Evidence map›Paper›PMID 37659745›Full record

ArticleAmerican journal of obstetrics and gynecology2024

Association between stillbirth and severe maternal morbidity.

Samuel H Nyarko, Lucy T Greenberg, Ciaran S Phibbs, Jeffrey S Buzas, Scott A Lorch, Jeannette Rogowski, George R Saade, Molly Passarella, Nansi S Boghossian

Open access · greenAbstract read
In one paragraph

Article in American journal of obstetrics and gynecology, 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
4.6field-weighted citation impact, top 5% 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

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
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  5. Short-Term Increases in NOEnvironmental science & technology · 2024
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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 7 institutions in 1 country.

Samuel H NyarkoDepartment of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
Lucy T GreenbergVermont Oxford Network, Burlington, VT.
Ciaran S PhibbsHealth Economics Resource Center and Center for Implementation to Innovation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA; Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
Jeffrey S BuzasDepartment of Mathematics and Statistics, University of Vermont, Burlington, VT.
Scott A LorchDepartment of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA; Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania, Philadelphia, PA.
Jeannette RogowskiDepartment of Health Policy and Administration, The Pennsylvania State University, State College, PA.
George R SaadeDepartment of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA.
Molly PassarellaDepartment of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA.
Nansi S BoghossianDepartment of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC. Electronic address: nboghoss@email.sc.edu.
University of Pennsylvania · USUniversity of South Carolina · USEastern Virginia Medical School · USPennsylvania State University · USUniversity of Vermont · USVA Palo Alto Health Care System · USVermont Oxford Network · US

Funding

Hospital quality, Medicaid expansion, and racial/ethnic disparitiesin maternal mortality and morbidityR01MD016012 · NIMHD · UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA · PI BOGHOSSIAN, NANSI · 2020 to 2024
$3.2M
NIMHD NIH HHS R01 MD016012
6 · The paper itself

Abstract

backgroundSevere maternal morbidity has been increasing in the past few decades. Few studies have examined the risk of severe maternal morbidity among individuals with stillbirths vs individuals with live-birth deliveries.

objectiveThis study aimed to examine the prevalence and risk of severe maternal morbidity among individuals with stillbirths vs individuals with live-birth deliveries during delivery hospitalization as a primary outcome and during the postpartum period as a secondary outcome. STUDY

designThis was a retrospective cohort study using birth and fetal death certificate data linked to hospital discharge records from California (2008-2018), Michigan (2008-2020), Missouri (2008-2014), Pennsylvania (2008-2014), and South Carolina (2008-2020). Relative risk regression analysis was used to examine the crude and adjusted relative risks of severe maternal morbidity along with 95% confidence intervals among individuals with stillbirths vs individuals with live-birth deliveries, adjusting for birth year, state of residence, maternal sociodemographic characteristics, and the obstetric comorbidity index.

resultsOf the 8,694,912 deliveries, 35,012 (0.40%) were stillbirths. Compared with individuals with live-birth deliveries, those with stillbirths were more likely to be non-Hispanic Black (10.8% vs 20.5%); have Medicaid (46.5% vs 52.0%); have pregnancy complications, including preexisting diabetes mellitus (1.1% vs 4.3%), preexisting hypertension (2.3% vs 6.2%), and preeclampsia (4.4% vs 8.4%); have multiple pregnancies (1.6% vs 6.2%); and reside in South Carolina (7.4% vs 11.6%). During delivery hospitalization, the prevalence rates of severe maternal morbidity were 791 cases per 10,000 deliveries for stillbirths and 154 cases per 10,000 deliveries for live-birth deliveries, whereas the prevalence rates for nontransfusion severe maternal morbidity were 502 cases per 10,000 deliveries for stillbirths and 68 cases per 10,000 deliveries for live-birth deliveries. The crude relative risk for severe maternal morbidity was 5.1 (95% confidence interval, 4.9-5.3), whereas the adjusted relative risk was 1.6 (95% confidence interval, 1.5-1.8). For nontransfusion severe maternal morbidity among stillbirths vs live-birth deliveries, the crude relative risk was 7.4 (95% confidence interval, 7.0-7.7), whereas the adjusted relative risk was 2.0 (95% confidence interval, 1.8-2.3). This risk was not only elevated among individuals with stillbirth during the delivery hospitalization but also through 1 year after delivery (severe maternal morbidity adjusted relative risk, 1.3; 95% confidence interval, 1.1-1.4; nontransfusion severe maternal morbidity adjusted relative risk, 1.2; 95% confidence interval, 1.1-1.3).

conclusionStillbirth was found to be an important contributor to severe maternal morbidity.

Indexed as

Pre-EclampsiaPregnancy ComplicationsFemaleFetal DeathHumansPregnancyRetrospective StudiesStillbirthacute renal failuredisseminated intravascular coagulationobstetric comorbidity index scorepostpartumsepsissevere maternal morbidityshockstillbirthtransfusion

Identifiers

PMID37659745
PMCPMC10904670
OpenAlexW4386315055

What Socratic holds

Textmetadata
LicenceTDM
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 Socratic graph.