Repeated maternal ICU admission: Results from a nationwide analysis

To determine the rate and profile of repeated maternal ICU admissions during or after pregnancy and to compare the characteristics of these women's first and second ICU admissions.

A descriptive analysis from the French national hospital discharge database that included all women admitted to an ICU during pregnancy or within 42 days after delivery, between 2010 and 2014.

During the 5-year study period, there were 371 women with more than one maternal ICU admission, representing 2.5% of all women admitted during or after pregnancy (371/15,096) and a 0.9 per 10,000 deliveries (371/4,030,409) rate of repeated maternal ICU admission. Compared with women with only one maternal ICU admission, those with repeated maternal ICU admissions were more often admitted during the pregnancy rather than during or after the delivery stay (P < 0.001), for organ failure or sepsis (P < 0.001), and with a SAPS-II score > 25 (P < 0.001). Women with repeated admissions were usually readmitted for the same indications and had similar SAPS-II scores. Half of ICU readmissions occurred within 72 h of first ICU discharge, with similar causes and levels of severity for both stays.

Although the rate of women with repeated maternal ICU admissions was low, their initial stay had a specific profile of causes of admission and greater severity compared with the stay of women admitted only once. The pattern and similar characteristics of both first and second ICU admission and the short interval for readmission suggests that some ICU discharges may have been potentially premature.