Table 1.
Frequency, length of hospitalisation, and case fatality rates associated with overall severe maternal morbidity (SMM), and for selected SMM types and subtypes evaluated for the new 2018 list of SMM, Canada (excluding Quebec), 2006‐2015 (based on 2 843 395 hospital deliveries)
| Morbidity | Number | Rate per 100 000 deliveries | Case fatality rate* | Length of stay (days) | ||
|---|---|---|---|---|---|---|
| No. of deaths | Rate per 1000 deliveries | Mean | %≥7 d | |||
| No SMM (2010 list16) | 2 801 128 | 98 513.5 | 12 | 0.004 | 2.3 | 1.1 |
| At least one SMM (2010 list16) | 42 267 | 1486.5 | 98 | 2.32 | 5.2 | 11.8 |
| SMM on 2010 list; deleted from 2018 list | ||||||
| HIV: asymptomatic infection or disease | 1434 | 50.4 | <5 | 0.70, 2.79 | 5.3 | 11.2 |
| HIV: asymptomatic infection | 1320 | 46.4 | 0 | 0.0 | 5.2 | 11.0 |
| Hypertensive heart/renal disease | 65 | 2.3 | 0 | 0.0 | 4.5 | 10.8 |
| Evacuation of incisional haematoma | 665 | 23.4 | 0 | 0.0 | 5.7 | 17.6 |
| SMM on 2010 list; retained in 2018 list | ||||||
| Acute renal failure without dialysis | 844 | 29.7 | 9 | 10.7 | 10.6 | 45.1 |
| Puerperal sepsis without ICU admission | 1969 | 69.2 | 0 | 0.0 | 6.7 | 5.6 |
| Evacuation incisional haematoma and RBC transfusion | 133 | 4.7 | 0 | 0.0 | 7.5 | 33.1 |
| HIV disease | 114 | 4.0 | <5 | 8.77, 35.1 | 5.8 | 13.2 |
| Cardiomyopathy | 605 | 21.3 | <5 | 1.65, 6.61 | 6.5 | 33.2 |
| New SMM evaluated; added to 2018 list | ||||||
| Severe pre‐eclampsia † | 2927 | 258.8 | <5 | 0.34, 1.37 | 6.3 | 33.0 |
| HELLP syndrome † | 3124 | 276.2 | <5 | 0.32, 1.28 | 5.3 | 22.4 |
| Acute fatty liver ‡ and plasma/RBC transfusion | 236 | 8.3 | 5 | 21.2 | 9.7 | 33.5 |
| Maternal intensive care unit admission | 5454 | 191.8 | 57 | 10.5 | 9.0 | 32.4 |
| Maternal intensive care unit admission ≤ 24 hours | 2259 | 79.4 | 27 | 12.0 | 5.9 | 16.3 |
| Inversion of uterus (vaginal delivery) | 289 | 10.2 | <5 | 3.46, 13.8 | 2.9 | 0.35 |
| New SMM evaluated; not added to 2018 list | ||||||
| Uterine rupture | 2959 | 104.1 | <5 | 0.34, 1.35 | 3.7 | 4.7 |
| Acute fatty liver ‡ | 12 505 | 439.8 | 6 | 0.48 | 3.1 | 3.5 |
| Malignant neoplasms | 1031 | 36.3 | 12 | 11.6 | 5.6 | 15.8 |
| Thyroid disorders | 21 034 | 739.7 | <5 | 0.05, 0.19 | 3.2 | 4.8 |
| Type 1 diabetes | 2098 | 73.8 | 0 | 0.0 | 5.9 | 21.2 |
| Type 2 diabetes | 3220 | 113.2 | <5 | 0.31, 1.24 | 4.2 | 12.8 |
| Obesity | 38 348 | 1348.7 | <5 | 0.03, 0.10 | 3.1 | 4.7 |
Abbreviations: RBC, red blood cells; ICU, intensive care unit.
*
If the numerator of the rate was >0 and <5, a range was provided (assuming a numerator of 1 and 4) instead of the actual value, and 95% interval estimates were not provided.
†
Based on hospitalisation data from 2012 to 2015.
‡
The conditions under acute fatty liver (O26.6) were expanded in ICD‐10‐CA version 2009 to include ‘Cholestasis (intrahepatic) in pregnancy’ and ‘Obstetric cholestasis’.