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OBSTETRIC ANESTHESIA

Maternal Mortality During Hospital Admission for Delivery: A Retrospective Analysis Using a State-Maintained Database

Sumedha Panchal, MD^*, Amelia M. Arria, PhD, and Snehalata A. Labhsetwar, MD

*Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine; The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; and Department of Obstetrics and Gynecology, St. Charles Hospital, Oregon, Ohio

Address correspondence to Sumedha Panchal, MD, Weill Medical College of Cornell University, Department of Anesthesiology, 525 East 68th St., M-329, New York, NY 10021. Address e-mail to sumedhapanchal{at}hotmail.com

This study reports the overall age- and race-specific delivery mortality ratios from January 1984 to December 1997 and medical and demographic risk factors associated with maternal death during hospital admission for delivery. We performed a retrospective case control study using patient records from a state-maintained anonymous database of all nonfederal Maryland hospitals that performed deliveries from 1984 to 1997. Variables studied included patient demographics and International Classification of Diseases, 9th Revision, Clinical Modification, diagnosis, and procedure codes. Mortality was the outcome variable. Of the 822,591 hospital admissions for delivery during the 14-yr study period, there were 135 deaths. The overall delivery mortality ratio was 16.4. The most common diagnoses associated with mortality during hospital admission for delivery included preeclampsia/eclampsia (22.2%), postpartum hemorrhage/obstetric shock (22.2%), pulmonary complications (14%), blood clot and/or amniotic embolism (8.1%), and anesthesia-related complications (5.2%). The identification of medical and demographic risk factors may have significant implications creating initiatives aimed at decreasing the public health burden associated with maternal mortality.

Implications: This study reports the medical and demographic risk factors associated withmaternal death during hospital admission for delivery by using astate-maintained database. This information could prove useful in the creationof initiatives aimed at decreasing the public health burden associated withmaternal mortality.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999