Evidence map›Paper›PMID 36311297›Full record

ArticleAJOG global reports2022

Association of severe maternal morbidity and post-traumatic stress disorder.

Christina J Duval, Ariane C Youssefzadeh, Heather E Sweeney, Alexandra M McGough, Rachel S Mandelbaum, Joseph G Ouzounian, Koji Matsuo

Abstract read
In one paragraph

Article in AJOG global reports, 2022. 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
–field-weighted citation impact
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.

  1. Article
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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

7 authors.

Christina J DuvalDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA (Ms Duval, Drs Youssefzadeh and Sweeney, Ms McGough, and Drs Mandelbaum and Matsuo).
Ariane C YoussefzadehDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA (Ms Duval, Drs Youssefzadeh and Sweeney, Ms McGough, and Drs Mandelbaum and Matsuo).
Heather E SweeneyDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA (Ms Duval, Drs Youssefzadeh and Sweeney, Ms McGough, and Drs Mandelbaum and Matsuo).
Alexandra M McGoughDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA (Ms Duval, Drs Youssefzadeh and Sweeney, Ms McGough, and Drs Mandelbaum and Matsuo).
Rachel S MandelbaumDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA (Ms Duval, Drs Youssefzadeh and Sweeney, Ms McGough, and Drs Mandelbaum and Matsuo).
Joseph G OuzounianDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA (Dr Ouzounian).
Koji MatsuoDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA (Ms Duval, Drs Youssefzadeh and Sweeney, Ms McGough, and Drs Mandelbaum and Matsuo).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSevere maternal morbidity refers to the most serious complications of pregnancy. Whether severe maternal morbidity is associated with post-traumatic stress disorder is currently under active investigation.

objectiveThis study aimed to examine the association between severe maternal morbidity and post-traumatic stress disorder at delivery. STUDY

designThis was a retrospective cohort study querying the Healthcare Cost and Utilization Project's National Inpatient Sample, which included 12,857,721 patients for national estimates who had vaginal or cesarean deliveries between January 2016 and December 2019. Patients with mental health conditions other than post-traumatic stress disorder and substance use disorder were excluded. Severe maternal morbidity was defined according to the Centers for Disease Control and Prevention definition (a total of 21 indicators). Main outcomes were trends and characteristics related to post-traumatic stress disorder, assessed with a multivariable binary logistic regression model. Sensitivity analysis included subcohort assessment restricted to patients per clinical and obstetrical demographics.

resultsA total of 8880 patients had a diagnosis of post-traumatic stress disorder during the hospital admission for delivery (prevalence rate, 6.9 per 10,000). The prevalence rate of post-traumatic stress disorder increased from 5.0 to 8.8 per 10,000 deliveries between 2016 and 2019. This increasing trend remained independent in multivariable analysis. The adjusted odds ratio, compared with 2016, was 1.26 (95% confidence interval, 1.19-1.35) for 2017, 1.50 (95% confidence interval, 1.41-1.60) for 2018, and 1.73 (95% confidence interval, 1.63-1.84) for 2019. Severe maternal morbidity occurred in 210,605 (1.6%) patients. Patients who had severe maternal morbidity were more likely to have a diagnosis of post-traumatic stress disorder than those without severe maternal morbidity (12.8 vs 6.8 per 10,000 deliveries; adjusted odds ratio, 1.57; 95% confidence interval, 1.39-1.78) in multivariable analysis. This association remained robust in several subcohort analyses including (1) participants aged ≤35 years (adjusted odds ratio, 1.62; 95% confidence interval, 1.41-1.86), (2) those aged ≤35 years without medical comorbidity (adjusted odds ratio, 2.01; 95% confidence interval, 1.70-2.37), and (3) those aged <35 years without medical comorbidity, cesarean delivery, and preterm delivery (adjusted odds ratio, 4.52; 95% confidence interval, 3.56-5.74).

conclusionThere has been a gradual increase in the number of patients with a diagnosis of post-traumatic stress disorder at delivery in recent years among those without other mental health or substance use conditions. These data suggest that there is a possible association between severe maternal morbidity and post-traumatic stress disorder.

Indexed as

post-traumatic stress disorderpregnancysevere maternal morbidity

Identifiers

PMID36311297
PMCPMC9597115

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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.