A Comorbidity-based Screening Tool to Predict Severe Maternal Morbidity at the Time of Delivery
Sarah Rae Easter, B.T. Bateman, Valerie Horton Sweeney, Karen Manganaro, Sarah C. Lassey, Julie Gagné, Julian N. Robinson
Abstract
( Am J Obstet Gynecol . 2019;221:271.e1–271.e10) An important strategy for improving maternal health is development of a tool that reliably identifies women at risk of severe maternal morbidity (SMM) and death. The obstetric comorbidity index (OB-CMI) summarizes the burden of maternal comorbidities and allows for the generation of a single numeric score to quantify risk assessment. While the OB-CMI was originally designed to address bias in research studies, the authors hypothesized it could be adapted for clinical use. The score is calculated from a 20-item list of comorbidities (eg, preeclampsia, multiple gestation, asthma, advanced maternal age). The comorbidities are weighted (eg, preeclampsia with severe features is 5 points, diabetes on insulin is 1 point). The points are summed for a total score. The aim of this study was to prospectively evaluate the performance of this comorbidity index as a screening tool to accurately identify laboring women at risk of SMM.