Evidence map›Paper›PMID 34418536›Full record

ArticleAnnals of epidemiology2021

The impact of Severe Maternal Morbidity on probability of subsequent birth in a population-based study of women in California from 1997-2017.

Shalmali Bane, Suzan L Carmichael, Jonathan M Snowden, Can Liu, Audrey Lyndon, Elizabeth Wall-Wieler

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 2 countries.

Shalmali BaneDepartment of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA 94306.
Suzan L CarmichaelDepartment of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA 94306; Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford CA, USA 94306.
Jonathan M SnowdenSchool of Public Health, Oregon Health & Science University-Portland State University, Portland OR, USA 97239; Department of Obstetrics and Gynecology Oregon Health & Science University, Portland OR, USA 97239.
Can LiuDepartment of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA 94306.
Audrey LyndonRory Meyers College of Nursing, New York University, NY, USA 10010.
Elizabeth Wall-WielerDepartment of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada MB R3T 2N2.
Stanford University · USNew York University · USPortland State University · USStanford Medicine · USUniversity of Manitoba · CA

Funding

Severe Maternal Morbidity: An Investigation of Racial-Ethnic Disparities, Social Disadvantage & Maternal WeightR01NR017020 · NINR · STANFORD UNIVERSITY · PI SUZAN L CARMICHAEL · 2018 to 2026
$5.2M
NINR NIH HHS R01 NR017020
6 · The paper itself

Abstract

importanceComplications during pregnancy and birth can impact whether an individual has more children. Individuals experiencing SMM are at a higher risk of general and reproductive health issues after pregnancy, which could reduce the probability of a subsequent birth.

objectiveTo examine whether experiencing SMM during an individual's first birth affects their probability of having an additional birth, and whether this effect varies by maternal factors.

methodsThis retrospective cohort study US linked vital records and maternal discharges from 1997 to 2017 to identify all California births. The exposure, Severe Maternal Morbidity (SMM) was identified using a Centers for Disease Control and Prevention index. Individuals whose first birth was a singleton live birth were followed until their second birth or December 31, 2017, whichever came first. Hazard ratios for having a subsequent birth were estimated using Cox proportional hazard regression models. This association was assessed overall and stratified by maternal factors of a priori interest: age, race/ethnicity, and payer.

resultsOf the 3,916,413 individuals in our study, 51,872 (1.3%) experienced SMM at first birth. Compared to those who do not experience SMM, individuals who had SMM had a lower hazard, or instantaneous rate, of subsequent birth (adjusted HR 0.83, 95% CI: 0.82, 0.84); this association was observed in all levels of stratification (for example, adjusted HR range for known race/ethnicity: 0.78, 95% CI: 0.76, 0.80 for non-Hispanic White to 0.90, 95% CI: 0.88, 0.92 for Hispanic) and all indicators of SMM (0.24, 95% CI: 0.17, 0.35 for cardiac arrest/ventricular fibrillation to 0.84, 95% CI: 0.80, 0.87 for eclampsia). CONCLUSION AND RELEVANCE: Our findings suggest that individuals who experience SMM at the time of their first birth are less likely to have a subsequent birth as compared to those who do not experience SMM at the time of their first birth. While the reasons for these findings are unclear, they could inform reproductive life planning discussions for individuals experiencing SMM. Future directions include studies exploring the reasons for not having a subsequent birth.

Indexed as

Pregnancy ComplicationsCaliforniaChildFemaleHumansParturitionPregnancyRetrospective StudiesRisk FactorsFertilityPregnancyPregnancy ratePregnant WomenReproductive Health

Identifiers

PMID34418536
PMCPMC8629841
OpenAlexW3194855445

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.