Obstetrics & Gynecology · Public Health · 31 Oct
Severe Maternal Morbidity Linked to Lower Breast Milk Feeding at Discharge
A US population-based repeated cross-sectional study of 23.6 million singleton births from 2016 to 2023 assessed maternal ICU admission, unplanned peripartum hysterectomy, and breast milk feeding at hospital discharge. Severe morbidity increased over time and was associated with substantially lower feeding rates at discharge.
- Severe morbidity rose from 102 to 157 per 100,000 births.
- Morbidity affected 0.14% of the included births.
- Feeding at discharge was lower with severe morbidity.
- Feeding trends did not improve for the severe-morbidity group.
Researchers analyzed US National Vital Statistics System data for 23,589,073 liveborn singleton, non-anomalous deliveries at 34 weeks 0 days to 42 weeks 6 days of gestation from 2016 through 2023. Severe maternal morbidity was defined as maternal ICU admission and/or unplanned peripartum hysterectomy. The study assessed temporal trends and the association between morbidity and breast milk feeding by hospital discharge using Joinpoint regression and multivariable logistic regression.
Severe morbidity occurred in 33,121 births (0.14%). Its rate rose from 102 to 157 per 100,000 births (annual average percentage change 4.1%; 95% CI, 1.3%–7.2%). ICU admission alone and hysterectomy alone also increased; concurrent ICU admission and hysterectomy did not. Breast milk feeding at discharge was reported for 65.2% of patients with severe morbidity versus 84.1% without it; adjusted odds ratio 0.46 (95% CI, 0.45–0.47). Feeding rates increased over time among patients without severe morbidity, but not among those with severe morbidity.
The findings identify a group that may benefit from additional breastfeeding or expressed-milk support when clinically appropriate. The observational, population-level analysis establishes an association, not its causes, and is limited to the specified delivery population and feeding status at discharge.
In practice
Among patients delivering singleton, non-anomalous infants at 34 to 42 weeks in the United States, maternal ICU admission or unplanned peripartum hysterectomy was associated with lower breast milk feeding at hospital discharge than no severe morbidity (65.2% versus 84.1%). The study supports attention to feeding support for patients affected by severe morbidity, when clinically appropriate, but does not test an intervention or establish why rates were lower. Its observational findings do not establish that additional services will improve feeding outcomes.
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BJOG: An International Journal of Obstetrics & Gynaecology: Maternal Intensive Care Admission, Unplanned Peripartum Hysterectomy, and Breast Milk Feeding by Hospital Discharge: A Population Based Repeated Cross‐Sectional Study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.