From Survival to Recovery: Long-Term Sequelae of Severe Maternal Morbidity and Obstetric Critical Illness.

IMPORTANCE: Severe maternal morbidity (SMM) and obstetric critical illness are rising in the United States and contribute to striking maternal health disparities. While the acute complications of severe maternal morbidity are well documented, the long-term physical and psychosocial consequences remain understudied. OBJECTIVE: To conduct a narrative review of the long-term consequences of severe maternal morbidity, including obstetric critical illness, and interventions for improving health outcomes. EVIDENCE ACQUISITION: Original and review articles were identified using a structured search strategy in PubMed and relevant OpenEvidence searches; pertinent articles were reviewed. RESULTS: Severe maternal morbidity and obstetric ICU admission are associated with increased risks of hospital readmission, chronic cardiovascular and renal disease, psychiatric sequelae, including posttraumatic stress disorder, reduced quality of life, and adverse reproductive outcomes. Specific maternal morbidity conditions, such as hypertensive disorders of pregnancy, peripartum cardiomyopathy, postpartum hemorrhage, and peripartum hysterectomy, each carry distinct long-term health risks. Interventions including multidisciplinary specialty clinics, structured care transitions to primary care providers, psychosocial screening and support, and expansion of postpartum Medicaid coverage show promise in improving maternal health outcomes and reducing disparities. However, implementation remains inconsistent, and longitudinal data are needed. CONCLUSIONS: Survivors of severe maternal morbidity experience significant long-term health burdens that extend beyond the postpartum period. Holistic, multidisciplinary models of follow-up and expanded health policy initiatives are needed to address gaps in care and improve long-term maternal outcomes. RELEVANCE: This review offers an overview of the literature about the long-term consequences of severe maternal morbidity and obstetric critical illness.