2021
Call to Action: Maternal Health and Saving Mothers: A Policy Statement From the American Heart Association
Mehta LS, Sharma G, Creanga AA, Hameed AB, Hollier LM, Johnson JC, Leffert L, McCullough LD, Mujahid MS, Watson K, White CJ, Committee O. Call to Action: Maternal Health and Saving Mothers: A Policy Statement From the American Heart Association. Circulation 2021, 144: e251-e269. PMID: 34493059, DOI: 10.1161/cir.0000000000001000.Peer-Reviewed Original ResearchConceptsAmerican Heart AssociationMaternal healthMaternal outcomesHeart AssociationAmerican Heart Association MissionHigh maternal mortality rateMaternal mortality surveillanceReproductive health equityMaternal mortality rateDelivery of careMaternal morbidityCardiovascular diseaseMortality surveillanceSaving MothersChild healthMortality rateEpidemiological programEthnic disparitiesHealth equityTime courseHealthy lifeMother's lifeHealthCareOutcomes
2020
Risk Factors, Etiologies, and Screening Tools for Sepsis in Pregnant Women: A Multicenter Case-Control Study
Bauer M, Housey M, Bauer S, Behrmann S, Chau A, Clancy C, Clark E, Einav S, Langen E, Leffert L, Lin S, Madapu M, Maile M, McQuaid-Hanson E, Priessnitz K, Sela H, Shah A, Sobolewski P, Toledo P, Tsen L, Bateman B. Risk Factors, Etiologies, and Screening Tools for Sepsis in Pregnant Women: A Multicenter Case-Control Study. Obstetric Anesthesia Digest 2020, 40: 65-66. DOI: 10.1097/01.aoa.0000661332.57510.93.Peer-Reviewed Original ResearchMulticenter case-control studyCase-control studyMaternal sepsisQuick Sequential Organ Failure Assessment criteriaSequential Organ Failure Assessment criteriaSystemic inflammatory response syndrome criteriaPregnancy-related deathsSigns of sepsisMaternal morbidityMaternal outcomesSyndrome criteriaPrompt treatmentPregnant womenEarly sepsisRisk factorsSepsisEarly identificationDifferent screening methodsPregnancyScreening toolScreening criteriaPhysiological changesPrimary objectiveScreening methodHospitalization
2019
Update on Obstetric Hemorrhage
Reale S, Leffert L, Farber M. Update on Obstetric Hemorrhage. Current Anesthesiology Reports 2019, 9: 60-68. DOI: 10.1007/s40140-019-00311-6.Peer-Reviewed Original ResearchPostpartum hemorrhageObstetric hemorrhageRecent evidence-based advancesEarly fibrinogen replacementPreventable maternal morbidityTranexamic acid therapyMassive transfusion protocolRecent epidemiologic dataEvidence-based advancesPostpartum hemorrhage managementConsensus BundleMaternal morbidityTransfusion protocolTransfusion strategyBlood lossAcid therapyEpidemiologic dataFibrinogen replacementHemorrhageHemorrhage managementImportant causeProtocol useEnhanced risk assessmentMorbidityNational Partnership
2018
The Role of the Anesthesiologist in Preventing Severe Maternal Morbidity and Mortality
McQUAID E, Leffert LR, Bateman BT. The Role of the Anesthesiologist in Preventing Severe Maternal Morbidity and Mortality. Clinical Obstetrics & Gynecology 2018, 61: 372-386. PMID: 29319586, DOI: 10.1097/grf.0000000000000350.Peer-Reviewed Original ResearchMeSH KeywordsAirway ManagementAnesthesia, EpiduralAnesthesia, GeneralAnesthesiologistsAnesthetics, LocalBlood TransfusionEchocardiographyEpidural AbscessFemaleHeadacheHematoma, Epidural, SpinalHumansIntubation, IntratrachealMaternal DeathMeningitisMonitoring, PhysiologicObstetric Labor ComplicationsPhysician's RolePregnancyPuerperal DisordersRespiratory AspirationRisk FactorsConceptsObstetric anesthesiologistSevere maternal morbidityLife-saving interventionsMaternal morbidityCesarean deliveryUnstable patientsGeneral anesthesiaObstetric suiteObstetric proceduresBedside managementClinical scenariosAnesthesiologistsIntensivistsAnesthesiaGreater experienceDeliveryAnalgesiaMorbidityPatientsUnique roleMortalityClinicians
2017
The Validity of Discharge Billing Codes Reflecting Severe Maternal Morbidity
Sigakis M, Leffert L, Mirzakhani H, Sharawi N, Rajala B, Callaghan W, Kuklina E, Creanga A, Mhyre J, Bateman B. The Validity of Discharge Billing Codes Reflecting Severe Maternal Morbidity. Obstetric Anesthesia Digest 2017, 37: 16-17. DOI: 10.1097/01.aoa.0000512008.03839.93.Peer-Reviewed Original ResearchMassachusetts General HospitalPositive predictive valueMaternal morbiditySevere maternal complicationsSevere maternal morbidityHospital discharge dataMichigan Health SystemMaternal complicationsGeneral HospitalDiseases codesBilling codesAcademic centersPredictive valueICD codesHealth systemMorbidityPresent studyDischarge dataComplicationsHospital
2016
The Validity of Discharge Billing Codes Reflecting Severe Maternal Morbidity
Sigakis MJ, Leffert LR, Mirzakhani H, Sharawi N, Rajala B, Callaghan WM, Kuklina EV, Creanga AA, Mhyre JM, Bateman BT. The Validity of Discharge Billing Codes Reflecting Severe Maternal Morbidity. Anesthesia & Analgesia 2016, 123: 731-738. PMID: 27387839, PMCID: PMC7481827, DOI: 10.1213/ane.0000000000001436.Peer-Reviewed Original ResearchConceptsICD-9-CM codesSevere maternal morbidityPositive predictive valueMaternal morbidityMassachusetts General HospitalMichigan Health SystemGeneral HospitalClinical categoriesHealth systemCorresponding medical chartsConfidence intervalsLower confidence limitAnesthesia complicationsDelivery hospitalizationsObstetric categoryDelivery admissionMedical chartsDischarge diagnosisDiseases codesClinical dataLaboratory valuesBilling codesInternational ClassificationMorbidityBilling records
2013
Neurofibromatosis type 1 and pregnancy complications: a population-based study
Terry AR, Barker FG, Leffert L, Bateman BT, Souter I, Plotkin SR. Neurofibromatosis type 1 and pregnancy complications: a population-based study. American Journal Of Obstetrics And Gynecology 2013, 209: 46.e1-46.e8. PMID: 23535241, DOI: 10.1016/j.ajog.2013.03.029.Peer-Reviewed Original ResearchMeSH KeywordsAdultCesarean SectionFemaleFetal Growth RetardationHumansHypertension, Pregnancy-InducedInfant, NewbornInternational Classification of DiseasesLogistic ModelsMaternal MortalityNeurofibromatosis 1Obstetric Labor, PrematurePre-EclampsiaPregnancyPregnancy ComplicationsRetrospective StudiesUnited StatesConceptsNeurofibromatosis type 1Diagnosis of NF1Deep venous thrombosis/pulmonary embolismPopulation-based retrospective cohort studyVenous thrombosis/pulmonary embolismType 1Pregnancy-related admissionsPregnancy-related hospitalizationsRetrospective cohort studyGeneral obstetric populationAcute cardiac eventsIntrauterine growth restrictionMultivariable logistic regressionPopulation-based studyGestational hypertensionMaternal morbidityObstetric populationPregnancy complicationsPreterm laborCardiac eventsCesarean deliveryCohort studyPeripartum complicationsPulmonary embolismCerebrovascular disease
2012
Influence of Patient Comorbidities on the Risk of Near-Miss Maternal Morbidity or Mortality
Mhyre J, Bateman B, Leffert L. Influence of Patient Comorbidities on the Risk of Near-Miss Maternal Morbidity or Mortality. Obstetric Anesthesia Digest 2012, 32: 212-213. DOI: 10.1097/01.aoa.0000422690.35910.a1.Peer-Reviewed Original ResearchPeripartum Subarachnoid Hemorrhage
Bateman B, Olbrecht V, Berman M, Minehart R, Schwamm L, Leffert L. Peripartum Subarachnoid Hemorrhage. Anesthesiology 2012, 116: 324-333. PMID: 22166951, DOI: 10.1097/aln.0b013e3182410b22.Peer-Reviewed Original ResearchConceptsSubarachnoid hemorrhageHypertensive disordersRisk factorsPregnancy-related admissionsIndependent risk factorIntracranial venous thrombosisNationwide Inpatient SampleAfrican American raceVariety of etiologiesRange of etiologiesSickle cell diseaseIdentified admissionsHospital deathMaternal morbidityNonpregnant patientsNonpregnant womenIndependent predictorsMalignant etiologySevere headacheVenous thrombosisNonpregnant controlsPregnancy resultsVenous bleedingInstitution experienceInpatient Sample
2011
Influence of Patient Comorbidities on the Risk of Near-miss Maternal Morbidity or Mortality
Mhyre J, Bateman B, Leffert L. Influence of Patient Comorbidities on the Risk of Near-miss Maternal Morbidity or Mortality. Anesthesiology 2011, 115: 963-972. PMID: 21934482, DOI: 10.1097/aln.0b013e318233042d.Peer-Reviewed Original ResearchConceptsNear-miss morbidityMorbidity/mortalityMaternal morbidityNear-miss maternal morbidityImportant medical comorbiditiesEnd-organ injuryHigh-quality intrapartum careSystemic lupus erythematosusNationwide Inpatient SampleHigh-risk groupLength of stayMiss morbidityMedical comorbiditiesObstetric complicationsPulmonary hypertensionPatient comorbiditiesLupus erythematosusIntrapartum carePregnant womenNational burdenInpatient SampleMaternal characteristicsObstetric diseasesPublic health investmentDelivery outcomes
2010
The Epidemiology of Postpartum Hemorrhage in a Large, Nationwide Sample of Deliveries
Bateman BT, Berman MF, Riley LE, Leffert LR. The Epidemiology of Postpartum Hemorrhage in a Large, Nationwide Sample of Deliveries. Anesthesia & Analgesia 2010, 110: 1368-1373. PMID: 20237047, DOI: 10.1213/ane.0b013e3181d74898.Peer-Reviewed Original ResearchConceptsPostpartum hemorrhageUterine atonyRisk factorsCesarean deliveryRate of PPHCases of PPHIncidence of PPHSubstantial maternal morbidityIndependent risk factorClinical Modification codesNationwide Inpatient SampleLogistic regression modelingAntepartum haemorrhageDelivery complicationsHospital deathMaternal morbidityMaternal outcomesMultiple gestationsCommon complicationHospital admissionHypertensive diseaseCommon etiologyMaternal ageInpatient SampleContemporary epidemiology