ArticleObstetrics and gynecology2013
Development of a comorbidity index for use in obstetric patients.
Article in Obstetrics and gynecology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05704179 (Evaluation of the Relationship Between Obstetric Comorbidity Index and Obstetric Recovery Quality Score in Patients Who Undergo Operative Delivery), which is not on this map. Cited by 230 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation of the Relationship Between Obstetric Comorbidity Index and Obstetric Recovery Quality Score in Patients Who Undergo Operative Delivery
Who cites it
230 citing papers in PubMed, 479 citations in OpenAlex.
- High-risk pregnancies and their association with severe maternal morbidity in Nepal: A prospective cohort study.PloS one · 2020Trial
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- Maternal Health Outcomes Associated With Syphilis Infection During Pregnancy: Evidence From a Large US All-Payer Hospital-Centered Administrative Database.Open forum infectious diseases · 2026Article
- Psychostimulant Continuation and Postpartum Mental Health in Pregnant People With Attention-Deficit/Hyperactivity Disorder.Obstetrics and gynecology · 2026Article
- Medicaid Expansion and Severe Maternal Morbidity During Delivery Hospitalizations.Obstetrics and gynecology · 2026Article
- Inhaled Corticosteroids Continuation in the First Trimester and Pregnancy Outcomes in Women With Asthma.JAMA network open · 2026Article
- PregMedNet: Multifaceted maternal medication impacts on neonatal complications.Nature communications · 2026Article
- Predictive modeling of labor epidural catheter replacement or conversion to spinal or general anesthesia: a multicenter retrospective cohort study (2017-2024).International journal of obstetric anesthesia · 2026Article
- A novel maternal prenatal risk index to predict mortality-weighted severe maternal morbidity at hospitalization: a retrospective cohort study.Lancet regional health. Americas · 2026Article
- Antepartum hemoglobin concentrations and postpartum patient-reported outcomes: a retrospective study.Journal of anesthesia · 2026Article
- Relationship Between Maternal Death and Infant Outcomes in a Longitudinal, Population-Based Dataset.Obstetrics and gynecology · 2026Article
- Measuring Severe Maternal Morbidity: Current Practices, Challenges, and Opportunities.Obstetrics and gynecology · 2026Review
- Article
- Benzodiazepine or Z-hypnotic use during pregnancy and risk of psychiatric disorders in children: population based cohort study.BMJ (Clinical research ed.) · 2026Article
- Preconception metabolic-bariatric surgery and child health outcomes: Identification and cohort profile of the POSIT study protocol.medRxiv : the preprint server for health sciences · 2026Article
- Prenatal exposure to buprenorphine or methadone and adverse neurodevelopmental outcomes: population based cohort study.BMJ (Clinical research ed.) · 2026Article
- Delivery-related charges of elective induction compared with on-demand epidural labor analgesia: a retrospective cohort study.Journal of anesthesia · 2026Article
- Congenital malformation risk following prenatal antipsychotic exposure: a systematic safety surveillance approach.BMJ mental health · 2026Article
- The association between obstetric comorbidity index and delivery hospitalization associated cost: a nationwide population study in Taiwan.BMC health services research · 2026Article
170 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo develop and validate a maternal comorbidity index to predict severe maternal morbidity, defined as the occurrence of acute maternal end-organ injury, or mortality.
methodsData were derived from the Medicaid Analytic eXtract for the years 2000-2007. The primary outcome was defined as the occurrence of maternal end-organ injury or death during the delivery hospitalization through 30 days postpartum. The data set was randomly divided into a two-thirds development cohort and a one-third validation cohort. Using the development cohort, a logistic regression model predicting the primary outcome was created using a stepwise selection algorithm that included 24-candidate comorbid conditions and maternal age. Each of the conditions included in the final model was assigned a weight based on its beta coefficient, and these were used to calculate a maternal comorbidity index.
resultsThe cohort included 854,823 completed pregnancies, of which 9,901 (1.2%) were complicated by the primary study outcome. The derived score included 20 maternal conditions and maternal age. For each point increase in the score, the odds ratio for the primary outcome was 1.37 (95% confidence interval [CI] 1.35-1.39). The c-statistic for this model was 0.657 (95% CI 0.647-0.666). The derived score performed significantly better than available comorbidity indices in predicting maternal morbidity and mortality.
conclusionThis new maternal comorbidity index provides a simple measure for summarizing the burden of maternal illness for use in the conduct of epidemiologic, health services, and comparative effectiveness research. LEVEL OF EVIDENCE: II.
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