Severe obstetric morbidity in the United States: 1998-2005

Elena V Kuklina; Susan F Meikle; Denise J Jamieson; Maura K Whiteman; Wanda D Barfield; Susan D Hillis; Samuel F Posner

doi:10.1097/AOG.0b013e3181954e5b

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Severe obstetric morbidity in the United States: 1998-2005

Journal article

Peer reviewed

Severe obstetric morbidity in the United States: 1998-2005

Elena V Kuklina, Susan F Meikle, Denise J Jamieson, Maura K Whiteman, Wanda D Barfield, Susan D Hillis and Samuel F Posner

Obstetrics and gynecology (New York. 1953), Vol.113(2 Pt 1), pp.293-299

02/01/2009

DOI: 10.1097/AOG.0b013e3181954e5b

PMCID: PMC2743391

PMID: 19155897

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https://www.ncbi.nlm.nih.gov/pmc/articles/2743391View

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Abstract

To examine trends in the rates of severe obstetric complications and the potential contribution of changes in delivery mode and maternal characteristics to these trends. We performed a cross-sectional study of severe obstetric complications identified from the 1998-2005 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project. Logistic regression was used to examine the effect of changes in delivery mode and maternal characteristics on rates of severe obstetric complications. The prevalence of delivery hospitalizations (per 1,000) complicated by at least one severe obstetric complication increased from 0.64% (n=48,645) in 1998-1999 to 0.81% (n=68,433) in 2004-2005. Rates of complications that increased significantly during the study period included renal failure by 21% (from 0.23 to 0.28), pulmonary embolism by 52% (0.12 to 0.18), adult respiratory distress syndrome by 26% (0.36 to 0.45), shock by 24% (0.15 to 0.19), blood transfusion by 92% (2.38 to 4.58), and ventilation by 21 % (0.47 to 0.57). In logistic regression models, adjustment for maternal age had no effect on the increased risk for these complications in 2004-2005 relative to 1998-1999. However, after adjustment for mode of delivery, the increased risks for these complications in 2004-2005 relative to 1998-1999 were no longer significant, with the exception of pulmonary embolism (odds ratio 1.30) and blood transfusion (odds ratio 1.72). Further adjustment for payer, multiple births, and select comorbidities had little effect. Rates of severe obstetric complications increased from 1998-1999 to 2004-2005. For many of these complications, these increases were associated with the increasing rate of cesarean delivery. III.

Adult

Cesarean Section - statistics & numerical data

Cross-Sectional Studies

Female

Humans

Maternal Age

Obstetric Labor Complications - epidemiology

Odds Ratio

Pregnancy

Prevalence

United States - epidemiology

Young Adult

Details

Title: Subtitle: Severe obstetric morbidity in the United States: 1998-2005
Creators: Elena V Kuklina - Eunice Kennedy Shriver National Institute of Child Health and Human Development
Susan F Meikle - Eunice Kennedy Shriver National Institute of Child Health and Human Development
Denise J Jamieson - Eunice Kennedy Shriver National Institute of Child Health and Human Development
Maura K Whiteman - Eunice Kennedy Shriver National Institute of Child Health and Human Development
Wanda D Barfield - Eunice Kennedy Shriver National Institute of Child Health and Human Development
Susan D Hillis - Eunice Kennedy Shriver National Institute of Child Health and Human Development
Samuel F Posner - Eunice Kennedy Shriver National Institute of Child Health and Human Development
Resource Type: Journal article
Publication Details: Obstetrics and gynecology (New York. 1953), Vol.113(2 Pt 1), pp.293-299
DOI: 10.1097/AOG.0b013e3181954e5b
PMID: 19155897
PMCID: PMC2743391
NLM abbreviation: Obstet Gynecol
ISSN: 0029-7844
eISSN: 1873-233X
Grant note: Z99 HD999999 / Intramural NIH HHS
Language: English
Date published: 02/01/2009
Academic Unit: Obstetrics and Gynecology; VPMA - Administration
Record Identifier: 9984446068902771

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