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Poster Session 3

Category: Hypertension

Poster Session 3

(729) Assessment of gestational age specific severe maternal morbidity among patients with pre-eclampsia with severe features

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Ariane C. Youssefzadeh, MD

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California
Los Angeles, California, United States

Coauthor(s)

Yadira L. Bribiesca Leon, MD, MPH (she/her/hers)

Resident
Keck School of Medicine of USC, University of Southern California
Los Angeles, California, United States
ZC

Zaira Chavez Jimenez, MD

Keck School of Medicine of USC, University of Southern California
Los Angeles, California, United States
Fay Pon, MD (she/her/hers)

Resident Physician
Keck School of Medicine of USC, University of Southern California
Los Angeles, California, United States
CR

Carolyn Rocha, MD

Keck School of Medicine of USC, University of Southern California
Los Angeles, California, United States
BG

Brendan H. Grubbs, MD

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California
Los Angeles, California, United States
MI

Marc H. Incerpi, MD

Clinical Professor of Obstetrics and Gynecology
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California
Los Angeles, California, United States
JO

Joseph G. Ouzounian, MBA, MD

Professor and Chair of Obstetrics & Gynecology
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California
Los Angeles, California, United States
KM

Koji Matsuo, MD, PhD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California
Los Angeles, California, United States

Objective:
To (i) describe the temporal trend of preeclampsia with severe features (SPE) by gestational age at delivery (≥34 weeks, ≥28/< 34 weeks, and < 28 weeks) and (ii) compare severe maternal morbidity (SMM) among patients with SPE across these groups.

Study Design:
This was a cross-sectional study of Healthcare Cost and Utilization Project’s National Inpatient Sample including 21,773,049 deliveries. All hospital deliveries with a diagnosis of SPE from 2016-2022 were included. Exposure was gestational age at delivery. The outcome measured was SMM per the Center for Disease Control and Prevention. A multivariable generalized linear model was created, adjusting for the following a priori selected factors: maternal age, race and ethnicity, maternal comorbidities (systemic lupus erythematosus, pregestational diabetes, obesity), prior uterine scar, placental abruption, and cesarean delivery.

Results:
Among the 638,460 patients with SPE, 533,360 (83.5%) delivered at ≥34 weeks, 89,845 (14.1%) delivered at ≥28/< 34 weeks, and 15,255 (2.4%) delivered at < 28 weeks. The incidence of SPE increased during the study period among all three groups (Figure). In a multivariable analysis, compared to patients with SPE delivered at ≥34 weeks, patients with SPE who delivered at ≥28/< 34 weeks had higher composite SMM, cardiopulmonary indicators of SMM, and multiple individual indicators including pulmonary edema, myocardial infarction, ventilation requirement, eclampsia, and puerperal cerebrovascular disorders (all, adjusted-rate ratio >1.5; Table). Likewise, compared to patients with SPE delivered at ≥34 weeks, patients with SPE who delivered at ≤28 weeks also had higher composite SMM, cardiopulmonary indicators of SMM, and multiple individual indicators including pulmonary edema, renal failure, myocardial infarction, ventilation requirement, and eclampsia (all, adjusted-rate ratio >2.5, Table).

Conclusion:
This study demonstrates an on-going rise in SPE deliveries including those remote from term. This finding is clinically compelling and warrants further investigation.