MD: Agency for Healthcare Research and Quality; June 2023. DOI: https://doi.org/10.23970/AHRQEPCCER261. Posted final reports are located on the Effective Health Care Program search page.

This report is based on research conducted by the Brown Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 75Q80120D00001). The Patient-Centered Outcomes Research Institute^® (PCORI^®) funded the report (PCORI Publication No. 2023-SR-01). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ or PCORI, its Board of Governors, or Methodology Committee. Therefore, no statement in this report should be construed as an official position of PCORI, AHRQ, or the U.S. Department of Health and Human Services.

Drs. Alison Stuebe and Alex Peahl have published research studies that were considered for inclusion in this report. As a result, they did not participate in screening or determination of studies to be included in the systematic review, assessing risk of bias in studies, extracting data from studies, or grading of the strength of evidence. None of the other investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

The information in this report is intended to help healthcare decision makers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of healthcare services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

This report is made available to the public under the terms of a licensing agreement between the author and the Agency for Healthcare Research and Quality. Most AHRQ documents are publicly available to use for noncommercial purposes (research, clinical or patient education, quality improvement projects) in the United States, and do not need specific permission to be reprinted and used unless they contain material that is copyrighted by others. Specific written permission is needed for commercial use (reprinting for sale, incorporation into software, incorporation into for-profit training courses) or for use outside of the U.S. If organizational policies require permission to adapt or use these materials, AHRQ will provide such permission in writing.

PCORI^®, AHRQ, or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies, may not be stated or implied.

A representative from AHRQ served as a Contracting Officer’s Representative and reviewed the contract deliverables for adherence to contract requirements and quality. AHRQ did not directly participate in the literature search, determination of study eligibility criteria, data analysis, interpretation of data, or preparation or drafting of this report.

AHRQ and PCORI appreciate appropriate acknowledgment and citation of their work. Suggested language for acknowledgment: This work was based on an evidence report, Postpartum Care up to 1 Year After Pregnancy: A Systematic Review and Meta-Analysis, by the Evidence-based Practice Center Program at the Agency for Healthcare Research and Quality (AHRQ) and funded by the Patient-Centered Outcomes Research Institute (PCORI).