Patient-, Hospital-, and Neighborhood-Level Factors Associated with Severe Maternal Morbidity During Childbirth: A Cross-Sectional Study in New York State 2013-2014

Maternal and Child Health Journal
Jean GuglielminottiGuohua Li

Abstract

Background The incidence of severe maternal morbidity (SMM) during childbirth is increasing in the United States. A better characterization of risk factors for SMM may identify targets for improving maternal outcomes. This study aims to characterize patient-, hospital-, and neighborhood-level factors associated with SMM during childbirth. Methods SMM during childbirth was identified in the 2013-2014 State Inpatients Database for New York. Hospital and neighborhood characteristics were abstracted from the American Hospital Association and the Area Health Resources files. Multilevel modeling was used to identify factors associated with SMM, with and without blood transfusion, and its between-hospital variation. Results 403,116 delivery-related discharges from 139 hospitals were analyzed; 1557 (0.39%) recorded SMM without blood transfusion. In the final multilevel model, 7 patient-level factors were associated with a greater than fourfold increase in the risk of SMM: pulmonary hypertension, postpartum hemorrhage, placenta accreta, chronic kidney disease, cardiac conduction disorders, emergent cesarean delivery, and preeclampsia. Three hospital-level factors were associated with SMM: proportion of non-White patients, proportion of ...Continue Reading

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Citations

Dec 17, 2019·Anesthesia and Analgesia·Rachel M Kacmar, Jill M Mhyre
Feb 4, 2019·Maternal and Child Health Journal·Renata E HowlandEmily White Johansson
May 17, 2019·Anesthesiology·Jill M Mhyre, Brian T Bateman
Aug 18, 2020·American Journal of Obstetrics and Gynecology·Mahasin S MujahidSuzan L Carmichael
Mar 31, 2021·Anaesthesia Critical Care & Pain Medicine·Allison Lee, Ruth Landau
Apr 9, 2021·Obstetrics and Gynecology·Jessica R MeekerMary Regina Boland
May 15, 2021·Anesthesia and Analgesia·Charlotte GodebergeUNKNOWN EPIMOMS Study Group
Mar 24, 2021·American Journal of Epidemiology·Jonathan M SnowdenSuzan L Carmichael

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