{
    "abstract": "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.\nWe 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.\nThere 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\u2009>\u200913\u00a0weeks' gestation (8.9%; 95% CI 8.1-9.7%) compared with\u2009\u2264\u200913\u00a0weeks (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.\nIn 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.",
    "authors": [
        {
            "affiliation": "OHSU-PSU School of Public Health, 1805 SW 4th Avenue, Portland, OR, 97201, USA. Jacobsonlaura@gmail.com.\nDepartment of Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR, USA. Jacobsonlaura@gmail.com.",
            "firstname": "Laura E",
            "initials": "LE",
            "lastname": "Jacobson"
        },
        {
            "affiliation": "Ipas LAC, Mexico City, Mexico.",
            "firstname": "Biani",
            "initials": "B",
            "lastname": "Saavedra-Avendano"
        },
        {
            "affiliation": "Independent Consultant, Mexico City, Mexico.",
            "firstname": "Raffaela",
            "initials": "R",
            "lastname": "Schiavon"
        },
        {
            "affiliation": "OHSU-PSU School of Public Health, 1805 SW 4th Avenue, Portland, OR, 97201, USA.\nDepartment of Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR, USA.\nInstituto Nacional de Salud Publica (INSP), Centro de Investigacion en Salud Poblacional (CISP), Cuernavaca, Mexico.",
            "firstname": "Blair G",
            "initials": "BG",
            "lastname": "Darney"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025. The Author(s).",
    "doi": "10.1186/s12889-024-21182-5",
    "journal": "BMC public health",
    "keywords": [
        "Abortion Complications",
        "Health Services Research",
        "Induced Abortion",
        "Maternal Morbidity",
        "Mexico",
        "Post-Abortion Care",
        "Spontaneous Abortion"
    ],
    "methods": null,
    "publication_date": "2025-01-10",
    "pubmed_id": "39789473\n33006558\n26287503\n34417270\n34285067\n28968414\n31859163\n34801131\n29414987\n34321256\n23409907\n31821537\n31413159\n21877087\n29897702\n25560122\n34879191\n26374637\n17883835\n24188634\n35969817\n29053188\n34263683",
    "results": null,
    "title": "Public hospital-based care for abortive events in Mexico: complication rates and socio-demographic factors, 2018-2022.",
    "xml": "<Element 'PubmedArticle' at 0x788506760130>"
}