Obstetric admissions to intensive care units in Australia and New Zealand: a registry-based cohort study

BJOG. 2020 Nov;127(12):1558-1567. doi: 10.1111/1471-0528.16285. Epub 2020 May 31.

Abstract

Objective: Describe the epidemiology of obstetric patients admitted to an Intensive Care Unit (ICU).

Design: Registry-based cohort study.

Setting: One hundred and eighty-three ICUs in Australia and New Zealand.

Population: Women aged 15-49 years, admitted to ICU between 2008 and 2017, classified as pregnant, postpartum or with an obstetric-related diagnosis.

Methods: Data were extracted from the Australia and New Zealand Intensive Care Society (ANZICS) Adult Patient Database and national agencies.

Main outcome measures: Incidence of ICU admission, cohort characteristics, maternal outcomes and changes over time.

Results: The cohort comprised 16 063 patients. The annual number of obstetric ICU admissions increased, whereas their proportion of total ICU admissions (1.3%) did not change (odds ratio 1.02, 95% CI 0.99-1.04, P = 0.14). There were 10 518 (65%) with an obstetric-related ICU diagnosis, and 5545 (35%) with a non-obstetric ICU diagnosis. Mean (SD) age was 31 (6.4) years, 1463 (9.1%) were Indigenous, 2305 (14%) were transferred from another hospital, and 3008 (19%) received mechanical ventilation. Median [IQR] length of stay in hospital was 5.2 [3.1-7.9] days, which included 1.1 [0.7-1.8] days in ICU. There were 108 (0.7%) maternal deaths, most (n = 97, 90%) having a non-obstetric diagnosis. There was no change in risk-adjusted length of stay or mortality over time.

Conclusions: Obstetric patients account for a stable proportion of ICU admissions in Australia and New Zealand. These patients typically have a short length of ICU stay and low hospital mortality.

Tweetable abstract: Obstetric patients in Australia/New Zealand ICUs have a short length of ICU stay and low mortality.

Keywords: Critical illness; obstetrics; outcomes; postpartum; pregnancy.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Australia / epidemiology
  • Cohort Studies
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Middle Aged
  • New Zealand / epidemiology
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Registries
  • Young Adult