The association between hospital obstetrical volume and maternal postpartum complications

Kathy L. Kyser, Xin Lu, Donna A. Santillan, Mark K. Santillan, Stephen K. Hunter, Alison G. Cahill, Peter Cram

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: The purpose of this study was to examine the relationship between delivery volume and maternal complications. STUDY DESIGN: We used administrative data to identify women who had been admitted for childbirth in 2006. Hospitals were stratified into deciles that were based on delivery volume. We compared composite complication rates across deciles. RESULTS: We evaluated 1,683,754 childbirths in 1045 hospitals. Decile 1 and 2 hospitals had significantly higher rates of composite complications than decile 10 (11.8% and 10.1% vs 8.5%, respectively; P < .0001). Decile 9 and 10 hospitals had modestly higher composite complications as compared with decile 6 (8.8% and 8.5% vs 7.6%, respectively; P < .0001). Sixty percent of decile 1 and 2 hospitals were located within 25 miles of the nearest greater volume hospital. CONCLUSION: Women who deliver at very low-volume hospitals have higher complication rates, as do women who deliver at exceedingly high-volume hospitals. Most women who deliver in extremely low-volume hospitals have a higher volume hospital located within 25 miles.

Original languageEnglish (US)
Pages (from-to)42.e1-42.e17
JournalAmerican journal of obstetrics and gynecology
Issue number1
StatePublished - Jul 2012
Externally publishedYes


  • complication
  • obstetrical volume
  • patient safety

ASJC Scopus subject areas

  • Obstetrics and Gynecology


Dive into the research topics of 'The association between hospital obstetrical volume and maternal postpartum complications'. Together they form a unique fingerprint.

Cite this