Assessment of Cumulative Incidence and Factors Associated With Hospital Re-admission and Severe Maternal Morbidity After Delivery Discharge in British Columbia
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Morbidity;Perinatal
- Sponsor
- University of British Columbia
- Enrollment
- 15000
- Primary Endpoint
- Maternal hospital readmission
- Last Updated
- 3 years ago
Overview
Brief Summary
For every case of maternal death, many more women experience life-threatening complications during pregnancy and childbirth. Yet, severe maternal morbidity (SMM) cases are often overlooked post-delivery. Women have reported that roughly 15% of SMM cases first occurred in the six weeks following delivery. The underlying factors associated with these morbidities are likely different than those occurring antenatally and at the time of delivery. Further research is required to elucidate the exact burden of SMM in the postpartum period in British Columbia (BC).
Detailed Description
The ratio of maternal morbidity to maternal mortality is increasing globally (Geller 2018). In high-income countries, the World Health Organization (WHO) recommends routinely surveilling SMM to assess maternal health and quality of care (Geller 2018). To our knowledge, this is the first study conducted among pregnancies in BC aiming to examine the cumulative incidence, timing, and factors associated with postpartum maternal morbidity and hospital readmissions. This is a retrospective cohort study will use data from the BC Perinatal Data Registry (BCPDR), which contains maternal, fetal and neonatal health information from 99% of all deliveries in BC. The primary outcome assessed will be the cumulative incidence of hospital readmissions and SMM events occurring after delivery discharge within the first six weeks (42 days) of delivery. Secondary outcomes will include SMM-diagnosis, the rate and timing of postpartum SMM and readmissions, and maternal characteristics associated with these events. A multinominal logistic regression model will examine the association between postpartum SMM or readmission and determinants.
Investigators
Marianne Vidler
Assistant Professor
University of British Columbia
Eligibility Criteria
Inclusion Criteria
- •Delivered in BC from April 1, 2008 to March 31, 2021
- •Consented to data collected by the BCPDR
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Maternal hospital readmission
Time Frame: Up to six weeks post-delivery discharge
Cumulative incidence of women who get readmitted into the hospital after being discharged post-delivery
Severe maternal morbidity (SMM) event
Time Frame: Up to six weeks post-delivery discharge
Cumulative incidence of women who experience least one SMM event, defined as: severe pre-eclampsia, HELLP, eclampsia; severe haemorrhage; maternal ICU admission; surgical complications; hysterectomy; sepsis; embolism, shock, DIC; assisted ventilation; cardiac conditions; acute renal failure; several uterine rupture; cerebrovascular accidents; and other types of maternal morbidity.
Secondary Outcomes
- Timing of hospital readmission and SMM events(Up to six weeks postpartum)
- SMM type(Up to six weeks postpartum)
- Rate of hospital readmission and SMM events(Up to six weeks postpartum)
- Maternal characteristics(Up to six weeks postpartum)