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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 4

Category: Obstetric Quality and Safety

Poster Session 4

(1272) Incidence and preventability of severe early pregnancy morbidity at a tertiary referral center

Thursday, February 12, 2026
3:30 PM - 5:00 PM  
Objective:
To identify incidence of severe early pregnancy morbidity (SEPM) by adapting severe maternal morbidity (SMM) definitions to pregnancies < 24 weeks; secondarily, to assess preventability of these events using a validated tool

Study Design:
This is a retrospective cohort study of pregnant patients at a single tertiary care institution between 1/1/2017 to 12/31/2023. Individuals with a documented pregnancy episode or CPT code denoting an abortive outcome of pregnancy were included. We identified hospital encounters at < 24 0/7 weeks’ gestation. Using ICD-10 diagnosis codes, blood product administration records, and intensive care transfer records, we identified encounters with possible SEPM using the following three methods: CDC SMM diagnosis codes, ACOG/SMFM criteria (transfusion of >4 units of blood products or intensive care unit (ICU) transfer), or abortion-related morbidity, which is defined as pelvic infection, damage to pelvic organs, or hemorrhage with estimated blood loss >500 cc or requiring urgent intervention. We reviewed the electronic health record of all screen-positive cases to verify the presence of an SEPM event, assess preventability using the Alliance for Innovation on Maternal Health SMM review form, and screen for influence of abortion restrictions.

Results:
Of 46,181 pregnant patients, we identified 407 (0.88% of all pregnancies) SEPM events, with 233, 87, and 253 events meeting CDC, ACOG, and abortion-related morbidity criteria, respectively. Median gestational age at SEPM was 14 weeks [IQR 9]. Common SEPM events were hemorrhage (221; 0.47%), blood transfusion (126; 0.27%), ICU transfer (67; 0.15%) and sepsis (58; 0.13%). Common underlying etiologies were early pregnancy loss (130/407, 32%), non-obstetric infection (53/407, 13%), premature rupture of membranes or obstetric infection (42/407, 10%), and pre-existing conditions (42/407, 10%). SEPM was preventable in 126/407 (31%) of events, and 54/126 (43%) of preventability was related to restrictive abortion laws.

Conclusion:
SEPM contributes to preventable morbidity and may be affected by abortion restrictions.