Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 1;140(3):450-452.
doi: 10.1097/AOG.0000000000004902. Epub 2022 Aug 3.

Using Longitudinally Linked Data to Measure Severe Maternal Morbidity Beyond the Birth Hospitalization in California

Suzan L Carmichael  1 , Anna I Girsen, Chen Ma, Elliot K Main, Ronald S Gibbs
Affiliations

Using Longitudinally Linked Data to Measure Severe Maternal Morbidity Beyond the Birth Hospitalization in California

Suzan L Carmichael et al. Obstet Gynecol. .

Abstract

Most studies of severe maternal morbidity (SMM) include only cases that occur during birth hospitalizations. We examined the increase in cases when including SMM during antenatal and postpartum (within 42 days of discharge) hospitalizations, using longitudinally linked data from 1,010,250 births in California from September 1, 2016, to December 31, 2018. For total SMM, expanding the definition resulted in 22.8% more cases; for nontransfusion SMM, 45.1% more cases were added. Sepsis accounted for 55.5% of the additional cases. The increase varied for specific indicators, for example, less than 2% for amniotic fluid embolism, 7.0% for transfusion, 112.9% for sepsis, and 155.6% for acute myocardial infarction. These findings reiterate the importance of considering SMM beyond just the birth hospitalization and facilitating access to longitudinally linked data to facilitate a more complete understanding of SMM.

PubMed Disclaimer

Conflict of interest statement

Financial Disclosure The authors did not report any potential conflicts of interest.

References

    1. Declercq ER, Cabral HJ, Cui X, Liu CL, Amutah-Onukagha N, Larson E, Meadows A, Diop H. Using Longitudinally Linked Data to Measure Severe Maternal Morbidity.Obstet Gynecol 2022. Feb 1;139(2):165–171. doi: 10.1097/AOG.0000000000004641 - DOI - PMC - PubMed
    1. Callaghan WM. Identifying Cases of Severe Maternal Morbidity: Moving Beyond the Delivery Hospitalization. Obstet Gynecol 2022. Feb 1;139(2):163–164. doi: 10.1097/AOG.0000000000004665 - DOI - PubMed
    1. Main EK, Abreo A, McNulty J, Gilbert W, McNally C, Poeltler D, Lanner-Cusin K, Fenton D, Gipps T, Melsop K, Greene N, Gould JB, Kilpatrick S. Measuring severe maternal morbidity: validation of potential measures. Am J Obstet Gynecol 2016. May;214(5):643.e1–643.e10. doi: 10.1016/j.ajog.2015.11.004 - DOI - PubMed
    1. Carmichael SL, Abrams B, El Ayadi A, Lee HC, Liu C, Lyell DJ, Lyndon A, Main EK, Mujahid M, Tian L, Snowden JM. Ways Forward in Preventing Severe Maternal Morbidity and Maternal Health Inequities: Conceptual Frameworks, Definitions, and Data, from a Population Health Perspective. Womens Health Issues 2021. Dec 28:S1049-3867(21)00181-X. doi: 10.1016/j.whi.2021.11.006 - DOI - PMC - PubMed
    1. Girsen AI, Sie L, Carmichael SL, Lee HC, Foeller ME, Druzin ML, Gibbs RS. Rate and causes of severe maternal morbidity at readmission: California births in 2008-2012. J Perinatol 2020. Jan;40(1):25–29. doi: 10.1038/s41372-019-0481-z - DOI - PMC - PubMed

Publication types