Maternal morbidity during childbirth hospitalization in California

• Published in: The journal of maternal-fetal & neonatal medicine 2012-12, Vol.25 (12), p.2529-2535
• Main Authors: Lyndon, Audrey, Lee, Henry C., Gilbert, William M., Gould, Jeffrey B., Lee, Kathryn A.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; California - epidemiology; Childbirth hospitalization; Female; Hospitalization - statistics & numerical data; Humans; maternal morbidity; Middle Aged; Morbidity; Mothers - statistics & numerical data; Obstetric Labor Complications - epidemiology; Obstetric Labor Complications - etiology; Parturition - physiology; Pregnancy; Pregnancy Complications - epidemiology; Risk Factors; Socioeconomic Factors; Young Adult
• ISSN: 1476-7058; 1476-4954
• DOI: 10.3109/14767058.2012.710280

Objective: To determine the incidence and risk factors for maternal morbidity during childbirth hospitalization. Methods: Maternal morbidities were determined using ICD9-CM and vital records codes from linked hospital discharge and vital records data for 1,572,909 singleton births in California during 2005-2007. Socio-demographic, obstetric and hospital volume risk factors were estimated using mixed effects logistic regression models. Results: The maternal morbidity rate was 241/1000 births. The most common morbidities were episiotomy, pelvic trauma, maternal infection, postpartum hemorrhage and severe laceration. Preeclampsia (adjusted odds ratio [AOR]: 2.96; 95% confidence interval 2.8,3.13), maternal age over 35 years, (AOR: 1.92; 1.79,2.06), vaginal birth after cesarean, (AOR: 1.81; 1.47,2.23) and repeat cesarean birth (AOR: 1.99; 1.87,2.12) conferred the highest odds of severe morbidity. Non-white women were more likely to suffer morbidity. Conclusions: Nearly one in four California women experienced complications during childbirth hospitalization. Significant health disparities in maternal childbirth outcomes persist in the USA.