Supplemental Digital Content
1. SDC Table 1 : Diagnostic categories and definitions
2. SDC Table 2: Prevalence and adjusted hazard ratios of postpartum hospital encounters by hypertensive disorders of pregnancy status: less common condition-specific diagnostic categories
3. SDC Table 3: Prevalence of postpartum hospital encounters by hypertensive disorders of pregnancy subtype
4. SDC Table 4: Adjusted hazard ratios of postpartum hospital encounters by hypertensive disorders of pregnancy subtype: less common condition-specific diagnostic categories
SDC Table 1: Diagnostic categories and definitions Major diagnostic
category Condition-specific diagnostic
category ICD9 codes ICD9 code definitions Ambiguous ICD9
codes (not included in analysis)
Hypertension-
related Hypertensive disorders, including uncontrolled BP, eclampsia, and hypertensive encephalopathy
401.x, 402.x, 403.x, 404.x, 405.x, 437.2, 642.02, 642.04
401 Essential hypertension 402 Hypertensive heart disease
403 Hypertensive chronic kidney disease
404 Hypertensive heart and chronic kidney disease 405 Secondary
hypertension
437.2 Hypertensive encephalopathy
642.02 Benign essential hypertension, complicating pregnancy, childbirth, and the puerperium, delivered, with mention of
postpartum complication 642.04 Benign essential hypertension complicating pregnancy, childbirth, and the puerperium,
postpartum condition or complication
642.00 (unspecified as to episode of care)
Acute cardiovascular disease, including heart failure, cardiomyopathy, MI, ventricular fib/flutter, and cardiac arrest/cardiogenic
410.x, 411.x, 413.x, 427.4x, 427.5, 428.x, 674.52, 674.54, 785.51
411 Other acute and subacute forms of ischemic heart disease
412 Old myocardial infarction
425 cardiomyopathy, 425.1 hypertrophic cardiomyopathy, 425.18 other hypertrophic
shock 413 Angina pectoris 427.4 Ventricular fibrillation and flutter 427.5 Cardiac arrest 428 Heart failure 674.52 Peripartum
cardiomyopathy, delivered, with mention of
postpartum condition 674.54 Peripartum cardiomyopathy,
postpartum condition or complication
785.51 Cardiogenic shock
cardiomyopathy, 425.9 secondary cardiomyopathy (unspecified as to acuity); 518.4 Acute edema of lung, unspecified (cardiac etiology unspecified);
674.50 (unspecified as to episode of care);
674.51 (with or without mention of antepartum condition) Acute cerebrovascular disease,
including stroke, intracranial hemorrhage, and
carotid/vertebral artery dissection
430, 431, 432.x, 433.x ,434.x, 435.x, 436, 437.6, 443.21, 443.24, 674.02, 674.04, 997.02
430 Subarachnoid hemorrhage 431 Intracerebral hemorrhage
432 Other and unspecified intracranial hemorrhage 433 Occlusion and stenosis of precerebral arteries 434 Occlusion of cerebral arteries
435 Transient cerebral ischemia
436 Acute, but ill-defined, cerebrovascular disease 437.6 Nonpyogenic thrombosis of intracranial venous sinus
443.21 Dissection of carotid artery
674.00 (unspecified as to episode of care), 670.01 (with or without mention of antepartum condition)
443.24 Dissection of vertebral artery
674.02 Cerebrovascular disorders in the
puerperium, delivered, with mention of
postpartum complication 674.04 Cerebrovascular disorders in the
puerperium, postpartum condition or complication 997.02 Iatrogenic
cerebrovascular infarction or hemorrhage
Acute renal insufficiency or failure
584.x (includes 584.5, 584.6, 584.7, 584.8, 584.9), 669.32, 669.34
584 Acute kidney failure 669.32 Acute kidney failure following labor and delivery, delivered, with mention of postpartum complication
669.34 Acute kidney failure following labor and delivery, postpartum condition or complication
669.30 (unspecified as to episode of care)
Other, clinically related to childbirth hospitalization
Anesthesia complications 668.x2, 668..x4 668.02 Pulmonary
complications of anesthesia or other sedation in labor and delivery, delivered, with mention of
postpartum complication 668.04 Pulmonary
complications of anesthesia or other sedation in labor
668.x0 (unspecified as to episode of care);
668.x1 (with or without mention of antepartum condition)
and delivery, postpartum condition or complication 668.12 Cardiac
complications of anesthesia or other sedation in labor and delivery, delivered, with mention of
postpartum complication 668.14 Cardiac
complications of anesthesia or other sedation in labor and delivery, postpartum condition or complication 668.22 Central nervous system complications of anesthesia or other sedation in labor and delivery, delivered, with mention of postpartum complication
668.24 Central nervous system complications of anesthesia or other sedation in labor and delivery, postpartum condition or complication 668.82 Other
complications of anesthesia or other sedation in labor and delivery, delivered, with mention of
postpartum complication 668.84 Other
complications of anesthesia or other sedation in labor and delivery, postpartum condition or complication 668.92 Unspecified
complication of anesthesia and other sedation in labor and delivery, delivered, with mention of
postpartum complication 668.94 Unspecified
complication of anesthesia and other sedation in labor and delivery, postpartum condition or complication Bleeding risk/complications,
including blood loss anemia, hemorrhage, coagulation defects, and/or RPOC
69.02, 69.09, 69.52, 69.59, 280.0, 285.1, 648.22, 648.24, 649.32, 649.34, 666.02, 666.04, 666.12, 666.14, 666.2x, 666.32, 666.34, 667.02, 667.04, 667.12, 667.14, 998.11
69.02 Dilation and curettage following delivery or abortion 69.09 Other dilation and curettage
69.52 Aspiration curettage following delivery or abortion
69.59 Other aspiration curettage of uterus 280.0 Iron deficiency anemia secondary to blood loss (chronic)
285.1 Acute
posthemorrhagic anemia 648.22 Anemia of mother, delivered, with mention of postpartum complication
648.20, 649.30, 666.30, 667.00, 667.10 (unspecified as to episode of care)
648.24 Anemia of mother, postpartum condition or complication
649.32 Coagulation defects complicating pregnancy, childbirth, or the
puerperium, delivered, with mention of
postpartum complication 649.34 Coagulation defects complicating pregnancy, childbirth, or the
puerperium, postpartum condition or complication 666.02 Third-stage postpartum hemorrhage, delivered, with mention of postpartum complication 666.04 Third-stage postpartum hemorrhage, postpartum condition or complication
666.12 Other immediate postpartum hemorrhage, delivered, with mention of postpartum complication 666.14 Other immediate postpartum hemorrhage, postpartum condition or complication
666.2 Delayed and secondary postpartum hemorrhage
666.32 Postpartum coagulation defects, delivered, with mention of postpartum complication 666.34 Postpartum coagulation defects, postpartum condition or complication
667.02 Retained placenta without hemorrhage, delivered, with mention of postpartum complication 667.04 Retained placenta without hemorrhage, postpartum condition or complication
667.1 2 Retained portions of placenta or membranes, without hemorrhage, delivered, with mention of postpartum complication 667.14 Retained portions of placenta or membranes, without hemorrhage, postpartum condition or complication
998.11 Hemorrhage complicating a procedure Perineal complication
(including vulvar, urethral, vaginal, or cervical infection or inflammation) or surgical wound complication, infection,
54.0 (CS only), 54.3 (CS only), 54.6x (CS only), 54.7x (CS only), 69.4x (CS only),
54.0 Incision of abdominal wall
54.3 Excision or destruction of lesion or tissue of abdominal wall or
86.04, 86.22, 86.28, 86.3, 86.59
(operations on skin or wounds, unspecified as to site); 674.10,
management (excluding uterine
infection) 70.71, 70.72, 70.73,
70.74, 70.75, 70.79, 70.91, 71.09, 71.2x, 71.3, 71.4, 71.7x, 71.8, 71.9, 597.0, 597.8x, 599.1, 599.5, 616.x, 618.x, 619.x, 623.6, 624.5, 674.12 (CS only), 674.14 (CS only), 674.22 (CS only), 674.24 (CS only), 674.32, 674.34, 998.12, 998.13, 998.3x (CS only), 998.5x (CS only), 998.83
umbilicus
54.6 Suture Of Abdominal Wall And Peritoneum 54.7 Other Repair Of Abdominal Wall And Peritoneum
69.4 Uterine Repair 70.71 Suture of laceration of vagina
70.72 Repair of colovaginal fistula 70.73 Repair of rectovaginal fistula 70.74 Repair of other vaginoenteric fistula 70.75 Repair of other fistula of vagina 70.79 Other repair of vagina
70.91 Other operations on vagina
71.09 Other incision of vulva and perineum 71.2 Operations On Bartholin's Gland
71.3 Other local excision or destruction of vulva and perineum 71.4 Operations on clitoris
71.7 Repair Of Vulva And Perineum
71.8 Other operations on vulva
674.20, 674.30 (unspecified as to episode of care);
674.11, 674.21, 674.31 (with or without mention of antepartum condition)
71.9 Other operations on female genital organs 597.0 Urethral abscess 597.8 Other urethritis 599.1 Urethral fistula 599.5 Prolapsed urethral mucosa
616 Inflammatory disease of cervix vagina and vulva 618 Genital prolapse 619 Figustal involving female genital tract 623.6 Vaginal hematoma 624.5 Hematoma of vulva 674.12 Disruption of cesarean wound, delivered, with mention of
postpartum complication 674.14 Disruption of cesarean wound, delivered, postpartum condition or complication
674.22 Disruption of perineal wound, with mention of postpartum complication
674.24 Disruption of perineal wound,
postpartum condition or complication
674.32 Other complications of obstetrical surgical
wounds, delivered, with mention of postpartum complication
674.34 Other complications of obstetrical surgical wounds, postpartum condition or complication 998.12 Hematoma complicating a procedure 998.13 Seroma
complicating a procedure 998.3 Disruption of operation wound 998.5 Postoperative infection not elsewhere classified
998.83 Non-healing surgical wound Uterine infection, pelvic
inflammatory disease, peritonitis
567.0, 567.1, 567.2x, 567.89, 567.9, 614.x, 615.0, 670.x2, 670.x4
567.0 Peritonitis in infectious diseases classified elsewhere 567.1 Pneumococcal peritonitis
567.2 Other suppurative peritonitis
567.89 Other specified peritonitis
567.9 Unspecified peritonitis
614 Inflammatory disease of ovary fallopian tube pelvic cellular tissue and
615.9 unspecified inflammatory disease of uterus (unspecified as to acuity); 670.x0 (unspecified as to episode of care)
peritoneum
615 Inflammatory diseases of uterus except cervix 670.02 Major puerperal infection, delivered, with mention of postpartum complication
670.04 Major puerperal infection, postpartum condition or complication 670.12 Puerperal
endometritis, delivered, with mention of
postpartum complication 670.14 Puerperal
endometritis, postpartum condition or complication 670.22 Puerperal sepsis, delivered, with mention of postpartum complication 670.24 Puerperal sepsis, postpartum condition or complication
670.32 Puerperal septic thrombophlebitis,
delivered, with mention of postpartum complication 670.34 Puerperal septic thrombophlebitis, postpartum condition or complication
670.82 Other major puerperal infection,
delivered, with mention of postpartum complication 670.84 Other major puerperal infection, postpartum condition or complication
Urinary tract infection, including pyelonephritis
590.x, 595.x, 599.0, 646.62, 646.64
590 Infections of kidney 595 Cystitis
599.0 Urinary tract
infection, site not specified 646.62 Infections of genitourinary tract in pregnancy, delivered, with mention of postpartum complication
646.64 Infections of genitourinary tract in pregnancy, postpartum condition or complication
646.60 (unspecified as to episode of care)
Other urinary dysfunction (including obstruction, retention, incontinence)
599.6x, 625.6, 788.2x, 788.3x
599.6 Urinary obstruction 625.6 Stress incontinence, female
788.2 Retention of urine 788.3 Urinary incontinence Uncontrolled pain 338.11, 338.18,
338.19, 789.0x, 789.6x
338.11 Acute pain due to trauma
338.18 Other acute postoperative pain 338.19 Other acute pain 789.0 Abdominal pain 789.6 Abdominal tenderness
625.0 dyspareunia (usually chronic);
625.1 vaginismus (usually chronic);
625.7x vulvodynia (usually chronic);
625.8, 625.9
unspecified symptoms associated with female
genital organs; 789.9 other symptoms involving abdomen and pelvis
(unspecified as to pain)
Constipation, hemorrhoids 455.x, 564.0x 455 Hemorrhoids 564.0 Constipation
564.4 Other postoperative functional disorders (unspecified if constipation) Other, not
clinically related to childbirth
hospitalization
Venous thromboembolism
(excluding stroke and MI) 415.11, 415.13, 415.19, 453.2, 453.3, 453.4x, 453.6, 453.8x, 453.9, 673.22, 673.24, 673.82, 673.84
415.11 Iatrogenic
pulmonary embolism and infarction
415.13 Saddle embolus of pulmonary artery
415.19 Other pulmonary embolism and infarction 453.2 Other venous embolism and thrombosis of inferior vena cava 453.3 Other venous embolism and thrombosis of renal vein
453.4 Acute venous embolism and thrombosis of deep vessels of lower extremity
453.6 Venous embolism and thrombosis of
superficial vessels of lower extremity
453.8 Acute venous
671.9x except 691.94 Unspecified venous complication in pregnancy and the puerperium (unspecified if embolism); 673.20, 673.80 (unspecified as to episode of care)
embolism and thrombosis of other specified veins 453.9 Other venous embolism and thrombosis of unspecified site
673.22 Obstetrical blood- clot embolism, delivered, with mention of
postpartum complication 673.24 Obstetrical blood- clot embolism, postpartum condition or complication 673.82 Other obstetrical pulmonary embolism, delivered, with mention of postpartum complication 673.84 Other obstetrical pulmonary embolism, postpartum condition or complication
Psychiatric disease, including substance abuse
291.x, 293.81, 293.82, 293.83, 293.84, 294.x, 295.x, 296.x, 297.x, 298.x, 300.x, 301.x, 302.70, 302.71, 302.72, 302.73, 302.76, 302.79, 302.9, 303.x, 304.x, 305.0x, 305.2x, 305.3x, 305.4x, 305.5x, 305.6x, 305.7x, 305.8x,
291 Alcohol-induced mental disorders
293.81 Psychotic disorder with delusions in
conditions classified elsewhere
293.82 Psychotic disorder with hallucinations in conditions classified elsewhere
293.83 Mood disorder in conditions classified elsewhere
292.x drug-induced mental disorders (could be iatrogenic);
648.30, 648.40 (unspecified as to episode of care);
648.31, 648.41 (with or without mention of antepartum condition)
305.9x, 307.1, 307.5x, 308.x, 309.x, 311, 648.32, 648.34, 648.42, 648.44, 790.3
293.84 Anxiety disorder in conditions classified elsewhere
294 Persistent mental disorders due to conditions classified elsewhere
295 Schizophrenic disorders
296 Episodic mood disorders
297 Delusional disorders 298 Other nonorganic psychoses
300 Anxiety, dissociative and somatoform disorders 301 Personality disorders 302.70 Psychosexual dysfunction, unspecified 302.71 Hypoactive sexual desire disorder
302.72 Psychosexual dysfunction with inhibited sexual excitement
302.73 Female orgasmic disorder
302.76 Dyspareunia, psychogenic
302.79 Psychosexual dysfunction with other specified psychosexual dysfunctions
302.9 Unspecified psychosexual disorder
303 Alcohol dependence syndrome
304 Drug dependence 305.0 Nondependent alcohol abuse
305.2 Nondependent cannabis abuse 305.3 Nondependent hallucinogen abuse 305.4 Nondependent sedative, hypnotic or anxiolytic abuse 305.5 Nondependent opioid abuse
305.6 Nondependent cocaine abuse
305.7 Nondependent amphetamine or related acting sympathomimetic abuse
305.8 Nondependent antidepressant type abuse 305.9 Nondependent other mixed or unspecified drug abuse
307.1 Anorexia nervosa 307.5x Other and unspecified disorders of eating
308 Acute reaction to stress
309 Adjustment reaction 311 Depressive disorder,
not elsewhere classified 648.32 Drug dependence of mother, delivered, with mention of postpartum complication
648.34 Drug dependence of mother, postpartum condition or complication 648.42 Mental disorders of mother, delivered, with mention of postpartum complication
648.44 Mental disorders of mother, postpartum condition or complication 790.3 Excessive blood level of alcohol
Poor glycemic control/Diabetic complications a
250.x2, 250.x3, 250.9x, 648.02, 648.04, 648.82, 648.84, 790.2x
250.02 Diabetes mellitus without mention of complication, type II or unspecified type, uncontrolled
250.03 Diabetes mellitus without mention of complication, type I [juvenile type], uncontrolled
250.12 Diabetes with ketoacidosis, type II or unspecified type, uncontrolled
250.13 Diabetes with ketoacidosis, type I
250.x is a catch-all for diabetes (would be okay to use if looking only at primary diagnosis), while 250.x2 and 250.x3 specify uncontrolled (would be okay to use for any order
diagnosis); 648.00, 648.80 (unspecified as to episode of care);
648.01, 648.81 (with or without mention of antepartum condition)
[juvenile type], uncontrolled
250.22 Diabetes with hyperosmolarity, type II or unspecified type,
uncontrolled
250.23 Diabetes with hyperosmolarity, type I [juvenile type],
uncontrolled
250.32 Diabetes with other coma, type II or
unspecified type, uncontrolled
250.33 Diabetes with other coma, type I [juvenile type], uncontrolled
250.42 Diabetes with renal manifestations, type II or unspecified type,
uncontrolled
250.43 Diabetes with renal manifestations, type I [juvenile type], uncontrolled
250.52 Diabetes with ophthalmic manifestations, type II or unspecified type, uncontrolled
250.53 Diabetes with ophthalmic manifestations, type I [juvenile type], uncontrolled
250.62 Diabetes with neurological
manifestations, type II or unspecified type,
uncontrolled
250.63 Diabetes with neurological
manifestations, type I [juvenile type], uncontrolled
250.72 Diabetes with peripheral circulatory disorders, type II or unspecified type, uncontrolled
250.73 Diabetes with peripheral circulatory disorders, type I [juvenile type], uncontrolled
250.82 Diabetes with other specified manifestations, type II or unspecified type, uncontrolled
250.83 Diabetes with other specified manifestations, type I [juvenile type], uncontrolled
250.9 Diabetes with unspecified complication 250.90 Diabetes with unspecified complication, type II or unspecified type, not stated as uncontrolled
250.91 Diabetes with unspecified complication, type I [juvenile type], not stated as uncontrolled 250.92 Diabetes with unspecified complication, type II or unspecified type, uncontrolled
250.93 Diabetes with unspecified complication, type I [juvenile type], uncontrolled
648.02 Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, delivered, with mention of
postpartum complication 648.04 Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium,
postpartum condition or complication
648.82 Abnormal glucose tolerance of mother, delivered, with mention of postpartum complication 648.84 Abnormal glucose tolerance of mother, postpartum condition or complication
790.2 Abnormal glucose
Breast infections/Lactation
complications 675.x, 676.x, 611.0, 611.1, 611.2, 611.5, 611.7x
675 Infections of the breast and nipple associated with childbirth
676 Other disorders of the breast associated with childbirth and disorders of lactation
611.0 Hypertrophy of breast
611.2 Fissure of nipple 611.5 Galactocele
611.7 Signs and symptoms in breast
Gallbladder
disease/Pancreatitis
574.x, 575.x, 576.x, 577.0
574 Cholelithiasis 575 Other disorders of gallbladder
576 Other disorders of biliary tract
577.0 Acute pancreatitis Acute respiratory
distress/failure
518.4, 518.5x, 518.81, 518.82, 518.84, 799.1
518.4 Acute edema of lung, unspecified 518.5 Pulmonary insufficiency following trauma and surgery 518.81 Acute respiratory failure
518.82 Other pulmonary insufficiency, not
elsewhere classified 518.84 Acute and chronic respiratory failure
799.1 Respiratory arrest
Upper respiratory infection 480.x, 481, 482.x, 480 Viral pneumonia 478.0 Other and
483.x, 484.x, 485, 486, 487.x, 488.x, 490, 491.x
481 Pneumococcal
pneumonia [Streptococcus pneumoniae pneumonia]
482 Other bacterial pneumonia
483 Pneumonia due to other specified organism 484 Pneumonia in infectious diseases classified elsewhere 485 Bronchopneumonia, organism unspecified 486 Pneumonia, organism unspecified
487 Influenza
488 Influenza due to certain identified influenza viruses
490 Bronchitis, not specified as acute or chronic
491 Chronic bronchitis
unspecified diseases of upper respiratory tract (unspecified as to infection or not)
Cellulitis 681.x , 682.x 681 Cellulitis and abscess of finger and toe
682 Other cellulitis and abscess
Appendicitis 540.x , 541, 542.x 540 Acute appendicitis 541 Appendicitis, unqualified
542 Other appendicitis Bacteremia/sepsis NOS 038.x , 785.52,
790.7, 998.02 038 Septicemia 785.52 Septic shock 790.7 Bacteremia
998.02 Postoperative shock, septic
Fever (unspecified) 672.02, 672.04, 780.60, 780.61, 780.62
672.02 Pyrexia of
unknown origin during the puerperium, delivered, with mention of
postpartum complication 672.04 Pyrexia of
unknown origin during the puerperium, postpartum condition or complication 780.60 Fever, unspecified 780.61 Fever presenting with conditions classified elsewhere
780.62 Postprocedural fever
672.00 (unspecified as to episode of care)
Malaise/Fatigue, Sleep disturbance
307.4x, 780.5x , 780.7x
307.4x Specific disorders of sleep of nonorganic origin
780.5x Sleep disturbances 780.7 Malaise and fatigue Family planning/Contraception V25.x, V26.x ,
V72.4x, 69.7
V25 Encounter for
contraceptive management V26 Procreative
management V72.4x Pregnancy examination or test 69.7 Insertion of
intrauterine contraceptive device
Non-specific postpartum diagnosis
646.82, 646.84, 648.92, 648.94,
646.82 Other specified complications of
646.80, 646.90, 648.90, 674.80,
674.82, 674.84,
679.02, 679.04 pregnancy, delivered, with mention of postpartum complication
646.84 Other specified complications of pregnancy, postpartum condition or complication 648.92 Other current conditions classifiable elsewhere of mother, delivered, with mention of postpartum complication 648.94 Other current conditions classifiable elsewhere of mother, postpartum condition or complication
674.82 Other complications of puerperium, delivered, with mention of
postpartum complication 674.84 Other
complications of
puerperium, postpartum condition or complication 679.02 Maternal
complications from in utero procedure, delivered, with mention of
postpartum complication 679.04 Maternal
complications from in
679.00 (unspecified as to episode of care)
utero procedure,
postpartum condition or complication
CS = cesarean section
a Certain diabetes codes were only considered if they were the primary diagnosis so as to avoid counting stable chronic conditions.
References:
Batra P, Fridman M, Leng M, Gregory KD. Emergency Department Care in the Postpartum Period: California Births, 2009-2011.
Obstet Gynecol. 2017;130(5):1073-1081. doi:10.1097/AOG.0000000000002269
Clapp MA, Little SE, Zheng J, Robinson JN. A multi-state analysis of postpartum readmissions in the United States. American Journal of Obstetrics and Gynecology. 2016;215(1):113.e1-113.e10. doi:10.1016/j.ajog.2016.01.174
Ehrenthal DB, Gelinas K, Paul DA, et al. Postpartum Emergency Department Visits and Inpatient Readmissions in a Medicaid Population of Mothers. J Womens Health (Larchmt). 2017;26(9):984-991. doi:10.1089/jwh.2016.6180
Romano PS, Rainwater JA, Schembri ME, et al. OSHPD Postpartum Maternal Outcomes Validation Study. 2006.
https://escholarship.org/uc/item/20h9h32c. Accessed February 21, 2020.
Severe Maternal Morbidity Indicators and Corresponding ICD Codes during Delivery Hospitalizations.
https://www.cdc.gov/reproductivehealth/maternalinfanthealth/smm/severe-morbidity-ICD.htm. Published January 16, 2019.
Accessed March 5, 2019.
Too G, Wen T, Boehme AK, et al. Timing and Risk Factors of Postpartum Stroke. Obstet Gynecol. 2018;131(1):70-78.
doi:10.1097/AOG.0000000000002372
SDC Table 2: Prevalence and adjusted hazard ratios of postpartum hospital encounters by hypertensive disorders of pregnancy status: less common condition-specific diagnostic categories
Postpartum complication Prevalence of hospital encountersa, n (%) HDP-associated hazards, HR (95% CI)
Without
HDP With HDP p-value Unadjusted Adjustedb
Uterine infection, pelvic inflammatory disease,
peritonitis 5,959 (0.26) 793
(0.44)
<0.001 1.71 (1.59, 1.84)
1.37 (1.26, 1.48) Constipation,
hemorrhoids 5,962 (0.26) 595
(0.33) <0.001 1.28 (1.18,
1.40) 1.08 (0.99, 1.18) Upper respiratory
infection 3,106 (0.13)
537 (0.30)
<0.001 2.22 (2.03, 2.44)
1.59 (1.45, 1.76) Poor glycemic
control/Diabetic
complications 1,266 (0.05) 752 (0.42)
<0.001 7.73 (7.07, 8.44)
2.01 (1.82, 2.22) Anesthesia complications
1,868 (0.08) 155 (0.09)
0.440 1.07 (0.91, 1.26)
1.03 (0.87, 1.23) Family
planning/Contraception 1,643 (0.07) 210 (0.12)
<0.001 1.64 (1.42, 1.90)
1.31 (1.13, 1.52) Malaise/Fatigue, Sleep
disturbance 1,385 (0.06) 268
(0.15) <0.001 2.49 (2.18,
2.84) 1.84 (1.60, 2.12) Appendicitis
1,354 (0.06) 120 (0.07)
0.171 1.14 (0.95, 1.37)
1.08 (0.89, 1.31) Acute cardiovascular
disease
780 (0.03)
513 (0.29)
<0.001 8.46 (7.57, 9.46)
5.11 (4.52, 5.79) Bacteremia/sepsis NOS
1,012 (0.04) 188 (0.10)
<0.001 2.39 (2.04, 2.79)
1.61 (1.36, 1.91) Venous
thromboembolism (excluding stroke and
MI) 876
(0.04) 172
(0.10)
<0.001 2.52 (2.14, 2.97)
1.46 (1.22, 1.73)
Other urinary
dysfunction (including obstruction, retention, incontinence)
838 (0.04)
78 (0.04)
0.129 1.20 (0.95, 1.51)
1.19 (0.93, 1.51)
Acute respiratory distress/failure
413 (0.02)
156 (0.09)
<0.001 4.84 (4.02, 5.82)
2.84 (2.32, 3.48) Acute renal insufficiency
or failure 334
(0.01) 156
(0.09) <0.001 6.00 (4.97,
7.26) 3.57 (2.89, 4.41) Acute cerebrovascular
disease 247
(0.01) 85
(0.05) <0.001 4.42 (3.46,
5.66) 3.36 (2.56, 4.42) CI = confidence interval; HDP = hypertensive disorders of pregnancy; HR = hazard ratio
a Prevalence defined as ≥1 maternal hospital encounter (with a qualifying diagnosis) in 12 weeks after delivery
b Adjusted for maternal age category, race/ethnicity, insurance status, prepregnancy obesity, chronic diabetes, gestational diabetes, mode of delivery, gestational age category, and birth outcome
SDC Table 3: Prevalence of postpartum hospital encounters by hypertensive disorders of pregnancy subtype
Postpartum complication Prevalencea, n (%) Gestational
hypertension Preeclampsia
-eclampsia Chronic
hypertension Chronic hypertension with
superimposed preeclampsia
Family p- value
Overall 5772 (10.8) 9424 (12.4) 4799 (14.4) 2939 (17.1) <0.001 Major diagnostic
categories14,34b
Hypertension-related 663 (1.2) 1260 (1.7) 1721 (5.2) 1271 (7.4) <0.001 Other, clinically related to
childbirth hospitalization
2449 (4.6) 4051 (5.3) 1975 (5.9) 1246 (7.3) <0.001 Other, not clinically
related to childbirth hospitalization
2261 (4.2) 3835 (5.1) 2047 (6.1) 1264 (7.4) <0.001
Condition-specific diagnostic categories
Urinary tract infection 876 (1.6) 1520 (2.0) 685 (2.1) 474 (2.8) <0.001 Non-specific postpartum
diagnosis
896 (1.7) 1587 (2.1) 768 (2.3) 537 (3.1) <0.001 Uncontrolled Pain 751 (1.4) 1157 (1.5) 694 (2.1) 360 (2.1) <0.001 Gallbladder
disease/Pancreatitis 462 (0.9) 781 (1.0) 288 (0.9) 170 (1.0) <0.001 Bleeding
risk/complications
509 (1.0) 909 (1.2) 376 (1.1) 265 (1.5) <0.001 Perineal complication or
surgical wound
complication, infection, management
489 (0.9) 817 (1.1) 445 (1.3) 326 (1.9) <0.001
Psychiatric disease 364 (0.7) 666 (0.9) 597 (1.8) 343 (2.0) <0.001 Breast
infections/Lactation complications
252 (0.5) 339 (0.5) 120 (0.4) 66 (0.4) 0.001
Cellulitis 289 (0.5) 390 (0.5) 287 (0.9) 160 (0.9) <0.001
Fever (unspecified) 196 (0.4) 329 (0.4) 131 (0.4) 68 (0.04) <0.001 Hypertensive disorders 582 (1.1) 1068 (1.4) 1675 (5.0) 1221 (7.1) <0.001 Uterine infection, pelvic 200 (0.37) 328 (0.43) 148 (0.44) 117 (0.68) <0.001
inflammatory disease, peritonitis
Constipation,
hemorrhoids 151 (0.28) 237 (0.31) 133 (0.40) 74 (0.43) <0.001 Upper respiratory
infection
118 (0.22) 200 (0.26) 137 (0.41) 82 (0.48) <0.001 Poor glycemic
control/Diabetic complications
101 (0.19) 244 (0.32) 224 (0.67) 214 (1.25) <0.001
Anesthesia complications 52 (0.10) 59 (0.08) 29 (0.09) 15 (0.09) 0.720 Family
planning/Contraception
50 (0.09) 85 (0.11) 44 (0.13) 31 (0.18) <0.001 Malaise/Fatigue, Sleep
disturbance 60 (0.11) 97 (0.13) 63 (0.19) 48 (0.28) <0.001
Appendicitis 30 (0.06) 56 (0.07) 22 (0.07) 12 (0.07) 0.468
Acute cardiovascular
disease 99 (0.2) 195 (0.3) 105 (0.3) 114 (0.7) <0.001
Bacteremia/sepsis NOS 30 (0.06) 79 (0.10) 38 (0.11) 41 (0.24) <0.001 Venous
thromboembolism
(excluding stroke and MI)
37 (0.07) 73 (0.10) 35 (0.10) 27 (0.16) <0.001
Other urinary dysfunction (including obstruction, retention, incontinence)
18 (0.03) 29 (0.04) 17 (0.05) 14 (0.08) 0.022
Acute respiratory
distress/failure 29 (0.05) 55 (0.07) 36 (0.11) 36 (0.21) <0.001 Acute renal insufficiency
or failure
15 (0.03) 68 (0.09) 33 (0.10) 40 (0.23) <0.001 Acute cerebrovascular
disease
18 (0.03) 34 (0.04) 17 (0.05) 16 (0.09) <0.001
a Prevalence defined as ≥1 maternal hospital encounter (with a qualifying diagnosis) in 12 weeks after delivery
b See Table 1 for the condition-specific diagnostic categories included in each major category.
SDC Table 4: Adjusted hazard ratios of postpartum hospital encounters by hypertensive disorders of pregnancy subtype: less common condition-specific diagnostic categories
Postpartum complication HDP subtype-associated hazards, adjusteda HR (95% CI) Gestational
hypertension
Preeclampsia- eclampsia
Chronic hypertension
Chronic hypertension with
superimposed preeclampsia Uterine infection, pelvic
inflammatory disease, peritonitis
1.24 (1.08, 1.44)
1.33 (1.18, 1.49)
1.41 (1.19, 1.66)
1.85 (1.53, 2.24) Constipation, hemorrhoids 0.97 (0.83,
1.15)
1.00 (0.88, 1.14)
1.35 (1.13, 1.61)
1.31 (1.03, 1.65) Upper respiratory infection 1.29 (1.07,
1.55)
1.47 (1.26, 1.70)
2.05 (1.72, 2.46)
2.11 (1.68, 2.65) Poor glycemic
control/Diabetic complications
1.64 (1.34, 2.02)
1.92 1.66, 2.22)
1.94 (1.66, 2.56)
2.71 (2.31, 3.18) Anesthesia complications 1.13 (0.86,
1.49)
0.98 (0.75, 1.28)
0.93 (0.63, 1.38)
1.16 (0.69, 1.93) Family
planning/Contraception
1.14 (0.86, 1.51)
1.25 (1.00, 1.57)
1.45 (1.07, 1.98)
1.79 (1.24, 2.59) Malaise/Fatigue, Sleep
disturbance 1.57 (1.20,
2.04) 1.57 (1.26,
1.95) 2.34 (1.80,
3.05) 2.81 (2.07, 3.82)
Appendicitis 0.92 (0.64,
1.32) 1.17 (0.89,
1.54) 1.12 (0.73,
1.72) 1.08 (0.59, 1.97) Acute cardiovascular
disease
4.26 (3.43, 5.30)
5.48 (4.64, 6.47)
4.26 (3.43, 5.30)
7.68 (6.17, 9.57) Bacteremia/sepsis NOS 0.99 (0.68,
1.45)
1.66 (1.30, 2.10)
1.73 (1.24, 2.42)
2.78 (1.99, 3.90) Venous thromboembolism
(excluding stroke and MI)
1.33 (0.95, 1.85)
1.55 (1.21, 1.98)
1.36 (0.96, 1.93)
1.57 (1.05, 2.35) Other urinary dysfunction
(including obstruction, retention, incontinence)
0.93 (0.58, 1.49)
1.10 (0.75, 1.60)
1.36 (0.84, 2.22)
2.06 (1.18, 3.61) Acute respiratory
distress/failure
2.27 (1.55, 3.32)
2.64 (1.97, 3.54)
3.02 (2.11, 4.33)
4.49 (3.09, 6.54) Acute renal insufficiency
or failure 1.56 (0.3,
2.63) 3.82 (2.89,
5.04) 3.93 (2.68,
5.76) 6.79 (4.72, 9.76) Acute cerebrovascular
disease 2.61 (1.57,
4.35) 3.73 (2.55,
5.45) 3.13 (1.87,
5.22) 4.57 (2.54, 8.23) CI = confidence interval; HDP = hypertensive disorders of pregnancy; HR = hazard ratio
a Compared to normotensive; adjusted for maternal age category, race/ethnicity, insurance status, prepregnancy obesity, chronic diabetes, gestational diabetes, mode of delivery, gestational age category, and birth outcome
