Overview of maternal morbidity during hospitalization for labor and delivery in the United States: 1993-1997 and 2001-2005.

OBJECTIVE To assess progress toward meeting the U.S. Healthy People 2010 objective of reducing the rate of maternal morbidity at delivery hospitalization by comparing National Hospital Discharge Survey data from two time periods. METHODS Using data from the National Hospital Discharge Survey, we estimated rates of intrapartum morbidity defined by obstetric complications, preexisting medical conditions, and cesarean delivery during 2001-2005 and compared them with rates published for 1993-1997. We calculated and compared the rates for categories of morbidity as well as rates for the summary groups of morbidity. RESULTS Between the two time periods, the rate of obstetric complications remained unchanged at 28.6%; the prevalence of preexisting medical conditions at delivery increased from 4.1% to 4.9%. Rates of chronic hypertension and preeclampsia, gestational and preexisting diabetes, asthma, and postpartum hemorrhage increased, whereas rates of third- and fourth-degree lacerations and various types of infection decreased. The cesarean delivery rate increased from 21.8% to 28.3%. CONCLUSION Between 1993-1997 and 2001-2005, the rate of intrapartum morbidity associated with obstetric complications was unchanged and the rate of pregnancies complicated by preexisting medical conditions increased.