Table 4:
Risk of an Emergency Department (ED) encounter or hospitalization within one year of delivery of liveborn singleton neonate coded for substance use, with and without severe intrapartum morbidity, among women without preexisting psychiatric illness in the nine months prior to delivery
| Composite Substance Use Morbidity | |||||
|---|---|---|---|---|---|
| Liveborn singleton with SMM (n (%)) | Liveborn singleton without SMM (n=1,178,458) (n (%)) | Unadjusted Odds Ratio (95% Confidence Interval) | Adjusted Odds Ratio (95% Confidence Interval)1 | Attributable Risk due to SMM | |
| Overall Severe Maternal Morbidity Composite (N=15,510) | 168 (1.1) | 6856 (0.6) | 1.90 (1.65 -2.24) | 1.89 (1.62 – 2.21) | 0.5% |
| Transfusion (N=9780) | 98 (1.4) | 6926 (0.6) | 1.72 (1.41 – 2.10) | 1.69 (1.38 – 2.07) | 0.8% |
| Composite Severe Maternal Morbidity Without Transfusion (N=5730) | 70 (1.2) | 6954 (0.6) | 2.18 (1.72 – 2.76) | 2.17 (1.71 – 2.75) | 0.6% |
| Acute Myocardial Infarction2 (N=28) | 0 (0.0) | 7024 (0.6) | -- | *** | 0.0% |
| Aneurysm (N=11) | 0 (0.0) | 7024 (0.6) | -- | *** | 0.0% |
| Acute renal failure (N=541) | -- | -- | 3.87 (2.72 – 5.51) | *** | -- |
| Adult Respiratory Distress Syndrome (N =983) | 14 (1.4) | 7010 (0.6) | 2.44 (1.44 – 4.14) | *** | 0.8% |
| Amniotic Fluid Embolism2 (N=51) | 0 (0.0) | 7024 (0.6) | -- | *** | 0.0% |
| Cardiac Arrest / Ventricular Fibrillation2 (N=104) | -- | -- | 1.64 (0.23 – 11.76) | *** | -- |
| Conversion of Cardiac arrhythmia2 (N=209) | -- | -- | 2.46 (0.79 – 7.70) | *** | -- |
| Disseminated Intravascular Coagulation (N=2552) | 19 (0.7) | 7005 (0.6) | 1.27 (0.81 – 1.99) | *** | 0.1% |
| Eclampsia2 (N=1137) | -- | -- | 1.05 (0.50 – 2.20) | *** | -- |
| Heart Failure/Arrest During Surgery or Procedure2 (N=167) | 0 (0.0) | 7024 (0.6) | -- | *** | 0.0% |
| Puerperal Cerebrovascular Disorder2 (N=359) | -- | -- | 1.43 (0.46 – 4.44) | *** | -- |
| Pulmonary Edema / Acute heart failure (N=618) | 15 (2.4) | 7009 (0.6) | 2.41 (1.60 – 3.62) | *** | 1.8% |
| Severe Anesthesia Complication2 (N=218) | -- | -- | 0.78 (0.11 – 5.55) | *** | -- |
| Sepsis2 (N=426) | -- | -- | 4.20 (2.86 – 6.15) | *** | -- |
| Shock2 (N=314) | -- | -- | 1.63 (0.52 – 5.08) | *** | -- |
| Sickle Cell Disease with Crisis (N=212) | 25 (11.8) | 6999 (0.6) | 22.67 (14.93 – 34.44) | *** | 10.4% |
| Air and Thrombotic Embolism2 (N=197) | -- | -- | 1.73 (0.43 – 6.98) | *** | -- |
| Hysterectomy2 (N=879) | -- | -- | 1.55 (0.77 – 3.12) | *** | -- |
| Temporary tracheostomy2 (N=43) | -- | -- | 4.02 (0.55 – 29.24) | *** | -- |
| Ventilation2 (N=101) | -- | -- | 5.18 (1.65 – 16.34) | *** | -- |
1
Adjusted for maternal age, race/ethnicity, insurance type, income quartile by zip code, mode of delivery, and maternal medical comorbidities. Adjusted Odds Ratios calculated for SMM composite, blood transfusion alone, and SMM composite without blood transfusion. If not calculated, denoted as “***”
2
Unable to report (less than 11 women had at least one condition within the substance use composite)