Maternal morbidity during childbirth hospitalization in California

Abstract

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.

Keywords::

• Childbirth hospitalization
• maternal morbidity
• risk factors

Acknowledgments

We thank Ms. Chengshi Jin and Dr. Lance Pollack for programming support.

Declaration of Interest: This study was supported by NIH/NCRR/OD UCSF-CTSI Grant Number KL2 RR024130. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. The linkage of OSHPD and California Vital Statistics datasets was made possible through a grant from the March of Dimes. Sponsor role: none.