Evidence map›Paper›PMID 38844640›Full record

ArticleIntensive care medicine2024

Measuring the impact of maternal critical care admission on short- and longer-term maternal and birth outcomes.

John A Masterson, Imad Adamestam, Monika Beatty, James P Boardman, Louis Chislett, Pamela Johnston, Judith Joss, Heather Lawrence, Kerry Litchfield, Nicholas Plummer and 6 more

Abstract read
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Article in Intensive care medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Review
  5. Maternal critical care.Intensive care medicine · 2024
    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

16 authors.

John A MastersonDepartment of Anaesthesia, Critical Care, and Pain Medicine, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK.ORCID 0000-0003-1409-2164
Imad AdamestamEdinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, UK.
Monika BeattyDepartment of Anaesthesia, Critical Care, and Pain Medicine, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-2521-8909
James P BoardmanCentre for Reproductive Health, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh BioQuarter, Edinburgh, UK.ORCID 0000-0003-3904-8960
Louis ChislettInstitute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-2578-3625
Pamela JohnstonDepartment of Anaesthesia, Critical Care, and Pain Medicine, Ninewells Hospital, Dundee, UK.
Judith JossDepartment of Anaesthesia, Critical Care, and Pain Medicine, Ninewells Hospital, Dundee, UK.ORCID 0000-0002-5619-5033
Heather LawrencePatient Representative, The University of Edinburgh, Edinburgh, UK.
Kerry LitchfieldDepartment of Anaesthesia, Critical Care, and Pain Medicine, Glasgow Royal Infirmary, Glasgow, UK.ORCID 0000-0003-0879-758X
Nicholas PlummerDepartment of Critical Care, Nottingham University Hospitals, Nottingham, UK.ORCID 0000-0002-1239-9253
Stella RhodeUsher Institute, The University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK.ORCID 0009-0009-1005-441X
Timothy WalshDepartment of Anaesthesia, Critical Care, and Pain Medicine, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-3590-8540
Arlene WiseDepartment of Anaesthesia, Critical Care, and Pain Medicine, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK.
Rachael WoodUsher Institute, The University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK.ORCID 0000-0003-4453-623X
Christopher J WeirEdinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-6494-4903
Nazir I LoneDepartment of Anaesthesia, Critical Care, and Pain Medicine, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK. nazir.lone@ed.ac.uk.ORCID 0000-0003-2707-2779

Funding

Obstetric Anaesthetists' Association
6 · The paper itself

Abstract

purposeFactors increasing the risk of maternal critical illness are rising in prevalence in maternity populations. Studies of general critical care populations highlight that severe illness is associated with longer-term physical and psychological morbidity. We aimed to compare short- and longer-term outcomes between women who required critical care admission during pregnancy/puerperium and those who did not.

methodsThis is a cohort study including all women delivering in Scottish hospitals between 01/01/2005 and 31/12/2018, using national healthcare databases. The primary exposure was intensive care unit (ICU) admission, while secondary exposures included high dependency unit admission. Outcomes included hospital readmission (1-year post-hospital discharge, 1-year mortality, psychiatric hospital admission, stillbirth, and neonatal critical care admission). Multivariable Cox and logistic regression were used to report hazard ratios (HR) and odds ratios (OR) of association between ICU admission and outcomes.

resultsOf 762,918 deliveries, 1449 (0.18%) women were admitted to ICU, most commonly due to post-partum hemorrhage (225, 15.5%) followed by eclampsia/pre-eclampsia (133, 9.2%). Over-half (53.8%) required mechanical ventilation. One-year hospital readmission was more frequent in women admitted to ICU compared with non-ICU populations [24.5% (n = 299) vs 8.9% (n = 68,029)]. This association persisted after confounder adjustment (HR 1.93, 95% confidence interval [CI] 1.33, 2.81, p < 0.001). Furthermore, maternal ICU admission was associated with increased 1-year mortality (HR 40.06, 95% CI 24.04, 66.76, p < 0.001), stillbirth (OR 12.31, 95% CI 7.95,19.08, p < 0.001) and neonatal critical care admission (OR 6.99, 95% CI 5.64,8.67, p < 0.001) after confounder adjustment.

conclusionCritical care admission increases the risk of adverse short-term and long-term maternal, pregnancy and neonatal outcomes. Optimizing long-term post-partum care may benefit maternal critical illness survivors.

Indexed as

Patient ReadmissionAdultCohort StudiesCritical CareCritical IllnessFemaleHumansInfant, NewbornIntensive Care UnitsMaternal MortalityPatient AdmissionPregnancyPregnancy ComplicationsPregnancy OutcomeScotlandHospitalizationMaternal critical careMaternal mortalityNeonatal outcomesStillbirth

Identifiers

PMID38844640

What OpenQuestion holds

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Registered trials

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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.