Table 1:
Demographic characteristics and rates of maternal morbidity per 10,000 deliveries (unweighted n=1,382,865; weighted=6,914,317).
| Patient Characteristics | % | Severe Maternal Morbidity per 10,000 Deliveries*** | Severe Maternal Morbidity, excluding blood transfusions per 10,000 Deliveries*** |
|---|---|---|---|
| Age | |||
| <20a | 5.4 | 194.0 | 44.0 |
| 20–29 | 49.2 | 130.1 | 33.8 |
| 30–39 | 42.3 | 132.8 | 47.2 |
| 40+ | 3.1 | 243.8 | 101.3 |
| Race/ethnicityb | |||
| Non-Hispanic Whitea | 52.6 | 102.1 | 31.4 |
| Non-Hispanic Black | 15.0 | 221.3 | 71.1 |
| Hispanic | 20.6 | 160.9 | 45.9 |
| Non-Hispanic Asian | 6.4 | 151.4 | 49.7 |
| Other | 5.3 | 158.2 | 43.6 |
| Payer | |||
| Privatea | 50.5 | 112.7 | 35.8 |
| Medicaid | 43.7 | 166.6 | 48.7 |
| Medicare | 0.7 | 280.4 | 126.4 |
| Other (including self-pay) | 5.1 | 127.8 | 37.3 |
| Any comorbidityc | |||
| Noa | 66.0 | 48.3 | 16.3 |
| Yes | 34.0 | 313.0 | 92.4 |
| Delivery type | |||
| Vaginala | 67.6 | 76.2 | 17.9 |
| Cesarean Section | 32.4 | 267.9 | 92.7 |
| Median household income quartiled | |||
| Quartile 1 | 28.9 | 172.0 | 48.5 |
| Quartile 2 | 24.9 | 133.8 | 41.7 |
| Quartile 3 | 24.3 | 123.3 | 38.8 |
| Quartile 4a | 21.8 | 115.3 | 38.0 |
| Location of Residence | |||
| Large metropolitana | 58.7 | 145.8 | 47.1 |
| Small/medium metropolitan | 28.5 | 123.1 | 37.8 |
| Micropolitan | 7.7 | 138.9 | 29.6 |
| Rural (noncore) | 5.2 | 135.5 | 28.6 |
| Hospital Characteristics | |||
| Region | |||
| Northeasta | 16.4 | 170.6 | 49.1 |
| Midwest | 20.2 | 105.0 | 37.6 |
| South | 40.0 | 144.1 | 40.3 |
| West | 23.3 | 134.5 | 44.4 |
| Ownership | |||
| Publica | 11.9 | 185.8 | 53.3 |
| Private non-profit | 73.8 | 134.9 | 42.2 |
| Private for profit | 14.3 | 116.2 | 32.4 |
| Location/Teaching Status | |||
| Rurala | 9.0 | 137.9 | 18.3 |
| Urban non-teaching | 23.9 | 113.1 | 29.6 |
| Urban teaching | 67.1 | 147.2 | 49.7 |
| Safety-Net Hospitale | |||
| Noa | 63.8 | 118.2 | 37.4 |
| Yes | 36.2 | 173.7 | 50.5 |
| Minority-Serving Hospitale | |||
| Noa | 66.0 | 115.6 | 36.0 |
| Yes | 34.0 | 182.3 | 54.0 |
Authors’ analysis of data from the Healthcare Cost and Utilization Project, National Inpatient Sample, years 2016 and 2017. Severe Maternal Morbidity (SMM) identified using the Centers for Disease Control and Prevention SMM indicator list. SMM without Blood Transfusion indicates that a delivery with only a blood transfusion indicator, and no other SMM indicator, was identified as not having SMM.
Reference category in multivariate regressions
Race/ethnicity excluded in regressions on group analyses evaluating deliveries within race/ethnicities.
Any comorbidity among 25 Elixhauser comorbidity measures, which congestive heart failure, coagulation deficiency, hypertensive encephalopathy, pulmonary circulation disorders, and peripheral perivascular disease.
Household income is measured as the median household income at the ZIP code level, and it is based on the woman’s location of residence.
Safety-net and minority-serving hospital designation include hospitals in the top quartile of hospital discharges with Medicaid payment and women who were not of White race, respectively. Designations were determined for each year separately.
All tests for differences in rates between different characteristics were significant at a value of p<0.001.