Table 3. Adjusted ORs of Severe Maternal Morbidity and Postpartum Hemorrhage Associated With Neuraxial Analgesia for Vaginal Delivery After Inverse Propensity Score Weighting (New York Hospitals, 2010-2017).
| Variable | No neuraxial analgesia | Neuraxial analgesia | Risk difference, % (95% CI)a | Adjusted OR (95% CI) | |||||
|---|---|---|---|---|---|---|---|---|---|
| Women, No. | Events, No. | Incidence, % (95% CI) | Women, No. | Events, No. | Incidence, % (95% CI) | Without further adjustmentb | With further adjustmentc | ||
| All women | |||||||||
| SMM | 304 734 | 4427 | 1.45 (1.38 to 1.53) | 219 308 | 2727 | 1.24 (1.17 to 1.32) | −0.21 (−0.30 to −0.12) | 0.85 (0.81 to 0.90) | 0.86 (0.82 to 0.90) |
| PPH | 304 734 | 10796 | 3.54 (3.42 to 3.66) | 219 308 | 7277 | 3.32 (3.21 to 3.43) | −0.22 (−0.36 to −0.09) | 0.93 (0.91 to 0.96) | 0.91 (0.88 to 0.94) |
| Non-Hispanic White women | |||||||||
| SMM | 135 300 | 1473 | 1.09 (0.98 to 1.21) | 105 061 | 1069 | 1.02 (0.90 to 1.14) | −0.07 (−0.21 to 0.08) | 0.93 (0.86 to 1.01) | 0.92 (0.85 to 0.99) |
| PPH | 135 300 | 4561 | 3.37 (3.19 to 3.56) | 105 061 | 3247 | 3.09 (2.93 to 3.26) | −0.28 (−0.49 to −0.07) | 0.91 (0.87 to 0.95) | 0.89 (0.85 to 0.93) |
| Racial and ethnic minority womend | |||||||||
| SMM | 169 434 | 2954 | 1.74 (1.64 to 1.85) | 114 247 | 1658 | 1.45 (1.36 to 1.54) | −0.29 (−0.41 to −0.17) | 0.83 (0.78 to 0.88) | 0.82 (0.78 to 0.87) |
| PPH | 169 434 | 6235 | 3.68 (3.53 to 3.84) | 114 247 | 4030 | 3.53 (3.38 to 3.68) | −0.15 (−0.33 to −0.01) | 0.96 (0.92 to 0.99) | 0.93 (0.89 to 0.96) |
| Low-risk women (CMI-OB = 0) | |||||||||
| SMM | 211 159 | 2279 | 1.08 (1.01 to 1.15) | 150 698 | 1467 | 0.97 (0.89 to 1.06) | −0.11 (−0.20 to −0.01) | 0.90 (0.85 to 0.96) | 0.93 (0.87 to 0.98) |
| PPH | 211 159 | 6784 | 3.21 (3.08 to 3.35) | 150 698 | 4446 | 2.95 (2.82 to 3.09) | −0.26 (−0.42 to −0.09) | 0.92 (0.88 to 0.95) | 0.89 (0.86 to 0.92) |
| High-risk women (CMI-OB ≥1) | |||||||||
| SMM | 93 575 | 2148 | 2.30 (2.11 to 2.50) | 68 610 | 1261 | 1.84 (1.70 to 1.98) | −0.46 (−0.67 to −0.26) | 0.80 (0.74 to 0.85) | 0.79 (0.74 to 0.85) |
| PPH | 93 575 | 4011 | 4.29 (4.04 to 4.54) | 68 610 | 2830 | 4.12 (3.93 to 4.32) | −0.17 (−0.42 to 0.11) | 0.96 (0.92 to 1.01) | 0.95 (0.90 to 0.99) |
Abbreviations: CMI-OB, comorbidity index for obstetric patients; OR, odds ratio; PPH, postpartum hemorrhage; SMM, severe maternal morbidity.
95% CI estimated using bootstrap with replacement (B = 2000) and the percentile method.
OR estimated using a weighted logistic regression, without further adjustment for variables with persistent imbalance after weighting.
OR estimated using a weighted logistic regression, with further adjustment for 3 variables with persistent imbalance after weighting: (1) hospital proportion of racial and ethnic minority women, (2) hospital proportion of women who were safety net patients, and (3) hospital proportion of neuraxial analgesic or anesthetic techniques in deliveries.
Racial and ethnic minority women included the following categories: Asian or Pacific Islander, Black, Hispanic, Native American, and other.