{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:56:33Z","timestamp":1765727793755,"version":"3.37.3"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,5,5]],"date-time":"2015-05-05T00:00:00Z","timestamp":1430784000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Prevention and Treatment of Postpartum Hemorrhage Program"},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"crossref","award":["2010FZ0078"],"award-info":[{"award-number":["2010FZ0078"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Scientific Research Fund of Sichuan Provincial Education Department","award":["132130320"],"award-info":[{"award-number":["132130320"]}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the incidence of severe maternal morbidities (<jats:styled-content style=\"fixed-case\">SMM<\/jats:styled-content>) in China and explore effects of medical co\u2010morbidities on <jats:styled-content style=\"fixed-case\">SMM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Proactive multicenter clinic register collaboration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Data on all deliveries at eight hospitals in Sichuan province, China, collected from 1 January 2009 to 12 December 2010.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>33\u00a0993 delivering women and 34\u00a0547 live births.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We defined <jats:styled-content style=\"fixed-case\">SMM<\/jats:styled-content> as a combination indicator of severe maternal complications, critical interventions, admission to the intensive care unit and maternal near\u2010miss instances. We randomly selected 80% of the data from the entire database to build a logistic regression model. The remaining 20% were used to test the predictive power of the model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">SMM<\/jats:styled-content> incidence, adjusted odds ratios (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>s), and area under a receiver operating characteristic (<jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>) curve.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Severe maternal morbidities incidence was 43.4\/1000 live births [confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 41.24\u201345.56]. Fifteen variables were independent contributors to the model. Seven medical co\u2010morbidities significantly affected the occurrence of <jats:styled-content style=\"fixed-case\">SMM<\/jats:styled-content>, including iron\u2010deficiency anemia (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 3.07, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.47\u20133.83) and other hematological diseases (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 5.82, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 3.50\u20139.69), hepatitis\u2010B virus infection (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 1.48, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.12\u20131.97) and other hepatic diseases (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 3.81, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.61\u20139.04), cardiopathy (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 3.59, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.62\u20134.93), hypertension (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 5.23, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 4.06\u20136.75), and respiratory diseases (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 2.10, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.25\u20133.52). The area under the <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content> curve was 0.8127.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incidence of <jats:styled-content style=\"fixed-case\">SMM<\/jats:styled-content> was typical of a low resource area. There is a need to identify medical co\u2010morbidities and to adopt prophylactic measures and interventions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12657","type":"journal-article","created":{"date-parts":[[2015,4,17]],"date-time":"2015-04-17T11:42:51Z","timestamp":1429270971000},"page":"861-868","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effects of medical co\u2010morbidities on severe maternal morbidities in China: a multicenter clinic register study"],"prefix":"10.1111","volume":"94","author":[{"given":"Jing","family":"Tan","sequence":"first","affiliation":[{"name":"Chinese Evidence\u2010based Medicine Center West China Hospital Sichuan University Chengdu China"},{"name":"Chengdu University of Traditional Chinese Medicine Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xing\u2010Hui","family":"Liu","sequence":"additional","affiliation":[{"name":"West China Women's and Children's Hospital Sichuan University Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuan","family":"Yu","sequence":"additional","affiliation":[{"name":"Chinese Evidence\u2010based Medicine Center West China Hospital Sichuan University Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng","family":"Chen","sequence":"additional","affiliation":[{"name":"West China Women's and Children's Hospital Sichuan University Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao\u2010Fan","family":"Chen","sequence":"additional","affiliation":[{"name":"Chinese Evidence\u2010based Medicine Center West China Hospital Sichuan University Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Sun","sequence":"additional","affiliation":[{"name":"Chinese Evidence\u2010based Medicine Center West China Hospital Sichuan University Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"You\u2010Ping","family":"Li","sequence":"additional","affiliation":[{"name":"Chinese Evidence\u2010based Medicine Center West China Hospital Sichuan University Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,5,5]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"10 facts in maternal health.World Health Organization;2014. 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