Table 1.
Rate of total SMM, non-transfusion SMM, and SMM indicators during antenatal, birth and postpartum hospitalizations and additional percent of cases added by including antenatal and postpartum hospitalizations, California births from 9/1/2016-12/31/2018*
| Rate (95% CI) per 10,000 birth hospitalizations |
Cases added per indicator by including non-birth hospitalization % (n) |
||||
|---|---|---|---|---|---|
| SMM Indicator | Antenatal | Birth | Postpartum | Total cases added: antenatal and postpartum [% of total] |
|
| Total SMM | 19.8 (19.0 - 20.7) | 186.4 (183.7 - 189.0) | 22.6 (21.7 - 23.5) | 42.5 (38.6-46.5) [100] | 22.8 (4290) |
| Non-transfusion SMM | 17.7 (16.9 - 18.5) | 84.7 (82.9 - 86.5) | 20.5 (19.6 - 21.4) | 38.3 (35.5-41.1) [89.9] | 45.1 (3861) |
| Acute renal failure | 2.1 (1.8 - 2.4) | 13.8 (13.0 - 14.5) | 2.8 (2.4 - 3.1) | 4.9 (3.7-6.0) [11.5] | 35.3 (491) |
| Cardiac arrest | <0.1 | 0.8 (0.7 - 1.0) | <0.1 | <0.1 [<1] | <15 (n.r.) |
| Heart failure during surgery | <0.1 | 0.1 (0.1 - 0.2) | <0.1 | <0.1[<1] | <15 (n.r.) |
| Shock | 0.2 (0.1 - 0.3) | 5.4 (5.0 - 5.9) | 0.5 (0.4 - 0.7) | 0.7 (0.0-1.4) [1.7] | 13.2 (72) |
| Sepsis | 11.7 (11.1 - 12.4) | 20.9 (20.0 - 21.8) | 11.9 (11.2 - 12.5) | 23.6 (22.0-25.2) [55.6] | 112.9 (2386) |
| Disseminated intravascular coagulation | 0.6 (0.5 - 0.8) | 23.9 (23.0 - 24.9) | 1.5 (1.3 - 1.7) | 2.1 (0.7-3.5) [5.0] | 8.8 (213) |
| Amniotic fluid embolism | <0.1 | 0.6 (0.5 - 0.8) | 0 | <0.1 [<1] | <5 (n.r.) |
| Thrombotic embolism | 0.8 (0.6 - 1.0) | 2.4 (2.1 - 2.7) | 1.8 (1.6 - 2.1) | 2.6 (2.1-3.2) [6.1] | 109.1 (265) |
| Puerperal cerebrovascular disorders | 1.0 (0.8 - 1.2) | 2.6 (2.3 - 2.9) | 1.3 (1.1 - 1.6) | 2.3 (1.8-2.9) [5.4] | 88.3 (233) |
| Severe anesthesia complications | 0 | 0.1 (0.0 - 0.1) | <0.1 | 0.1 (0.0-0.3) [<1] | n.r. (<15) |
| Pulmonary edema | 0.7 (0.5 - 0.8) | 6.3 (5.8 - 6.8) | 2.9 (2.5 - 3.2) | 3.5 (2.7-4.3) [8.2] | 56.0 (357) |
| Adult respiratory distress syndrome | 2.9 (2.6 - 3.2) | 9.7 (9.1 - 10.3) | 2.2 (1.9 - 2.5) | 5.1 (4.1-6.1) [12.0] | 53.0 (517) |
| Acute myocardial infarction | 0.1 (0.1 - 0.2) | 0.4 (0.2 - 0.5) | 0.4 (0.3 - 0.6) | 0.6 (0.3-0.8) [1.4] | 155.6 (56) |
| Eclampsia | 0.1 (0.0 - 0.1) | 6.7 (6.2 - 7.2) | 1.0 (0.8 - 1.2) | 1.1 (0.3-1.8) [2.6] | 16.5 (111) |
| Sickle cell anemia | 0.3 (0.2 - 0.4) | 0.3 (0.2 - 0.4) | 0 | 0.3 (0.1-0.5) [<1] | 88.2 (30) |
| Aneurysm | <0.1 | 0.2 (0.1 - 0.3) | <0.1 | <0.1 [<1] | <25 (n.r.) |
| Ventilation | 0.9 (0.7 - 1.1) | 4.8 (4.4 - 5.2) | 0.7 (0.5 - 0.8) | 1.5 (0.9-2.2) [3.5] | 32.1 (156) |
| Hysterectomy | 0.1 (0.0 - 0.2) | 12.4 (11.7 - 13.1) | 0.7 (0.5 - 0.8) | 0.8 (0.0-1.8) [1.9] | 6.3 (79) |
| Temporary tracheostomy | <0.1 | <0.1 | <0.1 | <0.1 [<1] | 100.0 (n.r.) |
| Conversion of cardiac rhythm | 0.2 (0.1 - 0.3) | 0.9 (0.7 - 1.1) | <0.1 | 0.3 (0.0-0.5) [<1] | 28.6 (26) |
| Transfusion | 3.8 (3.4 - 4.2) | 122.0 (119.8 - 124.1) | 4.7 (4.3 - 5.1) | 8.5 (5.4-11.6) [20.0] | 7.0 (859) |
*
Values are approximated or not reported for cells that involve fewer than 11 cases per agreement with guidelines from the California Department of Health Care Access and Information.
n.r. = not reportable