Original Article
Journal of Perinatology (2006) 26, 79–84. doi:10.1038/sj.jp.7211432; published online 12 January 2006
A descriptive model of preventability in maternal morbidity and mortality
Funding from the Centers for Disease Control and Prevention and the Association of Schools of Public Health 'Investigation of Factors Associated with Maternal Mortality' (S1069/19–20)
S E Geller1, S M Cox2 and S J Kilpatrick1
- 1Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
- 2Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
Correspondence: Dr SE Geller, Department of Obstetrics and Gynecology (m/c 808), University of Illinois at Chicago, 820 S. Wood St., Chicago, IL 60612, USA. E-mail: sgeller@uic.edu
Received 27 June 2005; Revised 3 November 2005; Accepted 7 November 2005; Published online 12 January 2006.
Abstract
Objective:
To develop a descriptive model of preventability for maternal morbidity and mortality that can be used in quality assurance and morbidity and mortality review processes.
Study Design:
This descriptive study was part of a larger case–control study conducted at the University of Illinois at Chicago in which maternal deaths were cases and women with severe maternal morbidity served as controls. Morbidities and mortalities were classified by a team of clinicians as preventable or not preventable. Qualitative analysis of data was conducted to identify and categorize different types of preventable events.
Results:
Of 237 women, there were 79 women with preventable events attributable to provider or system factors. The most common types of preventable events were inadequate diagnosis/recognition of high-risk (54.4%), treatment (38.0%), and documentation (30.7%).
Conclusions:
A descriptive model was illustrated that can be used to categorize preventable events in maternal morbidity and mortality and can be incorporated into quality assurance and clinical case review to enhance the monitoring of hospital-based obstetric care and to decrease medical error.
Keywords:
maternal mortality, maternal morbidity, preventability, pregnancy complications
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