Common Complications and Conditions at Delivery Hospitalization by Race and Ethnicity in the United States

To identify and estimate the prevalence of common complications and conditions (eg, hypertensive disorders of pregnancy, substance use, mental health conditions) documented at delivery hospitalizations in the United States and the prevalence of multiple complications and conditions, overall and by race and ethnicity.

We conducted a cross-sectional analysis of hospital discharge data from the Healthcare Cost and Utilization Project's National Inpatient Sample. The data can be weighted to provide national estimates; these weights were applied. We included delivery hospitalizations in 2018 and 2019 among females aged 12-55 years. Delivery hospitalizations and condition groups were identified using International Classification of Diseases, Tenth Revision, Clinical Modification codes. Codes were grouped into 34 clinically relevant condition groups, including complications and conditions. These groups were selected based on prevalence, clinical significance, and relevance to maternal health. The prevalence of each condition group and the total number of condition groups were calculated overall and by race and ethnicity. Documenting racial and ethnic differences in maternal health conditions and complications can help identify disproportionately affected populations and guide efforts to improve outcomes.

We identified 6,892,304 delivery hospitalizations in the United States in 2018 and 2019. Overall, 65.5% of hospitalizations had at least one condition group documented. Nonhereditary anemia (19.5%), substance use (12.5%), hypertensive disorders of pregnancy (12.5%), obesity (12.0%), and mental health conditions (8.8%) were the most frequently documented. Prevalence and ranking of condition groups varied by race and ethnicity. Native American (74.9%) and Black patients (73.4%) had the highest prevalence of any condition group, and the highest prevalence of three or more condition groups (25.4% and 25.1%, respectively).

Approximately two of three delivery hospitalizations had at least one condition group documented, many associated with adverse maternal outcomes. Assessing the prevalence of a broad range of complications and conditions reveals the full burden of maternal morbidity and informs programs and policies to improve maternal health among all women.