{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T02:06:32Z","timestamp":1789178792911,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T00:00:00Z","timestamp":1640736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001665","name":"Agence Nationale de la Recherche","doi-asserted-by":"publisher","award":["ANR\u201010\u2010BLAN\u20101134\u201001"],"award-info":[{"award-number":["ANR\u201010\u2010BLAN\u20101134\u201001"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Severe maternal morbidity (SMM) is a key indicator of maternal health. Generally explored without distinction by the timing of the event, it mainly reflects postpartum SMM. Although antepartum (pre\u2010labour) SMM presents specific challenges in its need to optimise the risk\u2010benefit balance for both mother and foetus, its features remain inadequately explored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We explored risk factors of antepartum SMM and described adverse delivery and neonatal outcomes associated with antepartum SMM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We designed a population\u2010based nested case\u2010control study based on data from the EPIMOMS study (119 maternity hospitals of 6 French regions, 2012\u20132013, <jats:italic>N<\/jats:italic>\u00a0=\u00a0182,309 deliveries in the source cohort). This study included all women with antepartum SMM (cases, <jats:italic>n<\/jats:italic>\u00a0=\u00a0601) compared to a randomly selected sample of women who gave birth without SMM in the same hospitals (controls, <jats:italic>n<\/jats:italic>\u00a0=\u00a03651). Antepartum SMM risk factors were identified with multivariable logistic regression following imputations for missing data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Antepartum SMM complicated 0.33% (95% confidence interval [CI] 0.30, 0.36) of pregnancies. Antepartum SMM risk factors were maternal age \u226535\u00a0years (adjusted odds ratio [OR] 1.55, 95% CI 1.22, 1.97), increased body mass index (OR for 5\u00a0kg\/m<jats:sup>2<\/jats:sup> increase, 1.24, 95% CI 1.14, 1.36), maternal birth in sub\u2010Saharan Africa (OR 1.80, 95% CI 1.29, 2.53), pre\u2010existing medical condition (OR 2.56, 95% CI 1.99, 3.30), nulliparity (OR 2.26, 95% CI 1.83, 2.80), previous pregnancy\u2010related hypertensive disorders (OR 4.94, 95% CI 3.36, 7.26), multiple pregnancy (OR 5.79, 95% CI 3.75, 7.26), irregular prenatal care (OR 1.86, 95% CI 1.27, 2.72). For women with antepartum SMM, preterm delivery, neonatal mortality and transfer to the neonatal intensive care unit were 10 times more frequent than for controls. Emergency caesarean and general anaesthesia were more frequent in women with antepartum SMM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Antepartum SMM is rare but associated with increased rates of adverse delivery and neonatal outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12847","type":"journal-article","created":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T12:57:00Z","timestamp":1640782620000},"page":"171-180","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Antepartum severe maternal morbidity: A population\u2010based study of risk factors and delivery outcomes"],"prefix":"10.1111","volume":"36","author":[{"given":"M\u00e9gane","family":"Raineau","sequence":"first","affiliation":[{"name":"Centre for Epidemiology and Statistics Sorbonne Paris Cit\u00e9 (CRESS) Obstetric Perinatal and Paediatric Epidemiology Research Team EPOP\u00e9 INSERM INRA Paris University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6561-3321","authenticated-orcid":false,"given":"Catherine","family":"Deneux\u2010Tharaux","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology and Statistics Sorbonne Paris Cit\u00e9 (CRESS) Obstetric Perinatal and Paediatric Epidemiology Research Team EPOP\u00e9 INSERM INRA Paris University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lien","family":"Seco","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology and Statistics Sorbonne Paris Cit\u00e9 (CRESS) Obstetric Perinatal and Paediatric Epidemiology Research Team EPOP\u00e9 INSERM INRA Paris University  Paris France"},{"name":"Clinical Research Unit Necker\/Cochin AP\u2010HP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2055-8813","authenticated-orcid":false,"given":"Marie\u2010Pierre","family":"Bonnet","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology and Statistics Sorbonne Paris Cit\u00e9 (CRESS) Obstetric Perinatal and Paediatric Epidemiology Research Team EPOP\u00e9 INSERM INRA Paris University  Paris France"},{"name":"Department of Anaesthesia and Intensive Care Armand Trousseau Hospital Sorbonne University DMU DREAM  Paris France"},{"name":"Group of Clinical Research 29 (GRC 29) Assistance\u2010Publique H\u00f4pitaux de Paris (AP\u2010HP)  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the EPIMOMS Study 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