Maternal morbidity and risk of death at delivery hospitalization

Katherine H. Campbell, David Savitz, Erika F. Werner, Christian M. Pettker, Dena Goffman, Cynthia Chazotte, Heather S. Lipkind

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

OBJECTIVE:: To examine the effect of underlying maternal morbidities on the odds of maternal death during delivery hospitalization. METHODS:: We used data that linked birth certificates to hospital discharge diagnoses from singleton live births at 22 weeks of gestation or later during 1995-2003 in New York City. Maternal morbidities examined included prepregnancy weight more than 114 kilograms (250 pounds), chronic hypertension, pregestational or gestational diabetes mellitus, chronic cardiovascular disease, pulmonary hypertension, chronic lung disease, human immunodeficiency virus (HIV), and preeclampsia or eclampsia. Associations with maternal mortality were estimated using multivariate logistic regression. RESULTS:: During the specified time period, 1,084,862 live singleton births and 132 maternal deaths occurred. Patients with increasing maternal age, non-Hispanic black ethnicity, self-pay or Medicaid, primary cesarean delivery, and premature delivery had higher rates of maternal mortality during delivery hospitalization. From the entire study population, 4.1% had preeclampsia or eclampsia (n=44,004), 1.8% had chronic hypertension (n=19,647), 1.1% of patients were classified as obese (n=11,936), 0.7% had pregestational diabetes (n=7,474), 0.4% had HIV (n=4,665), and 0.01% had pulmonary hypertension (n=166). Preeclampsia or eclampsia (adjusted odds ratio [OR], 8.1; 95% confidence interval [CI], 5.5-12.1), chronic hypertension (adjusted OR, 7.7; 95% CI 4.7-12.5), underlying maternal obesity (adjusted OR, 2.9; 95% CI 1.1-8.1), pregestational diabetes (adjusted OR, 3.3; 95% CI 1.3-8.1), HIV (adjusted OR, 7.7; 95% CI 3.4-17.8), and pulmonary hypertension (adjusted OR, 65.1; 95% CI 15.8-269.3) were associated with an increased risk of death during the delivery hospitalization. CONCLUSION:: The presence of maternal disease significantly increases the odds of maternal mortality at the time of delivery hospitalization.

Original languageEnglish (US)
Pages (from-to)627-633
Number of pages7
JournalObstetrics and Gynecology
Volume122
Issue number3
DOIs
StatePublished - Sep 2013
Externally publishedYes

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Hospitalization
Odds Ratio
Mothers
Confidence Intervals
Morbidity
Eclampsia
Maternal Mortality
Pre-Eclampsia
Pulmonary Hypertension
Maternal Death
Live Birth
HIV
Hypertension
Chronic Disease
Birth Certificates
Gestational Diabetes
Maternal Age
Medicaid
Lung Diseases
Cardiovascular Diseases

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Campbell, K. H., Savitz, D., Werner, E. F., Pettker, C. M., Goffman, D., Chazotte, C., & Lipkind, H. S. (2013). Maternal morbidity and risk of death at delivery hospitalization. Obstetrics and Gynecology, 122(3), 627-633. https://doi.org/10.1097/AOG.0b013e3182a06f4e

Maternal morbidity and risk of death at delivery hospitalization. / Campbell, Katherine H.; Savitz, David; Werner, Erika F.; Pettker, Christian M.; Goffman, Dena; Chazotte, Cynthia; Lipkind, Heather S.

In: Obstetrics and Gynecology, Vol. 122, No. 3, 09.2013, p. 627-633.

Research output: Contribution to journalArticle

Campbell, KH, Savitz, D, Werner, EF, Pettker, CM, Goffman, D, Chazotte, C & Lipkind, HS 2013, 'Maternal morbidity and risk of death at delivery hospitalization', Obstetrics and Gynecology, vol. 122, no. 3, pp. 627-633. https://doi.org/10.1097/AOG.0b013e3182a06f4e
Campbell KH, Savitz D, Werner EF, Pettker CM, Goffman D, Chazotte C et al. Maternal morbidity and risk of death at delivery hospitalization. Obstetrics and Gynecology. 2013 Sep;122(3):627-633. https://doi.org/10.1097/AOG.0b013e3182a06f4e
Campbell, Katherine H. ; Savitz, David ; Werner, Erika F. ; Pettker, Christian M. ; Goffman, Dena ; Chazotte, Cynthia ; Lipkind, Heather S. / Maternal morbidity and risk of death at delivery hospitalization. In: Obstetrics and Gynecology. 2013 ; Vol. 122, No. 3. pp. 627-633.
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AU - Werner, Erika F.

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AU - Goffman, Dena

AU - Chazotte, Cynthia

AU - Lipkind, Heather S.

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N2 - OBJECTIVE:: To examine the effect of underlying maternal morbidities on the odds of maternal death during delivery hospitalization. METHODS:: We used data that linked birth certificates to hospital discharge diagnoses from singleton live births at 22 weeks of gestation or later during 1995-2003 in New York City. Maternal morbidities examined included prepregnancy weight more than 114 kilograms (250 pounds), chronic hypertension, pregestational or gestational diabetes mellitus, chronic cardiovascular disease, pulmonary hypertension, chronic lung disease, human immunodeficiency virus (HIV), and preeclampsia or eclampsia. Associations with maternal mortality were estimated using multivariate logistic regression. RESULTS:: During the specified time period, 1,084,862 live singleton births and 132 maternal deaths occurred. Patients with increasing maternal age, non-Hispanic black ethnicity, self-pay or Medicaid, primary cesarean delivery, and premature delivery had higher rates of maternal mortality during delivery hospitalization. From the entire study population, 4.1% had preeclampsia or eclampsia (n=44,004), 1.8% had chronic hypertension (n=19,647), 1.1% of patients were classified as obese (n=11,936), 0.7% had pregestational diabetes (n=7,474), 0.4% had HIV (n=4,665), and 0.01% had pulmonary hypertension (n=166). Preeclampsia or eclampsia (adjusted odds ratio [OR], 8.1; 95% confidence interval [CI], 5.5-12.1), chronic hypertension (adjusted OR, 7.7; 95% CI 4.7-12.5), underlying maternal obesity (adjusted OR, 2.9; 95% CI 1.1-8.1), pregestational diabetes (adjusted OR, 3.3; 95% CI 1.3-8.1), HIV (adjusted OR, 7.7; 95% CI 3.4-17.8), and pulmonary hypertension (adjusted OR, 65.1; 95% CI 15.8-269.3) were associated with an increased risk of death during the delivery hospitalization. CONCLUSION:: The presence of maternal disease significantly increases the odds of maternal mortality at the time of delivery hospitalization.

AB - OBJECTIVE:: To examine the effect of underlying maternal morbidities on the odds of maternal death during delivery hospitalization. METHODS:: We used data that linked birth certificates to hospital discharge diagnoses from singleton live births at 22 weeks of gestation or later during 1995-2003 in New York City. Maternal morbidities examined included prepregnancy weight more than 114 kilograms (250 pounds), chronic hypertension, pregestational or gestational diabetes mellitus, chronic cardiovascular disease, pulmonary hypertension, chronic lung disease, human immunodeficiency virus (HIV), and preeclampsia or eclampsia. Associations with maternal mortality were estimated using multivariate logistic regression. RESULTS:: During the specified time period, 1,084,862 live singleton births and 132 maternal deaths occurred. Patients with increasing maternal age, non-Hispanic black ethnicity, self-pay or Medicaid, primary cesarean delivery, and premature delivery had higher rates of maternal mortality during delivery hospitalization. From the entire study population, 4.1% had preeclampsia or eclampsia (n=44,004), 1.8% had chronic hypertension (n=19,647), 1.1% of patients were classified as obese (n=11,936), 0.7% had pregestational diabetes (n=7,474), 0.4% had HIV (n=4,665), and 0.01% had pulmonary hypertension (n=166). Preeclampsia or eclampsia (adjusted odds ratio [OR], 8.1; 95% confidence interval [CI], 5.5-12.1), chronic hypertension (adjusted OR, 7.7; 95% CI 4.7-12.5), underlying maternal obesity (adjusted OR, 2.9; 95% CI 1.1-8.1), pregestational diabetes (adjusted OR, 3.3; 95% CI 1.3-8.1), HIV (adjusted OR, 7.7; 95% CI 3.4-17.8), and pulmonary hypertension (adjusted OR, 65.1; 95% CI 15.8-269.3) were associated with an increased risk of death during the delivery hospitalization. CONCLUSION:: The presence of maternal disease significantly increases the odds of maternal mortality at the time of delivery hospitalization.

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