• Carla L DeSisto, Alexander C Ewing, Hafsatou Diop, Sarah Rae Easter, Elizabeth Harvey, Debra J Kane, Miriam Naiman-Sessions, Godwin Osei-Poku, Melanie Riley, Birgit Shanholtzer, Audrey M Stach, Ramya Dronamraju, Andrea Catalano, Elizabeth A Clark, Sabrina A Madni, Lindsay S Womack, Elena V Kuklina, David A Goodman, Sarah J Kilpatrick, and M Kathryn Menard.
• Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
• J Womens Health (Larchmt). 2024 Oct 25.

AbstractObjectives: To (1) determine associations between maternal risk conditions and severe adverse outcomes that may benefit from risk-appropriate care and (2) assess whether associations between risk conditions and outcomes vary by level of maternal care (LoMC). Methods: We used the 2017-2019 National Inpatient Sample (NIS) to calculate associations between maternal risk conditions and severe adverse outcomes. Risk conditions included severe preeclampsia, placenta accreta spectrum (PAS) conditions, and cardiac conditions. Outcomes included disseminated intravascular coagulation (DIC) with blood products transfusion or shock, pulmonary edema or acute respiratory distress syndrome (ARDS), stroke, acute renal failure, and a composite cardiac outcome. Then we used 2019 delivery hospitalization data from five states linked to hospital LoMC. We calculated associations between risk conditions and outcomes overall and stratified by LoMC and assessed for effect modification by LoMC. Results: We found positive measures of association between risk conditions and outcomes. Among patients with severe preeclampsia or PAS, the magnitudes of the associations with DIC with blood products transfusion or shock, pulmonary edema or ARDS, and acute renal failure were lower in Level III/IV compared with

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