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Women’s Preferences for Maternal and Neonatal Morbidity and Mortality in Childbirth

Author

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  • Brownsyne Tucker Edmonds

    (Department of OB/GYN, Indiana University School of Medicine, Indianapolis, IN, USA)

  • Fatima McKenzie

    (Department of OB/GYN, Indiana University School of Medicine, Indianapolis, IN, USA)

  • Stephen M. Downs

    (Children’s Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA)

  • Aaron E. Carroll

    (Pediatric and Adolescent Comparative Effectiveness Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA)

Abstract

Purpose. To measure utility values that describe women’s willingness to tradeoff maternal morbidity for fetal benefit among pregnant and nonpregnant women of reproductive age. Methods. We recruited English-speaking women aged 18 to 45 years in clinical and community-based settings. Eight health states were studied: 4 maternal (healthy, stroke, hysterectomy, death) and 4 neonatal (healthy, severe cerebral palsy [CP], severe mental retardation [MR], death). Utilities were assessed on a subset of 9 pairs of mom/baby delivery outcomes. Participants ranked the 9 pairs of outcomes in order of preference, then standard gamble methods were used to calculate utilities. Numeracy skills were assessed. Results. Utilities were obtained from 477 participants (recruitment rate = 94%). Twenty-one percent were pregnant, 63% were parents, and 54% were African American. Utilities did not differ significantly between pregnant and nonpregnant women or based on numeracy score. The highest (nonhealthy) values were assigned to baby healthy/mom hysterectomy (0.999), baby healthy/mom stroke (0.946), and baby CP/mom healthy (0.940). The lowest values were assigned to baby death/mom hysterectomy (0.203), baby MR/mom death (0.150), and baby death/mom stroke (0.087). Nonwhite participants assigned a significantly higher value to baby MR/mom death ( P = 0.01), baby MR/mom stroke ( P = 0.02), baby MR/mom healthy ( P

Suggested Citation

  • Brownsyne Tucker Edmonds & Fatima McKenzie & Stephen M. Downs & Aaron E. Carroll, 2019. "Women’s Preferences for Maternal and Neonatal Morbidity and Mortality in Childbirth," Medical Decision Making, , vol. 39(7), pages 755-764, October.
    • Handle: RePEc:sae:medema:v:39:y:2019:i:7:p:755-764
    DOI: 10.1177/0272989X19869910
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    References listed on IDEAS

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