Using a cohort study design, we analysed 17 diagnoses and 9 interventions (including critical care admission) as a composite measure of severe maternal morbidity for pregnancies recorded over 14 years in Scotland. There were 762,918 pregnancies, of which 7947 (10 in 1000 pregnancies) recorded 9345 severe maternal morbidity events, 2802 episodes of puerperal sepsis being the most common (30%). Severe maternal morbidity incidence increased from 9 in 1000 pregnancies in 2012 to 17 in 1000 pregnancies in 2018, due in part to puerperal sepsis recording. The odds ratio (95%CI) for severe maternal morbidity was higher for: older women, for instance 1.22 (1.13–1.33) for women aged 35–39 years and 1.44 (1.27–1.63) for women aged > 40 years compared with those aged 25–29 years; obese women, for instance 1.13 (1.06–1.21) for BMI 30–40 kg.m^-2 and 1.32 (1.15–1.51) for BMI > 40 kg.m^-2 compared with BMI 18.5–24.9 kg.m^-2; multiple pregnancy, 2.39 (2.09–2.74); and previous caesarean delivery, 1.52 (1.40–1.65). The median (IQR [range]) hospital stay was 3 (2–5 [1–8]) days with severe maternal morbidity and 2 (1–3 [1–5]) days without. Forty-one women died during pregnancy or up to 42 days after delivery, representing mortality rates per 100,000 pregnancies of about 365 with severe maternal morbidity and 1.6 without. There were 1449 women admitted to critical care, 807 (58%) for mechanical ventilation or support of at least two organs. We recorded an incidence of severe maternal morbidity higher than previously published, possibly because sepsis was coded inaccurately in our databases. Further research may determine the value of this composite measure of severe maternal morbidity.

中文翻译：

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苏格兰严重的孕产妇发病率

我们采用队列研究设计，分析了 17 项诊断和 9 项干预措施（包括重症监护入院），作为苏格兰 14 年来记录的严重孕产妇发病率的综合衡量标准。共有 762,918 例妊娠，其中 7947 例（每 1000 例妊娠中有 10 例）记录了 9345 例严重孕产妇发病事件，其中最常见的是 2802 例产后败血症 (30%)。严重孕产妇发病率从 2012 年的每 1000 名孕妇中有 9 例增加到 2018 年的每 1000 名孕妇中有 17 例，部分原因是产后败血症记录。严重孕产妇发病率 (95%CI) 较高：老年女性，例如 35-39 岁女性为 1.22 (1.13-1.33)，40 岁以上女性为 1.44 (1.27-1.63)年龄25-29岁；肥胖女性，例如，BMI 30-40 kg.m ^{-2为 1.13 (1.06-1.21)，BMI > 40 kg.m -2}为 1.32 (1.15-1.51)，与 BMI 18.5-24.9 kg.m ^-2相比；多胎妊娠，2.39 (2.09–2.74)；和之前的剖腹产手术相比，为 1.52 (1.40–1.65)。严重孕产妇发病的中位住院时间（IQR [范围]）为 3 (2–5 [1–8]) 天，无严重孕产妇发病的中位住院时间为 2 (1–3 [1–5]) 天。41 名妇女在怀孕期间或产后 42 天内死亡，每 100,000 名孕妇的死亡率约为 365 名患有严重孕产妇疾病的妇女和 1.6 名没有严重孕产妇疾病的妇女。有 1,449 名女性接受重症监护，其中 807 名（58%）接受机械通气或至少两个器官支持。我们记录的严重孕产妇发病率高于之前发布的数据，可能是因为我们的数据库中脓毒症的编码不准确。进一步的研究可能会确定这种严重孕产妇发病率综合衡量指标的价值。