Clinical outcomes and healthcare costs among Turkish and immigrant obstetric patients in intensive care unit: a 7-year retrospective cohort study from Turkey

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BACKGROUND: By analyzing pregnancy-related intensive care unit (ICU) admissions in different populations, the key risk factors of maternal outcomes can be identified. The aim of this study was to examine and compare outcomes and healthcare costs of critical care among Turkish obstetric patients (TOP) and immigrant obstetric patients (IOP) who were admitted to ICU. METHODS: This study was a retrospective cohort conducted at the intensive care unit of a Tertiary Care Hospital in Turkey. The data of all obstetric intensive care unit admissions over the period 2012-2018 were analyzed. Healthcare costs were also evaluated in both Turkish Lira and United States dollars ($). RESULTS: One hundred seventeen obstetric patients (75.2% TOP and 24.8% IOP) required ICU admissions over these 7 years. The average age of the IOP was significantly lower than that of the TOP (p < 0.05). It was determined that 39.8% (n = 35) of the TOP and 17.2% (n = 5) of the IOP were primiparous (p < 0.05). The TOP had a higher cesarean section rate (77.3%; n = 68) than the IOP (p < 0.05). The most common reasons for ICU admission were hypertensive disorders of pregnancy in both the TOP (36.4%) and the IOP (31.0%). IOP required antibiotic therapy more frequently (p < 0.05). The most common complication was acute kidney injury in both the TOP (17.0%) and the IOP (13.8%). Maternal death occurred in one of the IOP (3.4%) in six of the TOP (6.8%). The average cost of ICU during study period was 3682 Turkish liras ($1032) in Turkish citizen obstetric patients and 4585 Turkish liras ($1250) for immigrant patients. CONCLUSION: The critical care outcomes of immigrant and Turkish pregnant women were similar, except for some differences. The role of immigration status on the pregnancy, obstetric and gynecological critical care should be explored further.