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Severe maternal morbidity and related hospital quality measures in Maryland

Journal of Perinatology volume 38, pages 997–1008 (2018)Cite this article

Subjects

Abstract

Objective

To determine hospital characteristics and quality metrics associated with severe maternal morbidity (SMM) in Maryland.

Study Design

A population-based observational study of 364,113 statewide delivery hospitalizations during 2010–2015 linked with socio-economic community measures and hospital characteristics and quality measures. Multivariable logistic regression models with generalized estimating equations estimated SMM adjusting for individual, community, and hospital-level factors and clustering within hospitals and residence zip codes.

Results

The SMM prevalence was 197 per 10,000 deliveries. Adjusted SMM risk ratios were higher for younger (<20 years), older (35+ years), non-White non-Hispanic, unmarried, multiple substance users, women with multiple gestations, and chronic medical and mental health conditions than their counterparts. Communities with greater socio-economic disadvantage and hospitals with poorer patient experience and clinical care quality had higher rates of SMM.

Conclusion

Addressing socio-economic disparities and improving quality of care in delivery hospitals are key to reducing the SMM burden in Maryland.

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Acknowledgements

The authors would like to thank the support of the Maryland Health Services Cost Review Commission (HSCRC) for supplying the hospitalization data used for this study.

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Authors and Affiliations

  1. Office of Maternal and Child Health Epidemiology, Maryland Department of Health, Baltimore, MD, USA

    Lawrence D. Reid

  2. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Andreea A. Creanga

  3. Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Andreea A. Creanga

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  1. Lawrence D. Reid
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Correspondence to Lawrence D. Reid.

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Reid, L.D., Creanga, A.A. Severe maternal morbidity and related hospital quality measures in Maryland. J Perinatol 38, 997–1008 (2018). https://doi.org/10.1038/s41372-018-0096-9

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