Association of Pregnancy Characteristics and Maternal Mortality With Amniotic Fluid Embolism

Key Points Question What pregnancy characteristics and maternal outcomes are associated with amniotic fluid embolism (AFE)? Findings In this cohort study of 14.6 million deliveries in the National Inpatient Sample from 2016 to 2019, the incidence of AFE was 6.0 per 100 000 deliveries, and placental accreta spectrum was associated with a 10-times increased risk of AFE. Amniotic fluid embolism was associated with other severe maternal morbidities, including coagulopathy, cardiac arrest, and adult respiratory distress syndrome; failure-to-rescue rate after AFE was 17% overall but could exceed 30% in the setting of placental pathology or other comorbidities. Meaning This national-level analysis confirmed the dismal outcomes of pregnancies complicated by AFE and suggests that placental accreta spectrum may be associated with AFE.