Maternal Morbidity During Hospitalization for Delivery

Abstract

OBJECTIVE: 

To estimate nationally representative incidence rates of maternal morbidities and to examine if the incidence of maternal morbidity increased during a 4-year study period.

METHODS: 

We conducted a population-based retrospective cohort study of women delivering in hospitals in Ireland between 2005 and 2008 using nationally representative hospital discharge data from the Hospital In-Patient Enquiry data set. Using singleton deliveries, we categorized International Classification of Diseases 10, Australian Modification diagnostic codes into 38 clinically relevant maternal morbidity groups and assessed the incidence of morbidities potentially affecting labor, delivery, and the puerperium. Significant trends in morbidity over the course of the study period were determined using Cochran-Armitage tests.

RESULTS: 

Exclusive of cesarean delivery, approximately one in six women (17.2%) had a maternal morbidity diagnosed during Hospitalization. When cesarean delivery was included as an additional indicator of morbidity, more than one third (35.6%) had a maternal morbidity diagnosed. The percentage of women with either hemorrhage and genital tract trauma (6.5%) or pregnancy-induced conditions (6.4%) diagnosed were similar. Overall, 4.5% of women had nonacute or chronic conditions diagnosed, 1.6% had infections diagnosed, and 0.6% had acute medical conditions diagnosed. Between 2005 and 2008, rates significantly (P<.001) increased for postpartum hemorrhage, pelvic and perineal trauma, and gestational diabetes.

CONCLUSION: 

Maternal morbidities in Ireland are common and changing, underscoring the benefits of continuous comprehensive examination of maternity care services for all women during childbirth to address treatment of morbidities and to potentially prevent new morbidities.

LEVEL OF EVIDENCE: 

II

In Brief

Maternal morbidity affects a large proportion of women, and the presence and pattern of maternal morbidity are changing over time.