An Exploratory Spatiotemporal Analysis of Socio-Environmental Patterns in Severe Maternal Morbidity

Objectives Severe Maternal Morbidity (SMM) is a group of pregnancy complications in which a woman nearly dies. Despite its increasing prevalence, little research has evaluated geographic patterns of SMM and the underlying social determinants that influence excess risk. This study examined the spatia...

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Bibliographic Details
Published in:Maternal and child health journal 2022-05, Vol.26 (5), p.1077-1086
Main Authors: Harden, Stella R., Runkle, Jennifer D., Sugg, Margaret M.
Format: Article
Language:English
Subjects:
Ambient temperature
Blood transfusions
Childrens health
Cluster analysis
Comorbidity
Complications and side effects
Development and progression
Diabetes
Environmental factors
Ethnicity
Female
Gynecology
Health aspects
Hispanic people
Hospitalization
Hospitals
Humans
Hypertension
Income inequality
Maternal & child health
Maternal and Child Health
Medicine
Medicine & Public Health
Minority women
Morbidity
Obesity
Patients
Pediatrics
Population Economics
Pregnancy
Pregnancy complications
Pregnancy Complications - epidemiology
Pregnancy, Complications of
Prevalence
Public Health
Race
Risk Factors
Segregation
Sociology
Spatio-Temporal Analysis
Statistics
Trends
Womens health
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Summary:Objectives Severe Maternal Morbidity (SMM) is a group of pregnancy complications in which a woman nearly dies. Despite its increasing prevalence, little research has evaluated geographic patterns of SMM and the underlying social determinants that influence excess risk. This study examined the spatial clustering of SMM across South Carolina, US, and its associations with place-based social and environmental factors. Methods Hospitalized deliveries from 2012 to 2017 were analyzed using Kulldorff's spatial scan statistic to locate areas with abnormally high rates of SMM. SMM patients inside and outside risk clusters were compared using Generalized Estimating Equations (GEE) to determine underlying individual and community-level risk factors. Results GEE models revealed that the odds of living in a high-risk SMM21 (SMM including blood transfusions) cluster was 2.49 times higher among Black patients (p 
ISSN:1092-7875
1573-6628
DOI:10.1007/s10995-021-03330-0