Severe maternal morbidity following Cesarean hysterectomy for placenta accreta spectrum: a historical cohort study
Authors' conclusion
Patients with PAS who underwent Cesarean hysterectomy had a high incidence of SMM and ICU admissions.
Study context
- Population
- Patients with placenta accreta spectrum (PAS) who had Cesarean hysterectomy, US Premier Inc. database delivery hospitalizations, 1 October 2015 to 30 June 2021
- Participants
- 1,972 patients
- Outcome
- SMM (CDC-defined events, excluding hysterectomy) and ICU admission
Methodological detailsmixed-effects logistic regression with random intercepts for hospitals
- Mixed-effects logistic regression with random intercepts for hospitals
Main finding
As reported in the abstract
SMM (excluding hysterectomy) and ICU admission
Severe maternal morbidity (SMM) (excluding hysterectomy)
54%
Intensive care unit (ICU) admission
44%
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Factors associated with SMMPlacenta percreta vs Accreta | 1.46 (1.09–1.95) | |
| Factors associated with SMMNeuraxial anesthesia vs General anesthesia | 0.64 (0.44–0.91) | |
| Factors associated with SMMMidwest hospitals vs South | 0.56 (0.33–0.96) | |
| Factors associated with SMMWest hospitals vs South | 0.47 (0.26–0.84) | |
| 0.20.5125Odds ratio (log scale) |
Factors associated with SMM
| OR (95% CI) | ||
|---|---|---|
| Blood loss anemia | 1.71 (1.26–2.33) | |
| Deficiency anemia | 0.64 (0.43–0.96) | |
| Admission year | 0.73 (0.68–0.80) | |
| 0.512Odds ratio (log scale) |
- Factors associated with SMM: mixed-effects logistic regression with random intercepts for hospitals
Original publication
Severe maternal morbidity following Cesarean hysterectomy for placenta accreta spectrum: a historical cohort study. Can J Anaesth. Published 18 February 2026. doi:10.
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