Cardiac arrest during hospitalization for delivery in the United States, 1998-2011.
BACKGROUND
The objective of this analysis was to evaluate the frequency, distribution of potential etiologies, and survival rates of maternal cardiopulmonary arrest during the hospitalization for delivery in the United States.


METHODS
By using data from the Nationwide Inpatient Sample during the years 1998 through 2011, the authors obtained weighted estimates of the number of U.S. hospitalizations for delivery complicated by maternal cardiac arrest. Clinical and demographic risk factors, potential etiologies, and outcomes were identified and compared in women with and without cardiac arrest. The authors tested for temporal trends in the occurrence and survival associated with maternal arrest.


RESULTS
Cardiac arrest complicated 1 in 12,000 or 8.5 per 100,000 hospitalizations for delivery (99% CI, 7.7 to 9.3 per 100,000). The most common potential etiologies of arrest included hemorrhage, heart failure, amniotic fluid embolism, and sepsis. Among patients with cardiac arrest, 58.9% of patients (99% CI, 54.8 to 63.0%) survived to hospital discharge.


CONCLUSIONS
Approximately 1 in 12,000 hospitalizations for delivery is complicated by cardiac arrest, most frequently due to hemorrhage, heart failure, amniotic fluid embolism, or sepsis. Survival depends on the underlying etiology of arrest.
From the Department of Anesthesiology, University of Michigan Health System, Ann Arbor, Michigan (J.M.M.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (L.C.T.); The Intensive Care Unit of the Shaare Zedek Medical Center and the Hebrew University School of Medicine, Jerusalem, Israel (S.E.); Division for Heart Disease and Stroke Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia (E.V.K.); Department of Anesthesiology, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (L.R.L.); and Department of Anesthesiology, Critical Care, and Pain Medicine, Massachusetts General Hospital, and Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (B.T.B.).
Jill M
JM
Mhyre
Lawrence C
LC
Tsen
Sharon
S
Einav
Elena V
EV
Kuklina
Lisa R
LR
Leffert
Brian T
BT
Bateman
D000328:Adult; D015984:Causality; D015897:Comorbidity; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004619:Embolism, Amniotic Fluid / Q000453:epidemiology; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology*; D006333:Heart Failure / Q000453:epidemiology; D006470:Hemorrhage / Q000453:epidemiology; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D011247:Pregnancy; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D055815:Young Adult