American Journal of Obstetrics & Gynecology
Volume 191, Issue 3 , Pages 939-944, September 2004

The continuum of maternal morbidity and mortality: Factors associated with severity

  • Stacie E. Geller, PhD

      Affiliations

    • Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, and
    • Corresponding Author InformationReprint requests: Stacie E. Geller, PhD, Department of Obstetrics and Gynecology (m/c 808), University of Illinois at Chicago, 820 S Wood St, Chicago, IL 60612.
    • ,
  • Deborah Rosenberg, PhD

      Affiliations

    • Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Ill
    • ,
  • Suzanne M. Cox, MPH

      Affiliations

    • Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, and
    • ,
  • Monique L. Brown, MD, MBA

      Affiliations

    • Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, and
    • ,
  • Louise Simonson, MS, NP

      Affiliations

    • Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, and
    • ,
  • Catherine A. Driscoll, RN, BSN

      Affiliations

    • Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, and
    • ,
  • Sarah J. Kilpatrick, MD, PhD

      Affiliations

    • Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, and

Received 23 February 2004; received in revised form 11 May 2004; accepted 24 May 2004.

Objective

The goal of this study was to examine whether sociodemographic, clinical, and other service-related factors, as well as preventability issues affect a woman's progression along the continuum of morbidity and mortality.

Study design

This was a case-control study of pregnancy-related deaths, women with near-miss morbidity, and those with other severe, but not life threatening, morbidity. Factors associated with maternal outcome were examined.

Results

Provider factors (related to preventability) and clinical diagnosis were significantly associated with progression along the continuum after controlling for sociodemographic characteristics (P < .01 for both associations).

Conclusion

In order to improve mortality rates, we must understand maternal morbidity and how it may lead to death. This study shows that important initiatives include addressing preventability, in particular, provider factors, which may play a role in moving women along the continuum of morbidity and mortality.

Key words: Maternal mortality, Maternal morbidity, Preventability, Pregnancy complications

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 30.00 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

 Presented at the Twenty-Fourth Annual Meeting of the Society for Maternal Fetal Medicine, February 2-7, 2004, New Orleans, La.

 Funding from the Centers for Disease Control and Prevention and the Association of Schools of Public Health “Investigation of Factors Associated with Maternal Mortality” (S1069/19-20).

PII: S0002-9378(04)00902-0

doi:10.1016/j.ajog.2004.05.099

American Journal of Obstetrics & Gynecology
Volume 191, Issue 3 , Pages 939-944, September 2004

Article Tools

* Image Usage & Resolution