Table 3. Maternal mortality and severe maternal morbidity and rate per 10,000 singleton births, Washington State, US, 2003–2013.
| Outcome | Maternal age | ||||||
|---|---|---|---|---|---|---|---|
| 15–19 y (n = 62,904) | 20–24 y (n = 186,537) | 25–29 y (n = 239,319) | 30–34 y (n = 209,936) | 35–39 y (n = 104,985) | 40–44 y (n = 23,180) | ≥45 y (n = 1,408) | |
| Death | 4 (0.6) | 12 (0.6) | 12 (0.5) | 16 (0.8) | 7 (0.7) | 2 (0.9) | — |
| Antepartum hemorrhage/abruptiona | 35 (5.6) | 122 (6.5) | 206 (8.6) | 161 (7.7) | 123 (11.7) | 41 (17.7) | 4 (28.4) |
| Respiratory morbidity | 73 (11.6) | 204 (10.9) | 252 (10.5) | 228 (10.9) | 153 (14.6) | 54 (23.3) | 2 (14.2) |
| Obstetric embolism | 8 (1.3) | 30 (1.6) | 45 (1.9) | 44 (2.1) | 21 (2.0) | 11 (4.8) | — |
| AFE | 2 (0.3) | 6 (0.3) | 8 (0.3) | 12 (0.6) | 9 (0.9) | 7 (3.0) | — |
| Blood clot embolism (VTE) | 6 (1.0) | 21 (1.1) | 34 (1.4) | 29 (1.4) | 9 (0.9) | 3 (1.3) | — |
| Thromboembolism/DVT | 32 (5.1) | 82 (4.4) | 136 (5.7) | 114 (5.4) | 67 (6.4) | 21 (8.5) | — |
| Cerebrovascular morbidity | 12 (1.9) | 43 (2.3) | 58 (2.4) | 56 (2.7) | 30 (2.9) | 13 (5.6) | 1 (7.1) |
| Cerebral venous thrombosis | 5 (0.8) | 8 (0.4) | 31 (1.3) | 22 (1.1) | 9 (0.9) | 4 (1.7) | — |
| Cerebrovascular disorders in puerperium | 3 (0.5) | 13 (0.7) | 23 (2.0) | 15 (0.7) | 13 (1.2) | 6 (2.6) | 1 (7.1) |
| Acute cardiac morbidity | 17 (2.7) | 77 (4.1) | 112 (4.7) | 116 (5.5) | 83 (7.9) | 36 (15.5) | 1 (7.1) |
| Cardiac arrest/failure/MI | 12 (1.9) | 37 (2.0) | 47 (2.0) | 49 (2.3) | 35 (3.3) | 19 (8.2) | — |
| Peripartum cardiomyopathy | 4 (0.6) | 16 (0.9) | 20 (0.8) | 30 (1.4) | 10 (1.0) | 7 (3.0) | 1 (7.1) |
| Severe PPHa | 344 (54.7) | 797 (42.7) | 913 (38.2) | 831 (39.6) | 486 (46.3) | 116 (50.0) | 16 (113.6) |
| PPH with coagulation defects | 65 (10.3) | 175 (9.4) | 231 (9.7) | 210 (10.0) | 129 (12.3) | 39 (16.8) | 2 (14.2) |
| Maternal sepsis | 383 (60.9) | 741 (39.7) | 672 (28.1) | 509 (24.3) | 272 (25.9) | 68 (29.3) | 2 (14.2) |
| Puerperal sepsis | 372 (59.1) | 696 (37.3) | 632 (26.4) | 476 (22.7) | 251 (23.9) | 63 (27.2) | 1 (7.1) |
| Renal failure | 13 (2.1) | 25 (1.3) | 41 (1.7) | 37 (1.8) | 29 (2.8) | 10 (4.3) | 4 (28.4) |
| Obstetric shock | 8 (1.3) | 16 (0.9) | 28 (1.2) | 42 (2.0) | 35 (3.3) | 10 (4.3) | 1 (7.1) |
| Complicationsb | 79 (12.6) | 228 (12.2) | 387 (16.2) | 401 (19.1) | 260 (24.8) | 62 (26.8) | 9 (63.9) |
| Potentially life-saving procedures | 641 (101.9) | 1,434 (76.9) | 1,733 (72.4) | 1,543 (73.5) | 962 (91.6) | 297 (128.1) | 31 (220.2) |
| Hysterectomy | 9 (1.4) | 35 (1.9) | 129 (5.4) | 170 (8.1) | 154 (14.7) | 53 (22.9) | 11 (78.1) |
| Blood/blood products transfusion | 598 (95.1) | 1,270 (68.1) | 1,427 (59.6) | 1,197 (57.0) | 702 (66.9) | 207 (89.3) | 21 (149.2) |
| Respiratory (assisted ventilation) | 20 (3.2) | 80 (4.3) | 89 (3.7) | 84 (4.0) | 73 (7.0) | 23 (9.9) | 3 (21.3) |
| DIC | 10 (1.6) | 27 (1.5) | 52 (2.2) | 64 (3.1) | 38 (3.6) | 14 (6.0) | 4 (28.4) |
| Uterine rupture | 14 (2.2) | 75 (4.0) | 137 (5.7) | 140 (6.7) | 110 (10.5) | 29 (12.5) | 1 (7.1) |
| ICU admission | 62 (10.0) | 130 (7.1) | 195 (8.3) | 176 (8.6) | 122 (11.9) | 37 (16.4) | 11 (80.2) |
| Maternal death/severe morbidity | 1,307 (207.8) | 2,913 (156.2) | 3,431 (143.4) | 3,022 (144.0) | 1,863 (177.5) | 535 (230.8) | 50 (355.1) |
Data given as n (rate per 10,000 singleton births). Categories overlap; the composite outcome maternal death/severe morbidity includes all of the conditions listed in this table and in S1 Table: eclampsia, acute liver failure, etc.
aWith transfusion.
bComplications of anesthesia and obstetric interventions.
AFE, amniotic fluid embolism; DIC, disseminated intravascular coagulation; DVT, deep venous thrombosis; ICU, intensive care unit; MI, myocardial infarction; PPH, postpartum hemorrhage; VTE, venous thromboembolism.