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Phone: (843) 722-7550
West Ashley Library
9 a.m. - 6 p.m.
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Wando Mount Pleasant Library
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9 a.m. - 6 p.m.
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Phone: (843) 805-6930
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Trends and Risk Markers for Severe Maternal Morbidity and Other Obstetric Complications.
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- Author(s): Oot, Antoinette; Huennekens, Kaitlin; Yee, Lynn; Feinglass, Joe
- Source:
Journal of Women's Health (15409996). Jul2021, Vol. 30 Issue 7, p964-971. 8p. - Source:
- Additional Information
- Subject Terms: DISEASE risk factors; HOSPITALS; LENGTH of stay in hospitals; MEDICAL quality control; DISEASES; RETROSPECTIVE studies; REGRESSION analysis; MEDICAL care costs; SEVERITY of illness index; RISK assessment; SOCIOECONOMIC factors; PREGNANCY complications; CESAREAN section; DELIVERY (Obstetrics); POISSON distribution; PREGNANCY
- Subject Terms:
- Abstract: Background: Studies of obstetric quality of care have almost exclusively focused on severe maternal morbidity (SMM) and have rarely examined more common complications. Methods: This 2016–2018 retrospective, population-based cohort study analyzed maternal delivery outcomes at 127 Illinois hospitals. International Classification of Disease (ICD)-10 Revision codes were used to describe the incidence of SMM and route-specific complications. Poisson regression models were used to estimate the association of maternal sociodemographic, clinical, and hospital characteristics with the likelihood of coded complications. Results: Among 421,426 deliveries, the SMM rate was 1.4% overall, 0.4% for vaginal, and 2.8% for cesarean delivery. Other complications were documented for 6.9% of women with vaginal and 10.0% of women with cesarean deliveries. While SMM rates were stable, vaginal delivery complications increased 5.9% from 2016 to 2018 and cesarean delivery complications increased 13.8%. Patient age, minority race and ethnicity, high poverty level, and preexisting and pregnancy-related clinical conditions were significantly associated with each complication outcome. Higher hospital delivery volume was associated with higher route-specific complications. Conclusion: SMM significantly underestimates the incidence of maternal complications. Complicated deliveries have much higher charges and length of stay, although ICD-10 coding intensity may influence incidence. New outcome measures based on more detailed clinical data and linked antepartum and postpartum care will be necessary to improve obstetric quality of care measurement. [ABSTRACT FROM AUTHOR]
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