ArticlePloS one2023
Ranked severe maternal morbidity index for population-level surveillance at delivery hospitalization based on hospital discharge data.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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.
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.
Who cites it
13 citing papers in PubMed.
- Hospital-Based Severe Maternal Morbidity Surveillance and Review: A Strategy for Improving Maternity Care in Maryland.Medical care · 2026Article
- Effect of improved uterotonic availability on postpartum hemorrhage and maternal morbidity after vaginal delivery, review of a single-center quality-improvement initiative.Pregnancy (Hoboken, N.J.) · 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
- Relationship Between Maternal Death and Infant Outcomes in a Longitudinal, Population-Based Dataset.Obstetrics and gynecology · 2026Article
- The Role of State Perinatal Quality Collaboratives in Addressing Maternal Morbidity and Mortality.Obstetrics and gynecology · 2026Article
- Measuring Severe Maternal Morbidity: Current Practices, Challenges, and Opportunities.Obstetrics and gynecology · 2026Review
- Ranked Severe Maternal Morbidity Index for Population-Level Surveillance by Mode of Delivery.Journal of women's health (2002) · 2026Article
- Overview of Perinatal Quality Collaboratives and their activities to advance perinatal healthcare in the USA, 2022-2023.BMJ open quality · 2026Article
- Common Complications and Conditions at Delivery Hospitalization by Race and Ethnicity in the United States.Obstetrics and gynecology · 2026Article
- Using a deterministic matching computer routine to identify hospital episodes in a Brazilian de-identified administrative database for the analysis of obstetrics hospitalisations.International journal of population data science · 2025Article
- Hypertensive Disorders and Cardiovascular Severe Maternal Morbidity in the US, 2015-2019.JAMA network open · 2024Article
- Emergency Care Use During Pregnancy and Severe Maternal Morbidity.JAMA network open · 2024Article
- Community level factors and racial inequities in delivery hospitalizations involving severe maternal morbidity in the United States, 2016-2019.Scientific reports · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSevere maternal morbidity (SMM) is broadly defined as an unexpected and potentially life-threatening event associated with labor and delivery. The Centers for Disease Control and Prevention (CDC) produced 21 different indicators based on International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) hospital diagnostic and procedure codes to identify cases of SMM.
objectivesTo examine existing SMM indicators and determine which indicators identified the most in-hospital mortality at delivery hospitalization.
methodsData from the 1993-2015 and 2017-2019 Healthcare Cost and Utilization Project's National Inpatient Sample were used to report SMM indicator-specific prevalences, in-hospital mortality rates, and population attributable fractions (PAF) of mortality. We hierarchically ranked indicators by their overall PAF of in-hospital mortality. Predictive modeling determined if SMM prevalence remained comparable after transition to ICD-10-CM coding.
resultsThe study population consisted of 18,198,934 hospitalizations representing 87,864,173 US delivery hospitalizations. The 15 top ranked indicators identified 80% of in-hospital mortality; the proportion identified by the remaining indicators was negligible (2%). The top 15 indicators were: restoration of cardiac rhythm; cardiac arrest; mechanical ventilation; tracheostomy; amniotic fluid embolism; aneurysm; acute respiratory distress syndrome; acute myocardial infarction; shock; thromboembolism, pulmonary embolism; cerebrovascular disorders; sepsis; both DIC and blood transfusion; acute renal failure; and hysterectomy. The overall prevalence of the top 15 ranked SMM indicators (~22,000 SMM cases per year) was comparable after transition to ICD-10-CM coding.
conclusionsWe determined the 15 indicators that identified the most in-hospital mortality at delivery hospitalization in the US. Continued testing of SMM indicators can improve measurement and surveillance of the most severe maternal complications at the population level.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.