{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:55:24Z","timestamp":1790265324089,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T00:00:00Z","timestamp":1560988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study utilized the Dr. Foster Global Comparators database to identify pregnancy complications and associated risk factors that led to severe maternal morbidity during delivery hospitalisations in large university hospitals based in the USA, Australia, and England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Births in the USA, England and Australia from 2008 to 2013.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sample<\/jats:title>\n                    <jats:p>Data from delivery hospitalisations between 2008 and 2013 were examined using the Dr. Foster Global Comparators database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified delivery hospitalisations with life\u2010threatening diagnoses or use of life\u2010saving procedures, using algorithms for severe maternal morbidity from the Center for Disease Control. Frequency of severe maternal morbidity was calculated for each country.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Multivariable analysis was used to examine the association between morbidity and socio\u2010demographic and clinical characteristics within each country. Chi\u2010square tests assessed differences in covariates between countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 2008 to 2013, there were 516\u00a0781 deliveries from a total of 18 hospitals: 24.5% from the USA, 57.0% from England and 18.4% from Australia. Overall severe maternal morbidity rate was 8.2 per 1000 deliveries: 15.6 in the USA, 5.0 in England, and 8.2 in Australia. The most common codes identifying severe morbidity included transfusion, disseminated intravascular coagulation, acute renal failure, cardiac events\/procedures, ventilation, hysterectomy, and eclampsia. Advanced maternal age, hypertension, diabetes, and substance abuse were associated with severe maternal morbidity in all three countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Rates of severe maternal morbidity differed by country. Identification of geographical, socio\u2010demographic, and clinical differences can help target modifications of practice and potentially reduce severe maternal morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Tweetable abstract<\/jats:title>\n                    <jats:p>Rates of severe maternal morbidity vary, but risk factors associated with adverse outcomes are similar in developed countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.15818","type":"journal-article","created":{"date-parts":[[2019,5,17]],"date-time":"2019-05-17T12:14:49Z","timestamp":1558095289000},"page":"1223-1230","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Severe maternal morbidity during delivery hospitalisation in a large international administrative database, 2008\u20132013: a retrospective cohort"],"prefix":"10.1111","volume":"126","author":[{"given":"HS","family":"Lipkind","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LC","family":"Zuckerwise","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Vanderbilt University Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EB","family":"Turner","sequence":"additional","affiliation":[{"name":"Dr Foster \u2013 Global Comparators Ltd London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JJ","family":"Collins","sequence":"additional","affiliation":[{"name":"Institute of Psychology, Psychiatry and Neuroscience King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KH","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"UM","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JL","family":"Illuzi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AA","family":"Merriam","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(87)90423-5"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(85)90188-6"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69380-X"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31470-2"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31826d60c5"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.12.020"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181954e5b"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12624"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12074"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002307"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.16191"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2017.07.007"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000187894.71913.e8"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-014-3352-z"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2013.4617"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.04.004"},{"key":"e_1_2_7_18_1","unstructured":"NHS Connecting for Health.Clinical coding Instruction manual OPCS\u20104.6. 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