Public hospital-based care for abortive events in Mexico: complication rates and socio-demographic factors, 2018-2022
Abstract Background Abortion-related complications are difficult to measure due to lack of standardized definitions and limited available data. We describe the proportion of abortive events that result in a documented complication in Mexico’s public sector hospitals. Methods We used ICD-10 codes fro...
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2025-01-01
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| author | Laura E. Jacobson Biani Saavedra-Avendano Raffaela Schiavon Blair G. Darney |
| author_facet | Laura E. Jacobson Biani Saavedra-Avendano Raffaela Schiavon Blair G. Darney |
| author_sort | Laura E. Jacobson |
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| description | Abstract Background Abortion-related complications are difficult to measure due to lack of standardized definitions and limited available data. We describe the proportion of abortive events that result in a documented complication in Mexico’s public sector hospitals. Methods We used ICD-10 codes from Mexico’s hospital discharge system (2018-2022), Subsistema Automatizado de Egresos Hospitalarios (SAEH), to describe abortive events admitted to hospitals: complications for excessive bleeding, infection, embolism, and unspecified; patient socio-demographic and clinical characteristics; and municipality-level structural vulnerability. We estimate complications by pregnancy duration, describe types of complications, identify characteristics associated with the presence of a complication using multuvariable regression, and calculate complication rates (proportion of abortive event that result in a complication treated in a public sector hospital per 1,000 women of reproductive age) by state in 2022. Findings There were 399,405 abortive events that received hospital-based care in Secretaria de Salud (SS) hospitals between 2018-2022. Ninety-two percent had no complication reported. The adjusted predicted probability of a complication was higher among patients at > 13 weeks’ gestation (8.9%; 95% CI 8.1–9.7%) compared with ≤ 13 weeks (6.6%; 95% CI 6.0–7.2%). Higher parity, care at a tertiary hospital, and high marginalization at place of residence were positively associated with presence of a complication. States with higher complication rates are primarily in the central and southern regions. Conclusions In Mexico, 92% of patients who seek care for all abortive events (induced, spontaneous, post-abortion) in SS hospitals have no complications. Marginalized patients are more likely to have a complication and to seek care at later pregnancy durations. Routinely conflating care-seeking and complications leads to overestimates of the risk of abortion. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Public Health |
| spelling | doaj-art-e269a2ccd1964ad5a24d0cd3be2818682025-01-12T12:42:36ZengBMCBMC Public Health1471-24582025-01-0125111110.1186/s12889-024-21182-5Public hospital-based care for abortive events in Mexico: complication rates and socio-demographic factors, 2018-2022Laura E. Jacobson0Biani Saavedra-Avendano1Raffaela Schiavon2Blair G. Darney3OHSU-PSU School of Public HealthIpas LACIndependent ConsultantOHSU-PSU School of Public HealthAbstract Background Abortion-related complications are difficult to measure due to lack of standardized definitions and limited available data. We describe the proportion of abortive events that result in a documented complication in Mexico’s public sector hospitals. Methods We used ICD-10 codes from Mexico’s hospital discharge system (2018-2022), Subsistema Automatizado de Egresos Hospitalarios (SAEH), to describe abortive events admitted to hospitals: complications for excessive bleeding, infection, embolism, and unspecified; patient socio-demographic and clinical characteristics; and municipality-level structural vulnerability. We estimate complications by pregnancy duration, describe types of complications, identify characteristics associated with the presence of a complication using multuvariable regression, and calculate complication rates (proportion of abortive event that result in a complication treated in a public sector hospital per 1,000 women of reproductive age) by state in 2022. Findings There were 399,405 abortive events that received hospital-based care in Secretaria de Salud (SS) hospitals between 2018-2022. Ninety-two percent had no complication reported. The adjusted predicted probability of a complication was higher among patients at > 13 weeks’ gestation (8.9%; 95% CI 8.1–9.7%) compared with ≤ 13 weeks (6.6%; 95% CI 6.0–7.2%). Higher parity, care at a tertiary hospital, and high marginalization at place of residence were positively associated with presence of a complication. States with higher complication rates are primarily in the central and southern regions. Conclusions In Mexico, 92% of patients who seek care for all abortive events (induced, spontaneous, post-abortion) in SS hospitals have no complications. Marginalized patients are more likely to have a complication and to seek care at later pregnancy durations. Routinely conflating care-seeking and complications leads to overestimates of the risk of abortion.https://doi.org/10.1186/s12889-024-21182-5Induced AbortionSpontaneous AbortionPost-Abortion CareAbortion ComplicationsMaternal MorbidityHealth Services Research |
| spellingShingle | Laura E. Jacobson Biani Saavedra-Avendano Raffaela Schiavon Blair G. Darney Public hospital-based care for abortive events in Mexico: complication rates and socio-demographic factors, 2018-2022 BMC Public Health Induced Abortion Spontaneous Abortion Post-Abortion Care Abortion Complications Maternal Morbidity Health Services Research |
| title | Public hospital-based care for abortive events in Mexico: complication rates and socio-demographic factors, 2018-2022 |
| title_full | Public hospital-based care for abortive events in Mexico: complication rates and socio-demographic factors, 2018-2022 |
| title_fullStr | Public hospital-based care for abortive events in Mexico: complication rates and socio-demographic factors, 2018-2022 |
| title_full_unstemmed | Public hospital-based care for abortive events in Mexico: complication rates and socio-demographic factors, 2018-2022 |
| title_short | Public hospital-based care for abortive events in Mexico: complication rates and socio-demographic factors, 2018-2022 |
| title_sort | public hospital based care for abortive events in mexico complication rates and socio demographic factors 2018 2022 |
| topic | Induced Abortion Spontaneous Abortion Post-Abortion Care Abortion Complications Maternal Morbidity Health Services Research |
| url | https://doi.org/10.1186/s12889-024-21182-5 |
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