ArticleBMC pregnancy and childbirth2019
The contribution of maternal characteristics and cesarean delivery to an increasing trend of severe maternal morbidity.
Article in BMC pregnancy and childbirth, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 1 of them a synthesis that pooled it.
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Who cites it
72 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Extracorporeal Life Support in Pregnancy: A Systematic Review.Journal of the American Heart Association · 2020Pooled it
- Trends in Pregestational Diabetes and Gestational Diabetes Mellitus and Associations With Severe Maternal Morbidity in U.S. Delivery Hospitalizations, 2016-2022.Diabetes care · 2026Article
- 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
- Severe maternal morbidity in patients of advanced maternal age with and without metabolic syndrome.Archives of gynecology and obstetrics · 2026Article
- Retrospective Cohort Study on Racial and Ethnic Disparities in Cesarean Birth in a Midwifery-Integrated Health System.Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2026Article
- Ranked Severe Maternal Morbidity Index for Population-Level Surveillance by Mode of Delivery.Journal of women's health (2002) · 2026Article
- Risk factors for unplanned cesarean delivery among pregnant individuals with pre-existing diabetes.Pregnancy (Hoboken, N.J.) · 2026Article
- Lipidomics of prolonged labor duration in African American birthing people.Scientific reports · 2026Article
- Racial and Ethnic Differences in Labor Duration and Cesarean Indications Among Low-Risk Nulliparous Term Singleton Vertex Births: A Retrospective Analysis.Journal of clinical medicine · 2026Article
- Risk factors for the recurrence of severe maternal morbidity in first and second births in California, 1997 to 2020.American journal of obstetrics and gynecology · 2026Article
- Assessing Racial/Ethnic Variation and Trends in Vaginal Birth after Cesarean in California: A Retrospective Cohort Study Using Linked Birth Certificate and Hospital Discharge Records.American journal of perinatology · 2026Article
- Maternal levels of care and association with severe maternal morbidity during birth hospitalizations.PloS one · 2026Observational
- Distributions of Adverse Childbearing Experiences Across Racial and Ethnic Groups: A Research Note.Demography · 2025Article
- Characteristics of Births Conceived Through Medically Assisted Reproduction by Parental Structure in Louisiana (2016-2023).Journal of women's health (2002) · 2025Article
- Network analysis of PTSD symptoms following childbirth and comorbid conditions among women with sexual trauma history.Archives of women's mental health · 2025Article
- Comorbidities and Pregnancy-Related Risk Factors in Patients with Severe Maternal Morbidity: Application of a Validated Obstetrical Comorbidity Scoring System to a Surveillance-Identified Population.Healthcare (Basel, Switzerland) · 2025Article
- Excessive gestational weight gain associated with higher risk of cesarean delivery across body mass index categories in the United States.Journal of gynecology obstetrics and human reproduction · 2025Article
- Work Experience and Attitudes About Birth in Relation to Nurses' Cesarean Rates for Women With Low-Risk Pregnancies.Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2025Article
- Maternal Age Differences in Interpregnancy Interval and Preterm Birth Associations Accounting for Multiple Epidemiologic Biases.Paediatric and perinatal epidemiology · 2025Article
- Severe Maternal Morbidity by Race and Ethnicity and Birth Mode Among Individuals With a Prior Cesarean Birth.JAMA network open · 2025Article
12 more citing papers are in PubMed but not listed here.
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Abstract
backgroundSevere maternal morbidity - life-threatening childbirth complications - has more than doubled in the United States over the past 15 years, affecting more than 50,000 women (1.4% of deliveries) annually. During this time period, maternal age, obesity, comorbidities, and cesarean delivery also increased and may be related to the rise in severe maternal morbidity. We sought to evaluate: (1) the association of advanced maternal age, pre-pregnancy obesity, pre-pregnancy comorbidities, and cesarean delivery with severe maternal morbidity, and (2) whether changes in the prevalence of these risk factors affected the trend of severe maternal morbidity.
methodsThis population-based cohort study used linked birth record and patient discharge data from live births in California during 2007-2014 (n = 3,556,206). We used multivariable logistic regression models to assess the association of advanced maternal age (≥35 years), pre-pregnancy obesity (body mass index ≥30 kg/m
resultsThe prevalence of severe maternal morbidity increased by 65% during 2007-2014. Advanced maternal age, pre-pregnancy obesity, and pre-pregnancy comorbidity also increased during this period, but cesarean delivery did not. None of these risk factors affected the increasing trend of severe maternal morbidity. However, the pre-pregnancy risk factors together were estimated to contribute to 13% (95% confidence interval: 12, 14%) of severe maternal morbidity cases in the study population overall, and cesarean delivery was estimated to contribute to 37% (95% confidence interval: 36, 38%) of cases.
conclusionsPre-pregnancy health and cesarean delivery are important risk factors for severe maternal morbidity but do not explain an increasing trend of severe maternal morbidity in California during 2007-2014. Investigation of other potential contributors is needed in order to identify ways to reverse the trend of severe maternal morbidity.
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