Don't Go to the Hospital in July? Not True in Obstetrics [ID 1550]

INTRODUCTION: This study aims to determine whether there is an increase in severe maternal morbidity and mortality (SMM) in U.S. teaching hospitals throughout the academic year. METHODS: This was a population-based cohort study of 2015–2021 U.S. delivery hospitalizations from the National Inpatient Sample database. ICD-10 codes were used to identify delivery hospitalizations, maternal characteristics and comorbidities, and primary and secondary outcomes. The primary outcome was the risk of SMM, using Centers for Disease Control and Prevention criteria (excluding transfusion) and maternal mortality by admission quarter (January–March [Jan–Mar] versus April–June [Apr–June] versus July–September [July–Sept] versus October–December [Oct–Dec]) at teaching institutions. Secondary analyses included risk assessment by organ system-based SMM indicators, preventable SMM risk, and selected obstetric outcomes. Adjusted relative risks (aRRs) were estimated using multivariable logistic regression analysis. RESULTS: During the study period, 15,690,250 patients were delivered at teaching hospitals. When compared to July–Sept, there were no statistically significant differences in SMM noted across the academic year (Jan–Mar aRR 1.01 [0.97–1.04], Apr–June aRR 1.03 [0.99–1.07], Oct–Dec aRR 1.00 [0.97–1.04]). Additionally, there were no significant differences of preventable SMM (Jan–Mar aRR 1.01 [0.97–1.05], Apr–June aRR 1.04 [0.99–1.08], Oct–Dec aRR 1.00 [0.96–1.04]) and maternal death (Jan–Mar aRR 0.97 [0.63–1.49], Apr–June aRR 0.89 [0.57–1.37], Oct–Dec aRR 0.86 [0.56–1.31]) across the academic year when compared to July–Sept. There were no differences noted in rates of eclampsia, acute respiratory distress syndrome, or cardiac arrest across the academic year. CONCLUSIONS/IMPLICATIONS: This study reveals no increased risk of SMM, preventable SMM, or mortality when patients are delivered in July at teaching hospitals.