Abstract
SummaryBackgroundThe number of pregnant women with severe comorbidities is increasing. The aim of the present study was to analyze outcomes and determine trends in women who required peripartum admission to the intensive care unit (ICU).MethodsIn this retrospective study, we identified all women who were admitted to the ICU between the second trimester of pregnancy and 6 weeks postpartum. Women with ICU admission between 2011 and 2014 were assigned to the study group, whereas those admitted between 1996 and 2003 were assigned to the historical group. Comorbidities, characteristics, outcomes, and treatment efforts were assessed. Descriptive analysis, Fisher’s exact test, unpaired Student’s t-test and one-way ANOVA were performed.ResultsWe identified 238 cases, including 135 (56.7%) in the study group and 103 (43.3%) in the historical group. In 83 (34.9%) women, deterioration of the pre-existing medical condition was causal for ICU admission. Overall, preterm delivery and mean gestational age were 81.5% and 31.6 ± 6.2 weeks, respectively. In comparison to the historical group, women of the study group were older (p = 0.005), more frequently presented with multiple comorbidities (p = 0.003), pre-existing conditions (p < 0.001), and congenital heart disease (p = 0.012). Moreover, they had a shorter length of stay at the ICU than those of the historical group (p = 0.02).ConclusionsPeripartum ICU admissions are increasing in frequency. As maternal characteristics are changing, adequate risk stratification with multidisciplinary care are essential, and access to intermediate care units would be preferable for patients with short-term admission.
Highlights
Recent demographic data indicate that the number of women in childbearing age presenting with severe comorbidities is constantly rising [1, 2]
In order to determine trends in maternal characteristics, we differentiated between women who were treated between 1 January 2011 and 31 December 2014, and those treated between 1 January 1996 and 31 December 2003
One of our main findings is the increasing maternal age of women with intensive care unit (ICU) admission, which is higher than the overall obstetric population in Austria [11]
Summary
Recent demographic data indicate that the number of women in childbearing age presenting with severe comorbidities is constantly rising [1, 2] This trend may be a result of the increasing maternal age at the time of the first pregnancy, which was observed in developed countries during the last decades [3, 4]. Pregnancies of women with pre-existing conditions more often result in peripartum complications and these women frequently require admission to the intensive care unit (ICU) [6] This situation represents a significant challenge for clinicians by causing potentially avoidable complications with increased need for enhanced and multidisciplinary care [7].
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