Severe Maternal Morbidity, Race, and Rurality: Trends Using the National Inpatient Sample, 2012-2017

被引:32
|
作者
Luke, Alina A. [1 ,2 ]
Huang, Kristine [1 ]
Lindley, Kathryn J. [1 ]
Carter, Ebony B. [3 ]
Maddox, Karen E. Joynt [1 ,4 ]
机构
[1] Washington Univ, Sch Med, Dept Med, Cardiovasc Div, 660 S Euclid, St Louis, MO 63110 USA
[2] Emory Univ, Dept Behav Social & Hlth Educ Sci, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA
[3] Washington Univ, Sch Med, Dept Obstet & Gynecol, Div Maternal Fetal Med, St Louis, MO 63110 USA
[4] Washington Univ, Inst Publ Hlth, Ctr Hlth Econ & Policy, St Louis, MO 63110 USA
关键词
disparities; health equity; maternal complications; minority; peripartum; pregnancy; pregnancy outcomes; rural; suburban; urbanicity; HEALTH-CARE; COUNTIES; PREGNANCY; MORTALITY; OUTCOMES; WOMEN;
D O I
10.1089/jwh.2020.8606
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Severe maternal morbidity is related to maternal mortality and an important measure of maternal health outcomes. Our objective was to evaluate differences in rates of severe maternal morbidity and mortality (SMM&M) by rurality and race, and examine these trends over time. Materials and Methods: It involves the retrospective cohort study of delivery hospitalizations from January 1, 2012 to December 31, 2017 from the National Inpatient Sample. We identified delivery hospitalizations using International Classification of Diseases, Ninth Revision, Clinical Modification and International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis and procedure codes and diagnosis-related groups. We used hierarchical regression models controlling for insurance status, income, age, comorbidities, and hospital characteristics to model odds of SMM&M. Results: The eligible cohort contained 4,494,089 delivery hospitalizations. Compared with women from small cities, women in the most urban and most rural areas had higher odds of SMM&M (urban adjusted odds ratio [aOR] 1.09, 95% confidence interval [1.04-1.14]; noncore rural aOR 1.24 [1.18-1.31]). Among White women, the highest odds of SMM&M were in noncore rural counties (aOR 1.20 [1.12-1.27]), while among Black women the highest odds were in urban (aOR 1.21 [1.11-1.31]) and micropolitan areas (aOR 1.36 [1.19-1.57]). Findings were similar for Hispanic, Native American, and other race women. Rates of SMM&M increased from 2012 to 2017, especially among urban patients. Conclusions: Women in the most urban and most rural counties experienced higher odds of SMM&M, and these relationships differed by race. These findings suggest particular areas for clinical leaders and policymakers to target to reduce geographic and racial disparities in maternal outcomes.
引用
收藏
页码:837 / 847
页数:11
相关论文
共 50 条
  • [1] ALCOHOLIC HEPATITIS TRENDS: RESULTS FROM THE NATIONAL INPATIENT SAMPLE 2012-2017
    Pradhan, Faruq
    Al-Qaisi, Mohanad T.
    David, Aidan J.
    Sehmbey, Gurbir S.
    Ling, Jiali
    Kannadath, Bijun S.
    Fallon, Michael B.
    [J]. GASTROENTEROLOGY, 2021, 160 (06) : S794 - S794
  • [2] National Trends in Hospitalizations for Serious Infections in People with Psoriatic Arthritis Using the National Inpatient Sample 2012-2017
    Murugesan, Vagishwari
    Pilitsi, Eleni
    Rabasa, Gabriela
    Dubreuil, Maureen
    [J]. ARTHRITIS & RHEUMATOLOGY, 2021, 73 : 3714 - 3716
  • [3] HEPATOPULMONARY SYNDROME TRENDS IN CIRRHOSIS: RESULTS FROM THE NATIONAL INPATIENT SAMPLE 2012-2017
    Pradhan, Faruq
    Al-Qaisi, Mohanad
    Amundsen, Tyson
    Geetha, Saroja Devi
    Ling, Jiali
    Kannadath, Bijun
    Fallon, Michael B.
    [J]. HEPATOLOGY, 2020, 72 : 1071 - 1072
  • [4] Severe Maternal Morbidity and Mortality in Sickle Cell Disease in the National Inpatient Sample, 2012-2018
    Early, Macy L.
    Eke, Ahizechukwu C.
    Gemmill, Alison
    Lanzkron, Sophie
    Pecker, Lydia H.
    [J]. JAMA NETWORK OPEN, 2023, 6 (02) : E2254552
  • [5] Analgesic prescribing trends in a national sample of older veterans with osteoarthritis: 2012-2017
    Trentalange, Mark
    Runels, Tessa
    Bean, Andrew
    Kerns, Robert D.
    Bair, Matthew J.
    Brody, Abraham A.
    Brandt, Cynthia A.
    Hwang, Ula
    Balk, Ruth
    Dismore, Rachel
    Gaetano, Vera
    Gittleman, Dorian
    Leverty, David
    Linden, Erin
    Majeski, Brittany
    Manuel, Ebony
    Monde, Kai
    Natividad, Diana
    Polusny, Grace
    Rinaldi, Anthony
    Signor, Daniel
    Stefanis, Lee
    [J]. PAIN, 2019, 160 (06) : 1319 - 1326
  • [6] Role of Race in the Incidence and Mortality Outcomes of Clostridium difficile Infections in the United States: Results From the National Inpatient Sample Database 2012-2017
    Geetha, Saroja D.
    Amundsen, Tyson
    Zamarripa, Alec
    Ling, Jiali
    Thosani, Nirav
    Badillo, Ricardo
    Fallon, Michael B.
    Kannadath, Bijun S.
    Guha, Sushovan
    [J]. AMERICAN JOURNAL OF GASTROENTEROLOGY, 2020, 115 : S78 - S78
  • [7] Severe Maternal Morbidity and Mortality Risk at the Intersection of Rurality, Race and Ethnicity, and Medicaid
    Interrante, Julia D.
    Tuttle, Mariana S.
    Admon, Lindsay K.
    Kozhimannil, Katy B.
    [J]. WOMENS HEALTH ISSUES, 2022, 32 (06) : 540 - 549
  • [8] Transcatheter Aortic Valve Replacement for Symptomatic Severe Aortic Stenosis in Rheumatic Heart Disease: Analysis of the National Inpatient Sample Database (2012-2017)
    Grant, Jelani
    Ebner, Bertrand
    Maning, Jennifer
    Vincent, Louis
    Fernandes, Amanda
    Olarte, Neal
    Olorunfemi, Odunayo P.
    Cardoso, Rhanderson
    Colombo, Rosario A.
    Alfonso, Carlos
    [J]. CIRCULATION, 2020, 142
  • [9] Postpartum Hospital Readmissions With and Without Severe Maternal Morbidity Within 1 Year of Birth, Oregon, 2012-2017
    Kaufman, Menolly
    McConnell, K. John
    Carmichael, Suzan L.
    Rodriguez, Maria, I
    Richardson, Dawn
    Snowden, Jonathan M.
    [J]. AMERICAN JOURNAL OF EPIDEMIOLOGY, 2023, 192 (02) : 158 - 170
  • [10] PREDICTORS OF CLOSTRIDIOIDES DIFFICILE INFECTION INCIDENCE IN THE UNITED STATES: RESULTS FROM THE NATIONAL INPATIENT SAMPLE DATABASE 2012-2017
    Geetha, Saroja Devi
    Ling, Jiali
    Zamarripa, Alec
    Kannadath, Bijun S.
    Thosani, Nirav
    Guha, Sushovan
    Fallon, Michael B.
    [J]. GASTROENTEROLOGY, 2021, 160 (06) : S336 - S336