{
  "abstract": "Introduction Severe maternal morbidity (SMM) refers to life-threatening pregnancy-related complications that may have lasting effects on the mother beyond childbirth. Little is known about the impact of SMM on re-hospitalisations in the first year following birth hospitalisation discharge. In this study, we quantified the 1-year risk of maternal re-hospitalisation following birth discharge, comparing SMM-affected to SMM-unaffected individuals.Methods We conducted a population-based cohort study using hospitalisation data for all live births and stillbirths in Canada, excluding Québec, between 2008 and 2020 to individuals aged 16–55 years. SMM was assessed using a validated measure based on diagnostic and procedure codes for a composite of life-threatening diagnoses during pregnancy beginning at 20 weeks’ gestation, during childbirth, or within 42 days following birth hospitalisation discharge. Outcomes were all-cause re-hospitalisation within 42 days of birth hospitalisation discharge and from 43 to 365 days following birth hospitalisation discharge. Log-binomial regression with generalised estimating equations generated unadjusted and adjusted risk ratios (aRRs). We then described causes of re-hospitalisation according to International Classification of Diseases, 10th Revision, Canadian Enhancement chapters, based on the first diagnostic field.Results There were 3 405 716 births in the study, (mean maternal age 30.0 ± 5.5 years and 40% nulliparous), among which 60 260 (1.83%) experienced SMM. Individuals with versus without SMM were more likely to be re-hospitalised within 42 days, with respective rates of 14.6 vs 4.4 per 1000 births (aRR 2.90, 95% CI 2.68 to 3.13). For re-hospitalisation at 43–365 days, respective rates were 62.4 and 29.8 per 1000 births (aRR 1.90, 95% CI 1.84 to 1.96). The most frequent cause of re-hospitalisation in both groups was gallstone disease.Conclusions Individuals who experience SMM are more likely to be re-hospitalised in the first year following birth hospitalisation discharge, highlighting the need for tailored postpartum care to prevent re-hospitalisation.",
  "authors": [
    {
      "affiliations": [
        "Research Institute, McGill University Health Centre, Montreal, Quebec, Canada"
      ],
      "name": "Asia Blackman"
    },
    {
      "affiliations": [
        "Research Institute, McGill University Health Centre, Montreal, Quebec, Canada",
        "Department of Medicine, McGill University, Montreal, Quebec, Canada",
        "Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada"
      ],
      "name": "Ugochinyere Vivian Ukah"
    },
    {
      "affiliations": [
        "Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada"
      ],
      "name": "Robert W Platt"
    },
    {
      "affiliations": [
        "Research Institute, McGill University Health Centre, Montreal, Quebec, Canada",
        "Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada"
      ],
      "name": "Gabriel D Shapiro"
    },
    {
      "affiliations": [
        "Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada"
      ],
      "name": "Sarka Lisonkova"
    },
    {
      "affiliations": [
        "Research Institute, McGill University Health Centre, Montreal, Quebec, Canada",
        "Département de Médecine, Centre Hospitalier Universitaire Ste. Justine, Montreal, Quebec, Canada"
      ],
      "name": "Isabelle Malhamé"
    },
    {
      "affiliations": [
        "Li-Sha-King Institute of Knowledge, St. Michael's Hospital, Toronto, Ontario, Canada"
      ],
      "name": "Joel G Ray"
    },
    {
      "affiliations": [
        "Department of Obstetrics and Gynaecology and Newborn Care, University of Ottawa, Ottawa, Ontario, Canada"
      ],
      "name": "Darine El-Chaâr"
    },
    {
      "affiliations": [
        "Institut national de santé publique de Québec, Montreal, Quebec, Canada"
      ],
      "name": "Nathalie Auger"
    },
    {
      "affiliations": [
        "Research Institute, McGill University Health Centre, Montreal, Quebec, Canada",
        "Department of Medicine, McGill University, Montreal, Quebec, Canada",
        "Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada"
      ],
      "name": "Natalie Dayan"
    }
  ],
  "title": "Severe maternal morbidity and re-hospitalisation in the first postpartum year within Canada, 2008–2020: a population-based retrospective cohort study",
  "uid": "cc2a7c90-449e-50d1-b6f5-7e76b9e39730"
}