Evidence map›Paper›PMID 40813688›Full record

Observational studyCritical care (London, England)2025

Clinical features and outcomes of peripartum obstetric patients admitted to the intensive care unit: A nationwide inpatient database in Japan.

Satoshi Naruse, Mikio Nakajima, Yoshitaka Aoki, Daisuke Shigemi, Kyosuke Kamijo, Richard H Kaszynski, Hiroyuki Ohbe, Yusuke Sasabuchi, Shotaro Aso, Hiroki Matsui and 3 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

13 authors.

Satoshi NarusePerinatal Center, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-ku, Hamamatsu, Shizuoka, 431-3192, Japan.
Mikio NakajimaEmergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo, 150-0013, Japan. mickeyjmogulscob@gmail.com.
Yoshitaka AokiDepartment of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-ku, Hamamatsu, Shizuoka, 431-3192, Japan.
Daisuke ShigemiDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Kyosuke KamijoDepartment of Obstetrics and Gynecology, Nagano Prefectural Shinshu Medical Center, 1332 Suzaka, Suzaka, Nagano, 382-8577, Japan.
Richard H KaszynskiEmergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo, 150-0013, Japan.
Hiroyuki OhbeDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Yusuke SasabuchiDepartment of Real-world Evidence, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Shotaro AsoDepartment of Health Services Research, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Hiroki MatsuiDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Kiyohide FushimiDepartment of Health Policy and Informatics, Institute of Science Tokyo, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Yoshiki NakajimaDepartment of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-ku, Hamamatsu, Shizuoka, 431-3192, Japan.
Hideo YasunagaDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.

Funding

Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science 22K09568the Ministry of Health, Labour and Welfare, Japan 23AA2003
6 · The paper itself

Abstract

backgroundPregnant and postpartum women face an increasing risk of severe complications due to pathophysiological changes, advanced maternal age, obesity, and reproductive technologies. Globally, maternal mortality remains a critical concern, with numerous critically ill obstetric patients requiring intensive care each year. However, comprehensive nationwide data on obstetric intensive care unit (ICU) admissions in Japan remain scarce. This study aimed to provide a detailed analysis of the clinical characteristics, causes of ICU admission, interventions, and outcomes of obstetric patients in Japan using a large, nationwide inpatient database.

methodsThis retrospective observational study utilized the Japanese Diagnosis Procedure Combination inpatient database, which encompasses more than 90% of tertiary emergency hospitals, covering the period from July 2010 to March 2022. We included patients who were admitted to the ICU and delivered either during hospitalization or within one week before hospital admission. Patient demographics, comorbidities, causes of ICU admission, interventions, and clinical outcomes (e.g., in-hospital mortality) were analyzed. Comparative analyses were conducted between survivors and non-survivors to identify key differences in clinical presentation and outcomes.

resultsA total of 8,184 obstetric patients from 195 institutions were admitted to ICUs during the study period. The median age was 34 years (interquartile range, 30-38), and 53.2% underwent cesarean delivery. Hemorrhage was the most common cause of ICU admission (52.6%), followed by hypertensive disorders of pregnancy (16.7%). Major interventions included blood transfusions in 71.5% of patients, mechanical ventilation in 28.0%, and transcatheter arterial embolization in 18.0%. Overall in-hospital mortality was 1.1%. Compared with survivors, non-survivors had a lower proportion of hemorrhage-related cases but exhibited a higher prevalence of amniotic fluid embolism, cardiovascular and cerebrovascular disease, infection, pulmonary disease, trauma, and suicide.

conclusionsThis nationwide study highlights hemorrhage as the primary cause of obstetric ICU admissions in Japan, with an all cause in-hospital mortality of 1.1%. These findings highlight the need for targeted interventions to enhance maternal care, optimize ICU resource allocation, and improve outcomes among critically ill obstetric patients.

trial registrationThis was a retrospective observational study and was not registered prospectively as trial registration is not applicable to this type of study.

Indexed as

Peripartum PeriodAdultDatabases, FactualFemaleHospital MortalityHumansIntensive Care UnitsJapanPregnancyPregnancy ComplicationsRetrospective StudiesEpidemiologyHemorrhageMaternal mortalityPostpartumSevere maternal morbidity

Identifiers

PMID40813688
PMCPMC12355807

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.