{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T10:18:52Z","timestamp":1778494732143,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T00:00:00Z","timestamp":1704758400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To (1) determine associations between maternal risk conditions and severe adverse outcomes that may benefit from risk-appropriate care and (2) assess whether associations between risk conditions and outcomes vary by level of maternal care (LoMC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We used the 2017\u20132019 National Inpatient Sample (NIS) to calculate associations between maternal risk conditions and severe adverse outcomes. Risk conditions included severe preeclampsia, placenta accreta spectrum (PAS) conditions, and cardiac conditions. Outcomes included disseminated intravascular coagulation (DIC) with blood products transfusion or shock, pulmonary edema or acute respiratory distress syndrome (ARDS), stroke, acute renal failure, and a composite cardiac outcome. Then we used 2019 delivery hospitalization data from five states linked to hospital LoMC. We calculated associations between risk conditions and outcomes overall and stratified by LoMC and assessed for effect modification by LoMC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We found positive measures of association between risk conditions and outcomes. Among patients with severe preeclampsia or PAS, the magnitudes of the associations with DIC with blood products transfusion or shock, pulmonary edema or ARDS, and acute renal failure were lower in Level III\/IV compared with &lt;Level III facilities. Among patients with cardiac conditions, the magnitudes of the associations with these outcomes, along with stroke, were also lower in Level III\/IV compared with &lt;Level III facilities. The proportion of patients with risk conditions that delivered in &lt;Level III facilities was 19.8\u201346.8%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Odds of severe adverse outcomes among women with selected risk conditions were lower for births occurring at higher-level facilities, supporting the benefit of risk-appropriate care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jwh.2024.0547","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T07:59:28Z","timestamp":1729843168000},"page":"51-59","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Maternal Risk Conditions and Outcomes by Levels of Maternal Care"],"prefix":"10.1177","volume":"34","author":[{"given":"Carla L.","family":"DeSisto","sequence":"first","affiliation":[{"name":"Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander C.","family":"Ewing","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hafsatou","family":"Diop","sequence":"additional","affiliation":[{"name":"Division of MCH Research and Analysis, Massachusetts Department of Public Health, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Rae","family":"Easter","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Harvey","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."},{"name":"Division of Family Health and Wellness, Tennessee Department of Health, Nashville, Tennessee, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debra J.","family":"Kane","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."},{"name":"Iowa Department of Health and Human Services, Division of Community Access, Wellness and Prevention Branch, Bureau of Family Health, Des Moines, Iowa, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Naiman-Sessions","sequence":"additional","affiliation":[{"name":"Early Childhood and Family Support Division, Montana Department of Public Health and Human Services, Helena, Montana, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Godwin","family":"Osei-Poku","sequence":"additional","affiliation":[{"name":"Betsy Lehman Center for Patient Safety, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie","family":"Riley","sequence":"additional","affiliation":[{"name":"West Virginia Perinatal Partnership, Charleston, West Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgit","family":"Shanholtzer","sequence":"additional","affiliation":[{"name":"West Virginia Health Statistics Center, Charleston, West Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Audrey M.","family":"Stach","sequence":"additional","affiliation":[{"name":"Division of Family Health and Wellness, Tennessee Department of Health, Nashville, Tennessee, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramya","family":"Dronamraju","sequence":"additional","affiliation":[{"name":"Maternal and Infant Health, Association of State and Territorial Health Officials, Arlington, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Catalano","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2046-0472","authenticated-orcid":false,"given":"Elizabeth A.","family":"Clark","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina A.","family":"Madni","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7181-6758","authenticated-orcid":false,"given":"Lindsay S.","family":"Womack","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena V.","family":"Kuklina","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Goodman","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah 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