A review of the preventability of maternal mortality in one hospital system in Louisiana, USA

作者：Morong James J^*; Martin Jane K; Ware Robert S; Robichaux Alfred G III

来源：International Journal of Gynecology & Obstetrics, 2017, 136(3): 344-349.

DOI：10.1002/ijgo.12074

• Death
• Louisiana
• Maternal mortality
• Maternal mortality ratio
• Preventability
• USA

Objective: To determine preventability of in-hospital maternal mortality in the Ochsner Health System (OHS) in the US state of Louisiana.
Methods: A retrospective study was undertaken of all known cases of in-hospital maternal death (during pregnancy or within 42 days of termination) that occurred within OHS facilities in 1995-2013. Associations between characteristics and mortality and preventability were investigated. Incidence rate ratios (IRRs) were calculated in view of varying reference values.
Results: Among 16 eligible deaths, 12 (75%) were deemed potentially preventable. The incidences of overall and preventable maternal death were higher if the patient had late entry to prenatal care (IRR 6.3 [P=0.004] and 8.8 [P=0.004], respectively). Maternal mortality was increased if the patient had required transfer to the OHS (IRR 15.8 [P<0.001] overall and 15.8 [P=0.002] for preventable mortality). Deaths of patients with private insurance were more likely to be not preventable than were those of patients without such insurance (P=0.003). Uninsured patients had the highest MMR, with an IRR of 13.8 (P=0.014) when compared with Medicaid patients.
Conclusion: The factors most predictive of mortality were late entry to prenatal care, critical status requiring transfer from an outside facility, and non-private insurance status.

• 出版日期2017-3