AHRQ Report Details Sharp Increase in Severe Complications Among Women Giving Birth in Hospitals

A new AHRQ report shows that the rate of severe complications in women giving birth increased 45 percent in U.S. hospitals between 2006 and 2015. The factors most commonly associated with severe maternal morbidity in 2015 were blood transfusions, disseminated intravascular coagulation and hysterectomy. For example, nearly 80 percent of women with a severe complication in delivery had a blood transfusion. The new report, based on statistics from AHRQ’s Healthcare Cost and Utilization Project, also provides data on racial and ethnic disparities. Compared with white women, severe maternal morbidity was 110 percent more likely among black women, 40 percent more likely among Hispanic women and 20 percent more likely among Asian/Pacific Islander women in 2015. For more information, access the report, AHRQ’s press release and an infographic.

Trends and Disparities in Delivery Hospitalizations Involving Severe Maternal Morbidity, 2006-2015

Kathryn R. Fingar, Ph.D., M.P.H., Megan M, Hambrick, M.S.W., Kevin C. Heslin, Ph.D., and Jennifer E. Moore, Ph.D., R.N.

Highlights

The rate of severe maternal morbidity at delivery—as defined by 21 conditions and procedures–increased 45 percent from 2006 through 2015, from 101.3 to 146.6 per 10,000 delivery hospitalizations.

The most common indicators of severe maternal morbidity were blood transfusion, disseminated intravascular coagulation (DIC), and hysterectomy (in 2015, 121.1, 11.0, and 11.0 deliveries per 10,000, respectively.)

Some conditions often involved procedural intervention. In 2015, over half of deliveries with shock, amniotic fluid embolism, sickle cell disease with crisis, and DIC had a blood transfusion; one-third of deliveries with shock had a hysterectomy.

Severe maternal morbidity was highest among women aged 40+ years and lowest for those aged 20-29 years (248 and 136 per 10,000 deliveries, respectively).

On average Black mothers were younger than White mothers. Yet the rate of severe maternal morbidity was 112-115 percent higher for Blacks than for Whites in 2006 (164 vs. 76) and 2015 (241 vs. 114), with no change in the Black-White disparity.

Hispanics and Asian/Pacific Islanders also had higher rates of severe maternal morbidity than Whites in both years, but disparities decreased over time.

Although deaths decreased for all races/ethnicities, in-hospital mortality was 3 times higher for Blacks than for Whites in 2015 (11 vs. 4 per 100,000 deliveries).