Document Detail


An enhanced method for identifying obstetric deliveries: implications for estimating maternal morbidity.
MedLine Citation:
PMID:  17690963     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The accuracy of maternal morbidity estimates from hospital discharge data may be influenced by incomplete identification of deliveries. In maternal/infant health studies, obstetric deliveries are often identified only by the maternal outcome of delivery code (International Classification of Diseases code = V27). We developed an enhanced delivery identification method based on additional delivery-related codes and compared the performance of the enhanced method with the V27 method in identifying estimates of deliveries as well as estimates of maternal morbidity. METHODS: The enhanced and standard V27 methods for identifying deliveries were applied to data from the 1998-2004 Healthcare Cost and Utilization Project Nationwide Inpatient Sample, an annual nationwide representative survey of U.S. hospitalizations. Odds ratios (ORs) and 95% confidence intervals (CIs) from logistic regression were used to examine predictors of deliveries not identified using the V27 method. RESULTS: The enhanced method identified 958,868 (3.4%) more deliveries than the 27,128,539 identified using the V27 code alone. Severe complications including major puerperal infections (OR = 3.1, 95% CI 2.8-3.4), hysterectomy (OR = 6.0, 95% CI 5.3-6.8), sepsis (OR = 11.9, 95% CI 10.3-13.6) and respiratory distress syndrome (OR = 16.6, 95% CI 14.4-19.2) were strongly associated with deliveries not identified by the V27 method. Nationwide prevalence rates of severe maternal complications were underestimated with the V27 method compared to the enhanced method, ranging from 9% underestimation for major puerperal infections to 40% underestimation for respiratory distress syndrome. CONCLUSION: Deliveries with severe obstetric complications may be more likely to be missed using the V27 code. Researchers should be aware that selecting deliveries from hospital stay records by V27 codes alone may affect the accuracy of their findings.
Authors:
Elena V Kuklina; Maura K Whiteman; Susan D Hillis; Denise J Jamieson; Susan F Meikle; Samuel F Posner; Polly A Marchbanks
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Publication Detail:
Type:  Journal Article     Date:  2007-08-10
Journal Detail:
Title:  Maternal and child health journal     Volume:  12     ISSN:  1092-7875     ISO Abbreviation:  Matern Child Health J     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-30     Completed Date:  2009-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9715672     Medline TA:  Matern Child Health J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  469-77     Citation Subset:  IM    
Affiliation:
Quantell Inc., Taneytown, MD, USA. ekuklina@cdc.gov
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MeSH Terms
Descriptor/Qualifier:
Delivery, Obstetric / classification*,  statistics & numerical data*
Female
Health Care Surveys / methods*
Humans
International Classification of Diseases / statistics & numerical data*
Obstetric Labor Complications / classification,  epidemiology*
Pregnancy
United States / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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