Identification of severe maternal morbidity during delivery hospitalizations, United States, 1991-2003

Objective This investigation aimed to identify pregnancy complications and risk factors for women who experienced severe maternal morbidity during the delivery hospitalization and to estimate severe maternal morbidity rates. Study Design We used the National Hospital Discharge Survey for 1991-2003 t...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2008-08, Vol.199 (2), p.133.e1-133.e8
Main Authors: Callaghan, William M., MD, MPH, MacKay, Andrea P., MSPH, Berg, Cynthia J., MD, MPH
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Delivery, Obstetric
Delivery. Postpartum. Lactation
Female
Gynecology. Andrology. Obstetrics
Hospitalization
Humans
International Classification of Diseases
Length of Stay
Maternal Age
Medical sciences
Morbidity
Obstetric Labor Complications - epidemiology
Obstetrics and Gynecology
Pregnancy
pregnancy complication
Pregnancy Complications - epidemiology
Pregnancy Outcome
Risk Factors
severe maternal morbidity
Severity of Illness Index
surveillance
United States - epidemiology
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Summary:Objective This investigation aimed to identify pregnancy complications and risk factors for women who experienced severe maternal morbidity during the delivery hospitalization and to estimate severe maternal morbidity rates. Study Design We used the National Hospital Discharge Survey for 1991-2003 to identify delivery hospitalizations with maternal diagnoses and procedures that indicated a potentially life-threatening diagnosis or life-saving procedure. Results For 1991-2003, the severe maternal morbidity rate in the United States was 5.1 per 1000 deliveries. Most women who were classified as having severe morbidity had an ICD-9-CM code for transfusion, hysterectomy, or eclampsia. Severe morbidity was more common at the extremes of reproductive age and for black women, compared with white women. Conclusion Severe maternal morbidity is 50 times more common than maternal death. Understanding these experiences of these women potentially could modify the delivery of care in healthcare institutions and influence maternal health policy at the state and national level.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2007.12.020