ResearchObstetricsIdentification of severe maternal morbidity during delivery hospitalizations, United States, 1991-2003
Section snippets
Materials and Methods
We used information from the National Hospital Discharge Survey (NHDS) for the years 1991-2003 to identify delivery hospitalizations. This time period was chosen because it reflected the most recent design of the survey and encompassed a large number of deliveries, thereby allowing for exploration of trends in relatively rare events. The NHDS is conducted annually by the Centers for Disease Control and Prevention's National Center for Health Statistics, and its design is described in detail
Results
From 1991 through 2003, the NHDS contained 423,480 sampled records in which a delivery was indicated by the presence of a V27 code in the primary diagnosis field; the sample represented 50.6 million deliveries when the appropriate weighting was applied. In the same time period, there were 2235 discharge records for delivery hospitalizations with a length of stay of at least 3 days and at least 1 diagnosis or procedure code that met the severe maternal morbidity criteria; these records represent
Comment
Deaths of women as a consequence of pregnancy in the United States have been likened to “the tip of the iceberg”; that is, for every death, there are many women who have significant complications of pregnancy, labor, and delivery. During the period 1991-2003, we found that 5 of every 1000 women who delivered had at least 1 indicator of a severe complication during their delivery hospitalization. For every maternal death, approximately 50 women experience severe morbidity, which means that
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Cite this article as: Callaghan WM, MacKay AP, Berg CJ. Identification of severe maternal morbidity during delivery hospitalizations, United States, 1991-2003. Am J Obstet Gynecol 2008;199:133.e1-133.e8.
The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers of Disease Control and Prevention.