The continuum of maternal morbidity and mortality: factors associated with severity.
OBJECTIVE
The goal of this study was to examine whether sociodemographic, clinical, and other service-related factors, as well as preventability issues affect a woman's progression along the continuum of morbidity and mortality.


METHODS
This was a case-control study of pregnancy-related deaths, women with near-miss morbidity, and those with other severe, but not life threatening, morbidity. Factors associated with maternal outcome were examined.


RESULTS
Provider factors (related to preventability) and clinical diagnosis were significantly associated with progression along the continuum after controlling for sociodemographic characteristics (P < .01 for both associations).


CONCLUSIONS
In order to improve mortality rates, we must understand maternal morbidity and how it may lead to death. This study shows that important initiatives include addressing preventability, in particular, provider factors, which may play a role in moving women along the continuum of morbidity and mortality.
Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, 60612, USA. sgeller@uic.edu
Stacie E
SE
Geller
Deborah
D
Rosenberg
Suzanne M
SM
Cox
Monique L
ML
Brown
Louise
L
Simonson
Catherine A
CA
Driscoll
Sarah J
SJ
Kilpatrick
D016022:Case-Control Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D007348:Insurance, Health; D017533:Marital Status; D008428:Maternal Mortality; D009017:Morbidity; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000517:prevention & control; D044469:Racial Groups; D014592:Uterine Hemorrhage / Q000175:diagnosis / Q000401:mortality