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Severe Maternal Morbidity During Delivery Hospitalizations.

INTRODUCTION
Severe maternal morbidities include 25 complications resulting from, or exacerbated by, pregnancy. Nationally, in the last decade, these rates have doubled.


OBJECTIVE
This study describes trends in the rates of severe maternal morbidities at the time of hospitalization for delivery among different groups of Wisconsin women.


METHODS
Hospital discharge data and ICD-9-CM diagnosis and procedure codes were used to identify delivery hospitalizations and rates of severe maternal morbidity among Wisconsin women from 2000 to 2014. Subsequent analyses focused on recent years (2010-2014). Rates of severe maternal morbidity were calculated per 10,000 delivery hospitalizations for all 25 severe maternal morbidity conditions as well as 24 conditions (excluding blood transfusions). Rates and rate ratios were calculated overall and for racial/ethnic groups, age groups, public health region of residence, and hospital payer. Median hospital length of stay and median hospital charges were compared for delivery hospitalizations with increasing severe maternal morbidities.


RESULTS
Severe maternal morbidity rates increased 104% from 2000 to 2014 (P for trend <0.01). After excluding blood transfusions, rates increased 15% (P for trend <0.05). From 2010 to 2014, overall rates were stable over time, but varied by maternal age, race/ethnicity, payer, and public health region of residence. Median hospital charges and length of stay increased as the number of morbidities increased.


CONCLUSIONS
Monitoring severe maternal morbidities adds valuable information to understanding perinatal health and obstetric complications in order to identify opportunities for prevention of severe morbidities and improvements in the quality of maternity care.