Severe maternal morbidity and related hospital quality measures in Maryland

Lawrence D. Reid, Andreea Creanga

Research output: Contribution to journalArticlepeer-review


Objective: To determine hospital characteristics and quality metrics associated with severe maternal morbidity (SMM) in Maryland. Study Design: A population-based observational study of 364,113 statewide delivery hospitalizations during 2010–2015 linked with socio-economic community measures and hospital characteristics and quality measures. Multivariable logistic regression models with generalized estimating equations estimated SMM adjusting for individual, community, and hospital-level factors and clustering within hospitals and residence zip codes. Results: The SMM prevalence was 197 per 10,000 deliveries. Adjusted SMM risk ratios were higher for younger (<20 years), older (35+ years), non-White non-Hispanic, unmarried, multiple substance users, women with multiple gestations, and chronic medical and mental health conditions than their counterparts. Communities with greater socio-economic disadvantage and hospitals with poorer patient experience and clinical care quality had higher rates of SMM. Conclusion: Addressing socio-economic disparities and improving quality of care in delivery hospitals are key to reducing the SMM burden in Maryland.

Original languageEnglish (US)
Pages (from-to)1-12
Number of pages12
JournalJournal of Perinatology
StateAccepted/In press - Mar 28 2018

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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