Most studies of severe maternal morbidity (SMM) include only cases that occur during birth hospitalizations. We examined the increase in cases when including SMM during antenatal and postpartum (within 42 days of discharge) hospitalizations, using longitudinally linked data from 1,010,250 births in California from September 1, 2016, to December 31, 2018. For total SMM, expanding the definition resulted in 22.8% more cases; for nontransfusion SMM, 45.1% more cases were added. Sepsis accounted for 55.5% of the additional cases. The increase varied for specific indicators, for example, less than 2% for amniotic fluid embolism, 7.0% for transfusion, 112.9% for sepsis, and 155.6% for acute myocardial infarction. These findings reiterate the importance of considering SMM beyond just the birth hospitalization and facilitating access to longitudinally linked data to facilitate a more complete understanding of SMM.

大多数关于严重孕产妇发病率 (SMM) 的研究仅包括分娩住院期间发生的病例。我们使用 2016 年 9 月 1 日至 2018 年 12 月 31 日期间加利福尼亚州 1,010,250 名新生儿的纵向关联数据，研究了产前和产后（出院 42 天内）住院期间 SMM 病例的增加情况。对于总 SMM，扩大了定义导致病例增加 22.8%；对于非输血 SMM，增加了 45.1% 的病例。脓毒症占新增病例的 55.5%。具体指标的增幅有所不同，例如羊水栓塞的增幅不到2%，输血的增幅为7.0%，脓毒症的增幅为112.9%，急性心肌梗塞的增幅为155.6%。这些发现重申了考虑 SMM 的重要性，而不仅仅是分娩住院治疗，并促进获取纵向关联数据，以促进更全面地了解 SMM。