ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2005
Severe maternal morbidity in Canada, 1991-2001.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 6 of them syntheses that pooled it.
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Who cites it
52 citing papers in PubMed, 6 syntheses or guidelines pooled it, 278 citations in OpenAlex.
- Global burden of potentially life-threatening maternal conditions: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2024Pooled it
- Incidence of myocardial infarction in pregnancy: a systematic review and meta-analysis of population-based studies.European heart journal. Quality of care & clinical outcomes · 2017Pooled it
- Debriefing interventions for the prevention of psychological trauma in women following childbirth.The Cochrane database of systematic reviews · 2015Pooled it
- Management of pregnant and postnatal women with pre-existing diabetes or cardiac disease using multi-disciplinary team models of care: a systematic review.BMC pregnancy and childbirth · 2014Pooled it
- A systematic review of the relationship between severe maternal morbidity and post-traumatic stress disorder.BMC pregnancy and childbirth · 2012Pooled it
- Quantifying the fall in mortality associated with interventions related to hypertensive diseases of pregnancy.BMC public health · 2011Pooled it
- High-risk pregnancies and their association with severe maternal morbidity in Nepal: A prospective cohort study.PloS one · 2020Trial
- Risk factors for peripartum hysterectomy among women with postpartum haemorrhage: analysis of data from the WOMAN trial.BMC pregnancy and childbirth · 2018Trial
- Multifaceted intervention to decrease the rate of severe postpartum haemorrhage: the PITHAGORE6 cluster-randomised controlled trial.BJOG : an international journal of obstetrics and gynaecology · 2010Trial
- Effect of a collector bag for measurement of postpartum blood loss after vaginal delivery: cluster randomised trial in 13 European countries.BMJ (Clinical research ed.) · 2010Trial
- Whole blood transfusion in the management of obstetric hemorrhage: A scoping review.Transfusion · 2026Review
- Success rate and obstetric outcomes of trial of labor after cesarean delivery-Decision-tree analysis.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- Multimorbidity before, during and after pregnancy among women in low-income and middle-income countries: protocol for a scoping review.BMJ open · 2025Article
- Severe maternal morbidity in the high income setting: a systematic review of composite definitions.EClinicalMedicine · 2025Article
- Pregnancy-Associated Myocardial Infarction in Alberta: A Population-Based Study.JACC. Advances · 2025Article
- Importance of hemogram parameters for predicting uterine scar dehiscenceJournal of the Turkish German Gynecological Association · 2024Article
- Antepartum Rupture of the Posterior Uterine Wall in a Woman With Two Previous Cesarean Deliveries.Cureus · 2024Article
- Incidence, morbidity, and associated factors for sepsis in women hospitalized for delivery: a nationwide retrospective observational population-based study in Canada.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2022Observational
- Association between pre-pregnancy multimorbidity and adverse maternal outcomes: A systematic review.Journal of multimorbidity and comorbidity · 2022Review
- A scoping review of severe maternal morbidity: describing risk factors and methodological approaches to inform population-based surveillance.Maternal health, neonatology and perinatology · 2021Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough death rates are often used to monitor the quality of health care, in industrialized countries maternal deaths have become rare. Severe maternal morbidity has therefore been proposed as a supplementary indicator for surveillance of the quality of maternity care. Our purpose in this study was to describe severe maternal morbidity in Canada over a 10-year period, among women with or without major pre-existing conditions.
methodsWe carried out a retrospective cohort study of severe maternal morbidity involving 2,548,824 women who gave birth in Canadian hospitals between 1991 and 2000. Thirteen conditions that may threaten the life of the mother (e.g., eclampsia) and 11 major pre-existing chronic conditions (e.g., diabetes) that could be identified from diagnostic codes were noted.
resultsThe overall rate of severe maternal morbidity was 4.38 per 1000 deliveries. The fatality rate among these women was 158 times that of the entire sample. Rates of venous thromboembolism, uterine rupture, adult respiratory distress syndrome, pulmonary edema, myocardial infarction, severe postpartum hemorrhage requiring hysterectomy, and assisted ventilation increased substantially from 1991 to 2000. The presence of major pre-existing conditions increased the risk of severe maternal morbidity to 6-fold.
interpretationSevere maternal morbidity occurs in about 1 of 250 deliveries in Canada, with marked recent increases in certain morbid conditions such as pulmonary edema, myocardial infarction, hemorrhage requiring hysterectomy, and the use of assisted ventilation.
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