Antepartum severe maternal morbidity: A population‐based study of risk factors and delivery outcomes

• DOI: 10.1111/ppe.12847
• Publication Date: 2021-12-29T12:57:00Z
• Authors: Mégane Raineau; Catherine Deneux‐...; Aurélien Seco; Marie‐Pierre Bonnet
• Keywords: Antepartum haemorrhage

Abstract Background Severe maternal morbidity (SMM) is a key indicator of health. Generally explored without distinction by the timing event, it mainly reflects postpartum SMM. Although antepartum (pre‐labour) SMM presents specific challenges in its need to optimise risk‐benefit balance for both mother and foetus, features remain inadequately explored. Objectives We risk factors described adverse delivery neonatal outcomes associated with Methods designed population‐based nested case‐control study based on data from EPIMOMS (119 maternity hospitals 6 French regions, 2012–2013, N = 182,309 deliveries source cohort). This included all women (cases, n 601) compared randomly selected sample who gave birth same (controls, 3651). Antepartum were identified multivariable logistic regression following imputations missing data. Results complicated 0.33% (95% confidence interval [CI] 0.30, 0.36) pregnancies. age ≥35 years (adjusted odds ratio [OR] 1.55, 95% CI 1.22, 1.97), increased body mass index (OR 5 kg/m 2 increase, 1.24, 1.14, 1.36), sub‐Saharan Africa 1.80, 1.29, 2.53), pre‐existing medical condition 2.56, 1.99, 3.30), nulliparity 2.26, 1.83, 2.80), previous pregnancy‐related hypertensive disorders 4.94, 3.36, 7.26), multiple pregnancy 5.79, 3.75, irregular prenatal care 1.86, 1.27, 2.72). For SMM, preterm delivery, mortality transfer intensive unit 10 times more frequent than controls. Emergency caesarean general anaesthesia Conclusions rare but rates outcomes.