Maternal morbidity during childbirth hospitalization in California.
OBJECTIVE
To determine the incidence and risk factors for maternal morbidity during childbirth hospitalization.


METHODS
Maternal morbidities were determined using ICD9-CM and vital records codes from linked hospital discharge and vital records data for 1,572,909 singleton births in California during 2005-2007. Socio-demographic, obstetric and hospital volume risk factors were estimated using mixed effects logistic regression models.


RESULTS
The maternal morbidity rate was 241/1000 births. The most common morbidities were episiotomy, pelvic trauma, maternal infection, postpartum hemorrhage and severe laceration. Preeclampsia (adjusted odds ratio [AOR]: 2.96; 95% confidence interval 2.8,3.13), maternal age over 35 years, (AOR: 1.92; 1.79,2.06), vaginal birth after cesarean, (AOR: 1.81; 1.47,2.23) and repeat cesarean birth (AOR: 1.99; 1.87,2.12) conferred the highest odds of severe morbidity. Non-white women were more likely to suffer morbidity.


CONCLUSIONS
Nearly one in four California women experienced complications during childbirth hospitalization. Significant health disparities in maternal childbirth outcomes persist in the USA.
Department of Family Health Care Nursing, University of California, San Francisco, CA 94143, USA. audrey.lyndon@nursing.ucsf.edu
Audrey
A
Lyndon
Henry C
HC
Lee
William M
WM
Gilbert
Jeffrey B
JB
Gould
Kathryn A
KA
Lee
D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009017:Morbidity; D009035:Mothers / Q000706:statistics & numerical data*; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000209:etiology; D036801:Parturition / Q000502:physiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult