Table 4 Box summary of key points

Question

• Is there variability of ICU admission practices for pregnant and postpartum women in Canadian hospitals and what is the association between patient and hospital characteristics and ICU admission practices?

Findings

• In this nationwide population-based cohort study of 342 acute care hospitals with 3.1 million pregnancies in Canada, there were 3.2 ICU admissions per 1000 pregnancies with provincial variation.

• More comorbidities, urban residence, and lower incomes were associated with ICU admission.

• In comparison with the maternal comorbidity index = 0, increasing maternal comorbidity index has higher odds of admitting to ICU (index = 1, odds ratio 1.90; index = 2 or higher, odds ratio 8.67).

• Median odds ratio of ICU admission among Canadian pregnant women was 1.92, which demonstrated for two pregnant women with similar characteristics at different hospitals; the median odds of being admitted to ICU in one hospital compared to another was 1.92.

• Given the fact that only two thirds of all women who subsequently died were admitted to ICU, these happened to those who were less sick at the time of hospital admission and less likely to transfer to another institution for acute care, but more likely to develop a life-threatening condition in urban hospitals, compared to maternal death with ICU admission.

Meaning

• There is a substantial variability in admission patterns to intensive care for pregnant and postpartum women in Canadian hospitals.