Severe Maternal Morbidity

Severe maternal morbidity (SMM) includes unexpected outcomes of labor and delivery that can result in significant short- or long-term health consequences. SMM has been steadily increasing in recent years.

The consequences of the increasing SMM prevalence, in addition to the health effects for the woman, are wide-ranging. They include increased medical costs and longer hospitalization stays. To reduce SMM, it is essential to monitor trends and carry out interventions to improve the quality of maternal care.

To identify delivery hospitalizations with SMM, CDC uses administrative hospital discharge data and International Classification of Diseases (ICD) codes. The original list of 25 SMM indicators is based on the 9th Revision of ICD published in 2012.1 In 2015, the US transitioned to the 10th Revision of ICD.

CDC, along with our clinical and public health partners, took the opportunity to review this new version of ICD coding. CDC and partners updated the indicators, taking into account results from validation studies. These 21 indicators and corresponding ICD codes can identify delivery hospitalizations with SMM using administrative data starting in October 2015. Both ICD-9 and ICD-10 can be used to track SMM. Access the table which includes the list of 21 indicators and corresponding ICD codes.

Callaghan WM, Creanga AA, Kuklina EV. Severe maternal morbidity among delivery and postpartum hospitalizations in the United States. Obstet Gynecol. 2012;120(5):1029–1036.