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APHA Scientific Session and Event Listing

Marci G. Adams, MPH and Stacie E. Geller, PhD. Obstetrics and Gynecology, University of Illinois at Chicago, 820 S. Wood Street, M/C 808, Chicago, IL 60612, 312-413-8379, mgolds4@uic.edu

Objective: To evaluate the relationship between diagnosis, time of year and preventability of the progression of maternal morbidity and mortality. Methods: Deaths and serious morbidities of pregnant or postpartum women between 1992 and 2001 in Chicago were categorized by medical diagnosis and date of hospital admission. Race/ethnicity, age and parity were determined. For each subject, a review of the case by physicians and midwives was conducted to determine whether there were preventable provider or system events that led to progression of the patient's disease. Results: Among 223 pregnancy-related deaths, near-miss and severe morbidities, 77 (35%) were determined to have one or more preventable factors. Diagnoses included PIH (49%), cardiac (8%), hemorrhage (20%), infection (9%), and other conditions (13%). Infections were 50% more common in January-March than the rest of the year. Presence of infection was associated with a more than three-fold increase in the odds of having a preventable event as compared to other diagnoses, with odds ratio (OR) equal 3.5, 95% confidence interval (CI) (1.38, 8.87). After controlling for time of year, the relationship between infection and preventability was stronger (OR=4.2, CI=1.59, 11.02). Adding maternal age, parity, or race/ethnicity to the model did not significantly change the relationships. Conclusions: There is an association between infection and preventability of disease progression in pregnancy-related morbidity. This relationship is strengthened by accounting for the seasonal nature of infections, but is not altered by age, parity or race/ethnicity. Further research may reveal ways to improve medical care to reduce maternal morbidity and mortality.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Evaluate the relationship between diagnosis, time of year and preventability of the progression of maternal morbidity and mortality

Keywords: Maternal Morbidity, Women's Health

Presenting author's disclosure statement:

Not Answered