Evidence map›Paper›PMID 38513965›Full record

ArticleChest2024

The Association of Pregnancy With Outcomes Among Critically Ill Reproductive-Aged Women: A Propensity Score-Matched Retrospective Cohort Analysis.

Rachel Kohn, Deepshikha C Ashana, Kelly C Vranas, Elizabeth M Viglianti, Katrina Hauschildt, Catherine Chen, Emily A Vail, Leslie Moroz, Hayley B Gershengorn

Open access · greenAbstract read
In one paragraph

Article in Chest, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
3.3field-weighted citation impact, top 9% 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Response.Chest · 2025
    Article
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

9 authors at 8 institutions in 1 country.

Rachel KohnDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Palliative and Advanced Illness Research (PAIR) Center, University of Pennsylvania, Philadelphia, PA. Electronic address: rachel.kohn2@pennmedicine.upenn.edu.
Deepshikha C AshanaDepartment of Medicine, Duke University, Durham, NC.
Kelly C VranasPalliative and Advanced Illness Research (PAIR) Center, University of Pennsylvania, Philadelphia, PA; Department of Medicine, Oregon Health & Science University, Portland, OR; Center to Improve Veteran Involvement in Care, Portland, OR.
Elizabeth M VigliantiDepartment of Internal Medicine, University of Michigan Health System, Ann Arbor, MI; Department of Internal Medicine, VA Ann Arbor, Ann Arbor, MI.
Katrina HauschildtDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Catherine ChenDepartment of Medicine, University of Texas Southwestern Medical Center, Dallas, TX.
Emily A VailLeonard Davis Institute of Health Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA.
Leslie MorozDepartment of Obstetrics and Gynecology, Yale University, New Haven, CT.
Hayley B GershengornDepartment of Medicine, University of Miami Miller School of Medicine, Miami, FL; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.
University of Pennsylvania · USAlbert Einstein College of Medicine · USDuke University · USJohns Hopkins University · USThe University of Texas Southwestern Medical Center · USVA Ann Arbor Healthcare System · USVA Portland Health Care System · USYale University · US

Funding

Improving Risk-Stratification in Patients with Prolonged ICU StaysK23HL157364 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI VIGLIANTI, ELIZABETH MARIE · 2021 to 2025
$913k
Optimizing Critical Care for Patients with Acute Respiratory Failure: A Mixed-Methods StudyIK2HX003005 · VA · PORTLAND VA MEDICAL CENTER · PI VRANAS, KELLY C. · 2020 to 2023
–
HSRD VA IK2 HX003005
6 · The paper itself

Abstract

backgroundThe maternal mortality rate in the United States is unacceptably high. However, the relative contribution of pregnancy to these outcomes is unknown. Studies comparing outcomes among pregnant vs nonpregnant critically ill patients show mixed results and are limited by small sample sizes. RESEARCH QUESTION: What is the association of pregnancy with critical illness outcomes? STUDY DESIGN AND

methodsWe performed a retrospective cohort study of women 18 to 55 years of age who received invasive mechanical ventilation (MV) on hospital day 0 or 1 or who demonstrated sepsis on admission (infection with organ failure) discharged from Premier Healthcare Database hospitals from 2008 through 2021. The exposure was pregnancy. The primary outcome was in-hospital mortality. We created propensity scores for pregnancy (using patient and hospital characteristics) and performed 1:1 propensity score matching without replacement within age strata (to ensure exact age matching). We performed multilevel multivariable mixed-effects logistic regression for propensity-matched pairs with pair as a random effect.

resultsThree thousand ninety-three pairs were included in the matched MV cohort, and 13,002 pairs were included in the sepsis cohort. The characteristics of both cohorts were well balanced (all standard mean differences, < 0.1). Among matched pairs, unadjusted mortality was 8.0% vs 13.8% for MV and 1.4% vs 2.3% for sepsis among pregnant and nonpregnant patients, respectively. In adjusted regression, pregnancy was associated with lower odds of in-hospital mortality (MV: OR, 0.50; 95% CI, 0.41-0.60; P < .001; sepsis: OR, 0.52; 95% CI, 0.40-0.67; P < .001).

interpretationIn this large US cohort, critically ill pregnant women receiving MV or with sepsis showed better survival than propensity score-matched nonpregnant women. These findings must be interpreted in the context of likely residual confounding.

Indexed as

Critical IllnessHospital MortalityPropensity ScoreRespiration, ArtificialSepsisAdolescentAdultFemaleHumansMaternal MortalityMiddle AgedPregnancyPregnancy ComplicationsPregnancy OutcomeRetrospective StudiesUnited Statescritical care outcomescritical illnessmechanical ventilationpregnancysepsis

Identifiers

PMID38513965
PMCPMC11538888
OpenAlexW4392983343

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.