(1176) Risk factors associated with intensive care unit admission during the Peripartum period: A retrospective study

The aim of this study was to identify risk factors associated with peripartum admission to intensive care unit (ICU) including baseline characteristics, pregnancy data, and delivery outcomes.

Study Design:

This was a retrospective cohort study. Study group consisted of all patients admitted to the ICU during the peripartum period between January 2011 and January 2022. A control group included individuals who delivered at the same medical center during the specified time frame. We matched each study case with five control cases according to medical staff and delivery day. Baseline characteristics, pregnancy and delivery outcomes were compared between the two groups. Additionally, we analyzed the indications for ICU admission. Nonparametric statistics were applied for analysis.

Results:

A total of 113 patients were admitted to the ICU, which accounted for 0.1% of all births at our medical center during the same period. The controls consisted of 565 individuals. The median maternal age was significantly higher in the ICU group than in the control group. Patients admitted to the ICU had a significantly lower rate of spontaneous conception and higher rates of multifetal gestation, hypertensive diseases, preterm labor (PTL), and Cesarean sections (CS) (Table). 
Neonates born to patients admitted to the ICU tended to have a lower median birth weight and a longer hospitalization period, with higher rates of low Apgar scores, stillbirth, NICU admission, mechanical ventilation and cooling treatment (Table). 
Among the study group, observation for background disease was the leading cause for ICU admission (34.5%), followed by hematological complications (14.2%). Ten patients (8.8%) had hysterectomies, 5 (4.4%) had cardiac arrest and one patient (0.9%) had anoxic brain damage. Maternal death rate was 2.65%.

Conclusion:

Advanced maternal age, multifetal pregnancy, and hypertensive diseases are associated with peripartum maternal ICU admission. Patients admitted to ICU have higher rates of PTL, CS and neonatal complications. Identifying these risk factors may help in the early detection of high-risk individuals.