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Published on: January 12, 2018
Maternal morbidity during childbirth hospitalization in California
Audrey Lyndon1, Henry C Lee, William M Gilbert
1Department of Family Health Care Nursing, University of California, San Francisco, CA 94143, USA. audrey.lyndon@nursing.ucsf.edu
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.
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