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Poster Session 1

Category: Obstetric Quality and Safety

Poster Session 1

(185) Obstetric emergency response: predictability and long-term impact

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Elena Lands, MD (she/her/hers)

Fellow
University of Pittsbugh Medical Center Magee-Womens Hospital
Pittsburgh, Pennsylvania, United States

Coauthor(s)

Carrie Bennett, MD

Assistant Professor
University of Pittsburgh Medical Center
Wexford, Pennsylvania, United States
JE

Jes Eskridge, MD

Resident
UPMC Magee-Womens Hospital
Pittsburgh, Pennsylvania, United States
Anna B. Binstock, MD (she/her/hers)

Assistant Professor, Maternal-Fetal Medicine
UPMC Magee-Womens Hospital
UPMC, Pennsylvania, United States
JL

Jacob Larkin, MD

Associate Professor, Maternal-Fetal Medicine
UPMC Magee-Womens Hospital
Pittsburgh, Pennsylvania, United States

Objective:
Development of an obstetric emergency response (OER) team is promoted by ACOG as an important patient safety initiative. Despite the prominent role of OER teams in modern practice, optimal operational protocols and criteria for activation remain unknown. Moreover, the impact of the OER on an individual’s long-term mental health is not well understood. We aimed to: 1) identify characteristics associated with OER activation and 2) gauge its impact on postpartum mood disorders (PPMD).

Study Design:
Retrospective cohort study of 36,649 births from January 2021 through April 2024 at one tertiary academic medical center. Multivariate logistic regression was used to develop a predictive model for OER activation. In the subset delivered between May 2022 and April 2023, rates of PPMD and referral for mental health care were compared in births with and without OER.

Results:
OER rates significantly increased annually with 1 in 25 births affected in 2024 (Fig. 1, p< 0.001). OER was significantly more likely for African-American patients (aOR 1.5, 95% CI 1.3-1.73), those with spontaneous labor (aOR 1.36, 95% CI 1.17-1.59), and preterm births (aOR 2.98, 95% CI 2.57-3.47). OER was not associated with insurance status, hypertension, diabetes, or smoking. The developed model was a poor predictor for activation of OER with an AUC of 0.65 (Fig. 2). Those with OER were significantly more likely to be diagnosed with new mood disorders within 8 weeks postpartum (OR 2.65, 95% CI 1.72-4.09), to be referred to therapy (OR 12.41, 95% CI 6.67-23.11), and to attend therapy (OR 2.82, 95% CI 1.3-6.13).

Conclusion:
While at least 4% of delivering patients experience an OER, activation is difficult to predict and is often associated with new mood disorders and utilization of mental health services. This underscores a crucial need for robust evidence not only to optimize OER but also to develop strategies to prepare patients for its possibility and to reduce associated trauma.