LAUSR

Key Points Question What are the severe maternal morbidity (SMM) levels, primary causes, and factors associated with its preventability in birthing hospitals in Maryland? Findings This cross-sectional study of hospital-based SMM surveillance in Maryland identified 192 SMM events, with obstetric hemorrhage (43%), followed by severe COVID-19 infection (30%) and hypertensive disorders of pregnancy (9%), being the most common causes. Nearly two-thirds of SMM events reviewed were deemed preventable, with changes in clinician-level factors and interventions in the antepartum period having the largest potential to alter the SMM outcome. Meaning Immediate strategies to reduce SMM in Maryland should target its most common causes and address factors associated with SMM preventability identified at individual hospitals.