ArticleMaternal and child health journal2019
Patient-, Hospital-, and Neighborhood-Level Factors Associated with Severe Maternal Morbidity During Childbirth: A Cross-Sectional Study in New York State 2013-2014.
Article in Maternal and child health journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Structural racism and adverse maternal health outcomes: A systematic review.Health & place · 2022Pooled it
- Medicaid Expansion and Severe Maternal Morbidity During Delivery Hospitalizations.Obstetrics and gynecology · 2026Article
- Neighbourhood Poverty Histories and Severe Maternal Morbidity Across California Census Tracts.Paediatric and perinatal epidemiology · 2026Article
- Trends and factors associated with delivery hospitalizations involving severe maternal morbidity in portuguese public hospitals: A population-based study (2010-2018).Scientific reports · 2026Observational
- Structural Racism, Geographies of Opportunity, and Maternal Health Inequities: A Dynamic Conceptual Framework.Journal of racial and ethnic health disparities · 2026Article
- Neighbourhood Socioeconomic Disadvantage and Severe Maternal Morbidity: Secondary Analysis of a Prospective Cohort.BJOG : an international journal of obstetrics and gynaecology · 2025Observational
- Association of Community Characteristics as Measured by Social Deprivation Index Score with Prenatal Care and Obstetrical Outcomes.American journal of perinatology · 2025Article
- Maternal Vulnerability Index and Severe Maternal Morbidity.JAMA network open · 2025Article
- Validation of a measure of hospital maternal level of care for the United States.BMC health services research · 2024Article
- Impact of sex, race, and social determinants of health on neonatal outcomes.Frontiers in pediatrics · 2024Review
- Remapping racial and ethnic inequities in severe maternal morbidity: The legacy of redlining in California.Paediatric and perinatal epidemiology · 2023Article
- Neighborhood disinvestment and severe maternal morbidity in the state of California.American journal of obstetrics & gynecology MFM · 2023Article
- Obstetric Medicine: the protocol for a prospective three-dimensional cohort study to assess maternity care for women with pre-existing conditions (ForMaT).Frontiers in medicine · 2023Article
- Racial/ethnic disparities in severe maternal morbidity: An intersectional lifecourse approach.Annals of the New York Academy of Sciences · 2022Article
- Comparison of global indicators for severe maternal morbidity among South Korean women who delivered from 2003 to 2018: a population-based retrospective cohort study.Reproductive health · 2022Article
- Distinguishing High-Performing From Low-Performing Hospitals for Severe Maternal Morbidity: A Focus on Quality and Equity.Obstetrics and gynecology · 2022Article
- An Exploratory Spatiotemporal Analysis of Socio-Environmental Patterns in Severe Maternal Morbidity.Maternal and child health journal · 2022Article
- Use of Labor Neuraxial Analgesia for Vaginal Delivery and Severe Maternal Morbidity.JAMA network open · 2022Article
- Relationship Between Neighborhood Socioeconomic Disadvantage and Severe Maternal Morbidity and Maternal Mortality.Ethnicity & disease · 2022Article
- Neighbourhood material deprivation and severe maternal morbidity: a population-based cohort study in Ontario, Canada.BMJ open · 2021Article
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4 authors.
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Abstract
Background The incidence of severe maternal morbidity (SMM) during childbirth is increasing in the United States. A better characterization of risk factors for SMM may identify targets for improving maternal outcomes. This study aims to characterize patient-, hospital-, and neighborhood-level factors associated with SMM during childbirth. Methods SMM during childbirth was identified in the 2013-2014 State Inpatients Database for New York. Hospital and neighborhood characteristics were abstracted from the American Hospital Association and the Area Health Resources files. Multilevel modeling was used to identify factors associated with SMM, with and without blood transfusion, and its between-hospital variation. Results 403,116 delivery-related discharges from 139 hospitals were analyzed; 1557 (0.39%) recorded SMM without blood transfusion. In the final multilevel model, 7 patient-level factors were associated with a greater than fourfold increase in the risk of SMM: pulmonary hypertension, postpartum hemorrhage, placenta accreta, chronic kidney disease, cardiac conduction disorders, emergent cesarean delivery, and preeclampsia. Three hospital-level factors were associated with SMM: proportion of non-White patients, proportion of Medicaid beneficiaries, and coding intensity. No neighborhood-level factors were predictive of SMM. The proportion of variation in SMM explained by the model was 23.5 with 23.2% related to patient-level factors. The model explained 55% of the between-hospital variation, primarily related to patient-level factors. Similar results were observed for SMM with blood transfusion. Conclusions This study confirms the association between patient-level factors and SMM. It identifies patient-level factors as the major driver of between-hospital variation in SMM. Efforts to improve maternal outcomes should target patient-level factors.
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