Why Worst Speciation Ever Original Research nationally and in Illinois; in 2020, Black individuals were found to have double the rate of SMM and triple the maternal mortality rate
Trends in Severe Maternal Morbidity, Obstetric Comorbidities, and Birth Complications in Illinois
Mokashi, Mugdha MD, MPH; Yee, Lynn MD, MPH; Feinglass, Joseph PhD
O&G Open 1(4):p 046, December 2024. | DOI: 10.1097/og9.0000000000000046
- Open
- SDC
Metrics Abstract In Brief
OBJECTIVE:
To analyze trends in severe maternal morbidity (SMM) and route-specific complications of birth in Illinois hospitals from January 2016 to June 2023.
METHODS:
This retrospective population-based cohort study analyzed birth admission data from 159 hospitals using the Illinois Hospital Association Comparative Health Care and Hospital Data Reporting Services database from January 2016 to June 2023. Primary outcomes were incidence of SMM and route-specific delivery complications. Secondary outcomes included incidence of chronic and pregnancy-related comorbidities. Poisson regression was used to estimate incidence rate ratios for SMM; logistic regression was used to estimate odds ratios for route-specific birth complications; and model SEs were adjusted for clustering of observations within hospitals.
RESULTS:
In this cohort of 988,480 births, the overall SMM rate was 1.6%; the rate of SMM rose from 1.4% in 2016 to 2.0% in 2023. The rate of SMM was 0.9% for people who underwent vaginal births and 3.2% for people who underwent for cesarean births. Vaginal birth complications (7.3% overall) increased 22.4%, and cesarean birth complications (10.9% overall) increased 48.9%. Hypertensive disorders of pregnancy and anemia, both of which increased over the study period, were significant risk factors for SMM and birth complications. Over the study period, there were also increases in International Classification of Diseases, Tenth Revisionâcoded gestational diabetes (4.2â5.5%), depression (2.5â6.6%), anxiety (3.1â10.4%), and other chronic comorbidities (4.7â7.4%). Non-Hispanic Black patients had more than double the SMM rate (2.6%) compared with non-Hispanic White patients (1.1%).
CONCLUSION:
From 2016 to 2023, the rates of SMM and birth complications in Illinois increased alongside increases in coding for chronic and prepregnancy and pregnancy-related comorbidities. This study demonstrates the burden of cesarean birthâassociated adverse outcomes, including a higher rate of SMM, which increased over the study period.
Severe maternal morbidity (SMM) and other birth and postpartum complications have increased over time both nationally and in Illinois.1,2 Worsening maternal complications can be attributed to many factors, including the increase in the age of those giving birth, combined with the increasing prevalence of conditions such as obesity, hypertensive disorders of pregnancy (HDP), and gestational diabetes, among pregnant and postpartum individuals of all ages.3â7 Large racial disparities in SMM have been documented nationally and in Illinois; in 2020, Black individuals were found to have double the rate of SMM and triple the maternal mortality rate compared with White individuals within the state.2
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