Maternal Risk Conditions and Outcomes by Levels of Maternal Care.

Autor: DeSisto CL; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Ewing AC; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Diop H; Division of MCH Research and Analysis, Massachusetts Department of Public Health, Boston, Massachusetts, USA., Easter SR; Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Harvey E; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Division of Family Health and Wellness, Tennessee Department of Health, Nashville, Tennessee, USA., Kane DJ; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Iowa Department of Health and Human Services, Division of Community Access, Wellness and Prevention Branch, Bureau of Family Health, Des Moines, Iowa, USA., Naiman-Sessions M; Early Childhood and Family Support Division, Montana Department of Public Health and Human Services, Helena, Montana, USA., Osei-Poku G; Betsy Lehman Center for Patient Safety, Boston, Massachusetts, USA., Riley M; West Virginia Perinatal Partnership, Charleston, West Virginia, USA., Shanholtzer B; West Virginia Health Statistics Center, Charleston, West Virginia, USA., Stach AM; Division of Family Health and Wellness, Tennessee Department of Health, Nashville, Tennessee, USA., Dronamraju R; Maternal and Infant Health, Association of State and Territorial Health Officials, Arlington, Virginia, USA., Catalano A; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Clark EA; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Madni SA; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Womack LS; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Kuklina EV; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Goodman DA; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Kilpatrick SJ; Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, USA., Menard MK; Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina, USA.
Jazyk: angličtina
Zdroj: Journal of women's health (2002) [J Womens Health (Larchmt)] 2024 Oct 25. Date of Electronic Publication: 2024 Oct 25.
DOI: 10.1089/jwh.2024.0547
Abstrakt: Objectives: To (1) determine associations between maternal risk conditions and severe adverse outcomes that may benefit from risk-appropriate care and (2) assess whether associations between risk conditions and outcomes vary by level of maternal care (LoMC). Methods: We used the 2017-2019 National Inpatient Sample (NIS) to calculate associations between maternal risk conditions and severe adverse outcomes. Risk conditions included severe preeclampsia, placenta accreta spectrum (PAS) conditions, and cardiac conditions. Outcomes included disseminated intravascular coagulation (DIC) with blood products transfusion or shock, pulmonary edema or acute respiratory distress syndrome (ARDS), stroke, acute renal failure, and a composite cardiac outcome. Then we used 2019 delivery hospitalization data from five states linked to hospital LoMC. We calculated associations between risk conditions and outcomes overall and stratified by LoMC and assessed for effect modification by LoMC. Results: We found positive measures of association between risk conditions and outcomes. Among patients with severe preeclampsia or PAS, the magnitudes of the associations with DIC with blood products transfusion or shock, pulmonary edema or ARDS, and acute renal failure were lower in Level III/IV compared with
Databáze: MEDLINE