Severe Maternal Morbidity and Mental Health Readmissions: A National Analysis of U.S. Deliveries, 2018–2022
Abstract
Background: Maternal mental health diagnoses are the leading cause of pregnancy-related death in the U.S. Severe maternal morbidity (SMM), defined as unexpected outcomes of labor and delivery resulting in significant short- or long-term health consequences, includes 21 physical indicators, but excludes mental health diagnoses. Single state studies have shown an SMM diagnosis during delivery is associated with increased risk for readmission for a mental health disorder, but national-level studies have not been conducted. Methods: The National Readmissions Database (NRD) was used to identify deliveries occurring between January and September (to allow for 90-day readmission window) from 2018-2022 (N=7,205,813). ICD-10 codes were used to determine SMM and mental health diagnoses. Covariates included maternal age, mode of delivery, length of stay, insurance payer, and patient residence, at time of delivery. Frequencies and weighted percentages were used to describe the study population. Chi square tests and logistic regression models were used to determine associations and assess the relationship between SMM at delivery and 90-day readmission for a mental health disorder, respectively. Analyses were conducted using SAS 9.4. Results: Nearly 65,000 individuals (0.89%) had SMM and 39,762 (0.58%) were readmitted for mental health reasons within 90 days of delivery. After controlling for covariates, those with SMM had 2.4 times higher odds of being readmitted for a mental health reason within 90 days of delivery compared to individuals without SMM (aOR=2.41; 95% CI: 2.28 – 2.55; p<0.001). Discussion: At the national level, SMM at delivery was associated with higher odds of readmission for a mental health reason within 90 days of delivery, aligning with previous state-level research. However, the lack of race/ethnicity data in the NRD should be noted as a limitation, and future studies should account for additional potential confounding variables, such as mental health diagnoses prior to delivery and social determinants of health.
Start Time
15-4-2026 1:30 PM
End Time
15-4-2026 4:30 PM
Room Number
Culp Ballroom 316
Poster Number
32
Presentation Type
Poster
Presentation Subtype
Posters - Competitive
Presentation Category
Health
Student Type
Undergraduate Student
Faculty Mentor
Melissa White-Archer
Severe Maternal Morbidity and Mental Health Readmissions: A National Analysis of U.S. Deliveries, 2018–2022
Culp Ballroom 316
Background: Maternal mental health diagnoses are the leading cause of pregnancy-related death in the U.S. Severe maternal morbidity (SMM), defined as unexpected outcomes of labor and delivery resulting in significant short- or long-term health consequences, includes 21 physical indicators, but excludes mental health diagnoses. Single state studies have shown an SMM diagnosis during delivery is associated with increased risk for readmission for a mental health disorder, but national-level studies have not been conducted. Methods: The National Readmissions Database (NRD) was used to identify deliveries occurring between January and September (to allow for 90-day readmission window) from 2018-2022 (N=7,205,813). ICD-10 codes were used to determine SMM and mental health diagnoses. Covariates included maternal age, mode of delivery, length of stay, insurance payer, and patient residence, at time of delivery. Frequencies and weighted percentages were used to describe the study population. Chi square tests and logistic regression models were used to determine associations and assess the relationship between SMM at delivery and 90-day readmission for a mental health disorder, respectively. Analyses were conducted using SAS 9.4. Results: Nearly 65,000 individuals (0.89%) had SMM and 39,762 (0.58%) were readmitted for mental health reasons within 90 days of delivery. After controlling for covariates, those with SMM had 2.4 times higher odds of being readmitted for a mental health reason within 90 days of delivery compared to individuals without SMM (aOR=2.41; 95% CI: 2.28 – 2.55; p<0.001). Discussion: At the national level, SMM at delivery was associated with higher odds of readmission for a mental health reason within 90 days of delivery, aligning with previous state-level research. However, the lack of race/ethnicity data in the NRD should be noted as a limitation, and future studies should account for additional potential confounding variables, such as mental health diagnoses prior to delivery and social determinants of health.
