Adverse Delivery and Neonatal Outcomes Among Women with Severe Maternal Morbidity in Illinois, 2018–2019
Objective: To examine adverse delivery outcomes from 2018 to 2019 severe maternal morbidity (SMM) cases that were reviewed by facility-level review committees in Illinois ( n = 666) and describe the burden of adverse delivery outcomes among demographic subgroups, SMM etiology, and whether the SMM e...
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| Veröffentlicht in: | Journal of women's health (Larchmont, N.Y. 2002) N.Y. 2002), 2024-02, Vol.33 (2), p.163-170 |
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| container_title | Journal of women's health (Larchmont, N.Y. 2002) |
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| creator | Garland, Caitlin E Geller, Stacie E Koch, Abigail R |
| description | Objective:
To examine adverse delivery outcomes from 2018 to 2019 severe maternal morbidity (SMM) cases that were reviewed by facility-level review committees in Illinois (
n
= 666) and describe the burden of adverse delivery outcomes among demographic subgroups, SMM etiology, and whether the SMM event was potentially preventable.
Materials and Methods:
This is a descriptive analysis of the SMM review cohort. Consistent with expert recommendations to identify SMM for hospital quality review, SMM was defined as any intensive care or critical care unit admission and/or transfusion of four or more units of packed red blood cells from conception to 42 days postpartum. Adverse delivery outcomes were fetal death, low birthweight, preterm birth, neonatal intensive care unit admission, and 5-minute Apgar score |
| doi_str_mv | 10.1089/jwh.2023.0248 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2891752211</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2891752211</sourcerecordid><originalsourceid>FETCH-LOGICAL-c337t-b733ac4512493f3e5b01976f3b5e97e1790ecc5ab424a79c5ef40dd8132176e93</originalsourceid><addsrcrecordid>eNqFkL1OwzAUhS0EolAYWZFHBlL8k9TxWJW_Si0dAMEWOckNdZU4xU6ouvEOvCFPgqMWVqZzdPXdM3wInVEyoCSWV8v1YsAI4wPCwngPHVHJaRCH_HXf9ygkgZRy2EPHzi0JYYwScoh6XEjByJAcoeUo_wDrAF9DqX3bYGVy_AC1UY0q8bxtsroCh0dVbd7wi-8Gr3WzwI_gacAz1YA1npzVNtW5bjZYGzwpS21q7S4xIzT-_vzyIU_QQaFKB6e77KPn25un8X0wnd9NxqNpkHEumiAVnKssjCgLJS84RKn_FcOCpxFIAVRIAlkWqTRkoRIyi6AISZ7HlDMqhiB5H11sd1e2fm_BNUmlXQZlqQzUrUtYLKmIvArq0WCLZrZ2zkKRrKyulN0klCSd3sTrTTq9SafX8-e76TatIP-jf316gG-B7qyMKTWkYJt_Zn8A8DuGpw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2891752211</pqid></control><display><type>article</type><title>Adverse Delivery and Neonatal Outcomes Among Women with Severe Maternal Morbidity in Illinois, 2018–2019</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Garland, Caitlin E ; Geller, Stacie E ; Koch, Abigail R</creator><creatorcontrib>Garland, Caitlin E ; Geller, Stacie E ; Koch, Abigail R</creatorcontrib><description>Objective:
To examine adverse delivery outcomes from 2018 to 2019 severe maternal morbidity (SMM) cases that were reviewed by facility-level review committees in Illinois (
n
= 666) and describe the burden of adverse delivery outcomes among demographic subgroups, SMM etiology, and whether the SMM event was potentially preventable.
Materials and Methods:
This is a descriptive analysis of the SMM review cohort. Consistent with expert recommendations to identify SMM for hospital quality review, SMM was defined as any intensive care or critical care unit admission and/or transfusion of four or more units of packed red blood cells from conception to 42 days postpartum. Adverse delivery outcomes were fetal death, low birthweight, preterm birth, neonatal intensive care unit admission, and 5-minute Apgar score <7. Chi square and Fisher's exact tests compared maternal demographic and delivery characteristics between the SMM sample and 2018–2019 deliveries in Illinois. Logistic regression modeled the associations between primary cause of morbidity, maternal race/ethnicity, adverse delivery outcomes, and opportunities to alter the outcome to assess whether the burden of adverse birth outcomes was distributed evenly across subcategories of the cohort.
Results:
Overall, 53.9% of women with SMM had at least one adverse delivery outcome. SMM events owing to preeclampsia/eclampsia (adjusted odds ratio [aOR] = 4.41, 95% confidence interval [CI] = 2.37–8.24) and infection/sepsis (aOR = 4.40, 95% CI = 1.79–11.04) were more likely to be accompanied by adverse delivery outcomes compared with hemorrhage-related SMM. Non-Hispanic Black women with SMM were more likely to have an adverse delivery outcome compared with non-Hispanic White women with SMM (aOR = 1.74, 95% CI = 1.01–3.02).
Conclusion:
A greater proportion of the SMM review cohort experienced adverse delivery outcomes compared with the overall birthing population in the state. Non-Hispanic Black women with SMM were almost twice as likely to have an adverse delivery outcome compared with non-Hispanic White women.</description><identifier>ISSN: 1540-9996</identifier><identifier>EISSN: 1931-843X</identifier><identifier>DOI: 10.1089/jwh.2023.0248</identifier><identifier>PMID: 37972060</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc., publishers</publisher><subject>Ethnicity ; Female ; Humans ; Illinois - epidemiology ; Infant, Newborn ; Morbidity ; Original Articles ; Pregnancy ; Pregnancy Complications - epidemiology ; Premature Birth - epidemiology ; Retrospective Studies</subject><ispartof>Journal of women's health (Larchmont, N.Y. 2002), 2024-02, Vol.33 (2), p.163-170</ispartof><rights>2024, Mary Ann Liebert, Inc., publishers</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-b733ac4512493f3e5b01976f3b5e97e1790ecc5ab424a79c5ef40dd8132176e93</citedby><cites>FETCH-LOGICAL-c337t-b733ac4512493f3e5b01976f3b5e97e1790ecc5ab424a79c5ef40dd8132176e93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37972060$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Garland, Caitlin E</creatorcontrib><creatorcontrib>Geller, Stacie E</creatorcontrib><creatorcontrib>Koch, Abigail R</creatorcontrib><title>Adverse Delivery and Neonatal Outcomes Among Women with Severe Maternal Morbidity in Illinois, 2018–2019</title><title>Journal of women's health (Larchmont, N.Y. 2002)</title><addtitle>J Womens Health (Larchmt)</addtitle><description>Objective:
To examine adverse delivery outcomes from 2018 to 2019 severe maternal morbidity (SMM) cases that were reviewed by facility-level review committees in Illinois (
n
= 666) and describe the burden of adverse delivery outcomes among demographic subgroups, SMM etiology, and whether the SMM event was potentially preventable.
Materials and Methods:
This is a descriptive analysis of the SMM review cohort. Consistent with expert recommendations to identify SMM for hospital quality review, SMM was defined as any intensive care or critical care unit admission and/or transfusion of four or more units of packed red blood cells from conception to 42 days postpartum. Adverse delivery outcomes were fetal death, low birthweight, preterm birth, neonatal intensive care unit admission, and 5-minute Apgar score <7. Chi square and Fisher's exact tests compared maternal demographic and delivery characteristics between the SMM sample and 2018–2019 deliveries in Illinois. Logistic regression modeled the associations between primary cause of morbidity, maternal race/ethnicity, adverse delivery outcomes, and opportunities to alter the outcome to assess whether the burden of adverse birth outcomes was distributed evenly across subcategories of the cohort.
Results:
Overall, 53.9% of women with SMM had at least one adverse delivery outcome. SMM events owing to preeclampsia/eclampsia (adjusted odds ratio [aOR] = 4.41, 95% confidence interval [CI] = 2.37–8.24) and infection/sepsis (aOR = 4.40, 95% CI = 1.79–11.04) were more likely to be accompanied by adverse delivery outcomes compared with hemorrhage-related SMM. Non-Hispanic Black women with SMM were more likely to have an adverse delivery outcome compared with non-Hispanic White women with SMM (aOR = 1.74, 95% CI = 1.01–3.02).
Conclusion:
A greater proportion of the SMM review cohort experienced adverse delivery outcomes compared with the overall birthing population in the state. Non-Hispanic Black women with SMM were almost twice as likely to have an adverse delivery outcome compared with non-Hispanic White women.</description><subject>Ethnicity</subject><subject>Female</subject><subject>Humans</subject><subject>Illinois - epidemiology</subject><subject>Infant, Newborn</subject><subject>Morbidity</subject><subject>Original Articles</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - epidemiology</subject><subject>Premature Birth - epidemiology</subject><subject>Retrospective Studies</subject><issn>1540-9996</issn><issn>1931-843X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkL1OwzAUhS0EolAYWZFHBlL8k9TxWJW_Si0dAMEWOckNdZU4xU6ouvEOvCFPgqMWVqZzdPXdM3wInVEyoCSWV8v1YsAI4wPCwngPHVHJaRCH_HXf9ygkgZRy2EPHzi0JYYwScoh6XEjByJAcoeUo_wDrAF9DqX3bYGVy_AC1UY0q8bxtsroCh0dVbd7wi-8Gr3WzwI_gacAz1YA1npzVNtW5bjZYGzwpS21q7S4xIzT-_vzyIU_QQaFKB6e77KPn25un8X0wnd9NxqNpkHEumiAVnKssjCgLJS84RKn_FcOCpxFIAVRIAlkWqTRkoRIyi6AISZ7HlDMqhiB5H11sd1e2fm_BNUmlXQZlqQzUrUtYLKmIvArq0WCLZrZ2zkKRrKyulN0klCSd3sTrTTq9SafX8-e76TatIP-jf316gG-B7qyMKTWkYJt_Zn8A8DuGpw</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Garland, Caitlin E</creator><creator>Geller, Stacie E</creator><creator>Koch, Abigail R</creator><general>Mary Ann Liebert, Inc., publishers</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240201</creationdate><title>Adverse Delivery and Neonatal Outcomes Among Women with Severe Maternal Morbidity in Illinois, 2018–2019</title><author>Garland, Caitlin E ; Geller, Stacie E ; Koch, Abigail R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-b733ac4512493f3e5b01976f3b5e97e1790ecc5ab424a79c5ef40dd8132176e93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Ethnicity</topic><topic>Female</topic><topic>Humans</topic><topic>Illinois - epidemiology</topic><topic>Infant, Newborn</topic><topic>Morbidity</topic><topic>Original Articles</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - epidemiology</topic><topic>Premature Birth - epidemiology</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Garland, Caitlin E</creatorcontrib><creatorcontrib>Geller, Stacie E</creatorcontrib><creatorcontrib>Koch, Abigail R</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of women's health (Larchmont, N.Y. 2002)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Garland, Caitlin E</au><au>Geller, Stacie E</au><au>Koch, Abigail R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adverse Delivery and Neonatal Outcomes Among Women with Severe Maternal Morbidity in Illinois, 2018–2019</atitle><jtitle>Journal of women's health (Larchmont, N.Y. 2002)</jtitle><addtitle>J Womens Health (Larchmt)</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>33</volume><issue>2</issue><spage>163</spage><epage>170</epage><pages>163-170</pages><issn>1540-9996</issn><eissn>1931-843X</eissn><abstract>Objective:
To examine adverse delivery outcomes from 2018 to 2019 severe maternal morbidity (SMM) cases that were reviewed by facility-level review committees in Illinois (
n
= 666) and describe the burden of adverse delivery outcomes among demographic subgroups, SMM etiology, and whether the SMM event was potentially preventable.
Materials and Methods:
This is a descriptive analysis of the SMM review cohort. Consistent with expert recommendations to identify SMM for hospital quality review, SMM was defined as any intensive care or critical care unit admission and/or transfusion of four or more units of packed red blood cells from conception to 42 days postpartum. Adverse delivery outcomes were fetal death, low birthweight, preterm birth, neonatal intensive care unit admission, and 5-minute Apgar score <7. Chi square and Fisher's exact tests compared maternal demographic and delivery characteristics between the SMM sample and 2018–2019 deliveries in Illinois. Logistic regression modeled the associations between primary cause of morbidity, maternal race/ethnicity, adverse delivery outcomes, and opportunities to alter the outcome to assess whether the burden of adverse birth outcomes was distributed evenly across subcategories of the cohort.
Results:
Overall, 53.9% of women with SMM had at least one adverse delivery outcome. SMM events owing to preeclampsia/eclampsia (adjusted odds ratio [aOR] = 4.41, 95% confidence interval [CI] = 2.37–8.24) and infection/sepsis (aOR = 4.40, 95% CI = 1.79–11.04) were more likely to be accompanied by adverse delivery outcomes compared with hemorrhage-related SMM. Non-Hispanic Black women with SMM were more likely to have an adverse delivery outcome compared with non-Hispanic White women with SMM (aOR = 1.74, 95% CI = 1.01–3.02).
Conclusion:
A greater proportion of the SMM review cohort experienced adverse delivery outcomes compared with the overall birthing population in the state. Non-Hispanic Black women with SMM were almost twice as likely to have an adverse delivery outcome compared with non-Hispanic White women.</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc., publishers</pub><pmid>37972060</pmid><doi>10.1089/jwh.2023.0248</doi><tpages>8</tpages></addata></record> |
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| identifier | ISSN: 1540-9996 |
| ispartof | Journal of women's health (Larchmont, N.Y. 2002), 2024-02, Vol.33 (2), p.163-170 |
| issn | 1540-9996 1931-843X |
| language | eng |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Ethnicity Female Humans Illinois - epidemiology Infant, Newborn Morbidity Original Articles Pregnancy Pregnancy Complications - epidemiology Premature Birth - epidemiology Retrospective Studies |
| title | Adverse Delivery and Neonatal Outcomes Among Women with Severe Maternal Morbidity in Illinois, 2018–2019 |
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