Amniotic fluid embolism: 20-year incidence and case-fatality trends in the United States

Objective: To estimate incidence and case-fatality rates of amniotic fluid embolism (AFE) and to examine their temporal trends. Study design: Population-based retrospective cohort study using the 2000-2019 Health Care Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS). Annual population rates were estimated using HCUP-NIS specific weighting. Descriptive analyses and logistic regression described trends within the cohort. Results: Over the study period, AFE incidence rate remained stable (mean 4.9 cases/100,000 deliveries) and the case-fatality rate declined (mean 17.7 %,95 % CI 16.40-10.09). Highest AFE incidence rates and fatality rates were in women >= 35 years, African-Americans, and in urban-teaching hospitals. AFE mortality rates decreased among Hispanics. Conclusion: AFE rates remained stable and fatality rates declined over time. Highest rates of AFE occurrence and death were in women who typically have greater risk of experiencing adverse obstetrical outcomes. Continued research into early diagnostic methods and effective treatments are needed to further improve AFE incidence and mortality rates.