{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:30:07Z","timestamp":1792726207810,"version":"4.5.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>OBJECTIVE:<\/jats:title>\n            <jats:p>To analyze trends in severe maternal morbidity (SMM) and route-specific complications of birth in Illinois hospitals from January 2016 to June 2023.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>This retrospective population-based cohort study analyzed birth admission data from 159 hospitals using the Illinois Hospital Association Comparative Health Care and Hospital Data Reporting Services database from January 2016 to June 2023. Primary outcomes were incidence of SMM and route-specific delivery complications. Secondary outcomes included incidence of chronic and pregnancy-related comorbidities. Poisson regression was used to estimate incidence rate ratios for SMM; logistic regression was used to estimate odds ratios for route-specific birth complications; and model SEs were adjusted for clustering of observations within hospitals.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>In this cohort of 988,480 births, the overall SMM rate was 1.6%; the rate of SMM rose from 1.4% in 2016 to 2.0% in 2023. The rate of SMM was 0.9% for people who underwent vaginal births and 3.2% for people who underwent for cesarean births. Vaginal birth complications (7.3% overall) increased 22.4%, and cesarean birth complications (10.9% overall) increased 48.9%. Hypertensive disorders of pregnancy and anemia, both of which increased over the study period, were significant risk factors for SMM and birth complications. Over the study period, there were also increases in International Classification of Diseases, Tenth Revision\u2013coded gestational diabetes (4.2\u20135.5%), depression (2.5\u20136.6%), anxiety (3.1\u201310.4%), and other chronic comorbidities (4.7\u20137.4%). Non-Hispanic Black patients had more than double the SMM rate (2.6%) compared with non-Hispanic White patients (1.1%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION:<\/jats:title>\n            <jats:p>From 2016 to 2023, the rates of SMM and birth complications in Illinois increased alongside increases in coding for chronic and prepregnancy and pregnancy-related comorbidities. This study demonstrates the burden of cesarean birth\u2013associated adverse outcomes, including a higher rate of SMM, which increased over the study period.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/og9.0000000000000046","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T22:10:47Z","timestamp":1732227047000},"page":"046","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Trends in Severe Maternal Morbidity, Obstetric Comorbidities, and Birth Complications in Illinois"],"prefix":"10.1097","volume":"1","author":[{"given":"Mugdha","family":"Mokashi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Yee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Feinglass","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,12]]},"reference":[{"key":"R1-20241122","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/AOG.0000000000004183","article-title":"Statewide severe maternal morbidity review in Illinois","volume":"137","author":"Geller","year":"2021","journal-title":"Obstet Gynecol"},{"key":"R3-20241122","doi-asserted-by":"crossref","first-page":"e025050","DOI":"10.1161\/JAHA.121.025050","article-title":"Temporal trends in adverse pregnancy outcomes in birthing individuals aged 15 to 44 Years in the United States, 2007 to 2019","volume":"11","author":"Freaney","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"R4-20241122","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1001\/jama.2021.7217","article-title":"Trends in gestational diabetes at first live birth by race and ethnicity in the US, 2011-2019","volume":"326","author":"Shah","year":"2021","journal-title":"JAMA"},{"key":"R5-20241122","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1111\/1471-0528.17587","article-title":"Rural\u2013urban disparities in pregestational and gestational diabetes in pregnancy: serial, cross-sectional analysis of over 12 million pregnancies","volume":"131","author":"Venkatesh","year":"2024","journal-title":"BJOG Int J Obstet Gynaecol"},{"key":"R6-20241122","doi-asserted-by":"crossref","first-page":"e023791","DOI":"10.1161\/JAHA.121.023791","article-title":"Trends in the incidence of new-onset hypertensive disorders of pregnancy among rural and urban Areas in the United States, 2007 to 2019","volume":"11","author":"Cameron","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"R7-20241122","doi-asserted-by":"crossref","first-page":"E2228093","DOI":"10.1001\/jamanetworkopen.2022.28093","article-title":"Association of birth year of pregnant individuals with trends in hypertensive disorders of pregnancy in the United States, 1995-2019","volume":"5","author":"Cameron","year":"2022","journal-title":"JAMA Netw Open"},{"key":"R8-20241122","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1089\/jwh.2020.8821","article-title":"Trends and risk markers for severe maternal morbidity and other obstetric complications","volume":"30","author":"Oot","year":"2021","journal-title":"J Womens Health"},{"key":"R11-20241122","doi-asserted-by":"crossref","first-page":"S606","DOI":"10.1016\/j.ajog.2022.11.1028","article-title":"Early improvement in implementing key birth equity strategies in a statewide quality improvement effort","volume":"228","author":"Lee King","year":"2023","journal-title":"Am J Obstet Gynecol"},{"key":"R12-20241122","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.clp.2020.08.009","article-title":"Advances in maternal fetal medicine: perinatal quality collaboratives working together to improve maternal outcomes","volume":"47","author":"Lee King","year":"2020","journal-title":"Clin Perinatol"},{"key":"R14-20241122","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1001\/jama.2009.1356","article-title":"Evaluating obstetrical residency programs using patient outcomes","volume":"302","author":"Asch","year":"2009","journal-title":"JAMA"},{"key":"R15-20241122","doi-asserted-by":"crossref","first-page":"e108","DOI":"10.1097\/AOG.0000000000001151","article-title":"Limitations of perineal lacerations as an obstetric quality measure. 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