How useful are hospital morbidity data for monitoring conditions occurring in the perinatal period?

Taylor, Lee; Travis, Susan; Pym, Margaret; Olive, Emily C.; Henderson‐Smart, David J

doi:10.1111/j.1479-828x.2005.00339.x

Cited by 99 publications

(135 citation statements)

References 10 publications

Supporting

Mentioning

125

Contrasting

Order By: Relevance

“…A validation study comparing data in the APDC to medical records found neonatal jaundice had a sensitivity of 80.0% and a positive predictive value of 90.9%. 15 As a test of face validity, we found 87% of infants who had a diagnosis of jaundice received a procedure code for phototherapy, similar to the reported high positive predictive value. …”

supporting

confidence: 51%

Early Discharge of Infants and Risk of Readmission for Jaundice

et al. 2015

View full text Add to dashboard Cite

OBJECTIVES: To examine the association between early discharge from hospital after birth and readmission to hospital for jaundice among term infants, and among infants discharged early, to investigate the perinatal risk factors for readmission for jaundice.METHODS: Birth data for 781 074 term live-born infants born in New South Wales, Australia from 2001 to 2010 were linked to hospital admission data. Logistic regression models were used to investigate the association between postnatal length of stay (LOS), gestational age (GA), and readmission for jaundice in the first 14 days of life. Other significant perinatal risk factors associated with readmission for jaundice were examined for infants discharged in the first 2 days after birth.RESULTS: Eight per 1000 term infants were readmitted for jaundice. Infants born at 37 weeks' GA with an LOS at birth of 0 to 2 days were over 9 times (adjusted odds ratio [aOR] 9.43; 95% CI, and at 38 weeks' GA were 4 times (aOR 4.05; 95% CI, 3.62-4.54) more likely to be readmitted for jaundice compared with infants born at 39 weeks' GA with an LOS of 3 to 4 days. Other significant risk factors for readmission for jaundice for infants discharged 0 to 2 days after birth included vaginal birth, born to mothers from an Asian country, born to first-time mothers, or being breastfed at discharge.CONCLUSIONS: This study can inform guidelines or policy about identifying infants at risk for readmission for jaundice and ensure that appropriate post-discharge follow-up is received.WHAT'S KNOWN ON THIS SUBJECT: Studies examining early postnatal discharge and readmission for jaundice report conflicting results. Infants born 37 to 38 weeks' gestation have an increased risk for readmission for jaundice; however, the impact of early discharge on this group has not been investigated. WHAT THIS STUDY ADDS:Early postnatal discharge was significantly associated with readmission for jaundice. Of the infants discharged early, those born 37 to 38 weeks' gestation, born via vaginal delivery, born to Asian mothers, or were breastfed had the greatest risk for readmission. Dr Lain participated in the study design, took primary responsibility of the data analysis, and drafted the initial manuscript; Associate Professor Roberts participated in the study design and data analysis and interpretation, and reviewed and revised manuscript; Dr Bowen participated in interpretation of the data and revision of manuscript for important clinical content; Associate Professor Nassar participated in the study design and data analysis and interpretation, and reviewed and revised manuscript; and all authors approved the final manuscript as submitted. The length of stay (LOS) in hospital after the birth of a child has been a controversial topic over the past few decades. A Cochrane Review found early postnatal discharge, defined as earlier than standard care, to have no adverse effects on breastfeeding and maternal depression when accompanied by a policy of nursing/midwifery home visits. However, they reported more re...

show abstract

supporting

confidence: 51%

Early Discharge of Infants and Risk of Readmission for Jaundice

et al. 2015

View full text Add to dashboard Cite

show abstract

“…24,25 This study showed that combining smoking information from the birth and hospital admission data enhanced the identification of pregnant smokers and improved the estimates of prevalence of smoking during pregnancy among Australian women. Estimates of the effects of maternal smoking on placental abruption, preterm birth, stillbirth and low birthweight were similar to those in the published literature, irrespective of whether unenhanced or enhanced methods were used.…”

Section: Discussionmentioning

confidence: 89%

“…37 Although no separate data source was available to compare the enhanced identification of smokers, by benchmarking findings against the population-based surveys this research has demonstrated that the enhanced algorithms produce estimates of maternal smoking prevalence that are similar to the expected rates of smoking in women of reproductive age. Low false positives for smoking in birth records and hospital records 24,25,54 suggest that the use of linked data reduced the number of smokers who were incorrectly reported as nonsmokers, rather than incorrectly identifying non-smokers as smokers.…”

Section: Discussionmentioning

confidence: 99%

“…20,21 Underreporting of smoking status, however, may bias the findings of research relying on a single source of routine data. [22][23][24][25][26] Studies conducted in Australia and elsewhere using biochemical testing to validate self-reporting of smoking status have reported that between 6% and 39% of smoking women do not disclose their smoking status. [27][28][29][30][31] Greater levels of non-disclosure are found in women who are older, married and have higher socioeconomic status.…”

mentioning

confidence: 99%

“…24,25 Such evidence indicates that these data sources, when used alone, are likely to under-estimate smoking women.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Linking birth records to hospital admission records enhances the identification of women who smoke during pregnancy

Tran

Roberts

Havard

et al. 2014

Australian and New Zealand Journal of Public Health

View full text Add to dashboard Cite

Objective: Birth records and hospital admission records are valuable for research on maternal smoking, but individually are known to under-estimate smokers. This study investigated the extent to which combining data from these records enhances the identification of pregnant smokers, and whether this affects research findings such as estimates of maternal smoking prevalence and risk of adverse pregnancy outcomes associated with smoking. Methods:A total of 846,039 birth records in New South Wales, Australia, (2001Australia, ( -2010 were linked to hospital admission records (delivery and antenatal). Algorithm 1 combined data from birth and delivery admission records, whereas algorithm 2 combined data from birth record, delivery and antenatal admission records. Associations between smoking and placental abruption, preterm birth, stillbirth, and low birthweight were assessed using multivariable logistic regression.Results: Algorithm 1 identified 127,612 smokers (smoking prevalence 15.1%), which was a 9.6% and 54.6% increase over the unenhanced identification from birth records alone (prevalence 13.8%), and delivery admission records alone (prevalence 9.8%), respectively. Algorithm 2 identified a further 2,408 smokers from antenatal admission records. The enhancement varied by maternal socio-demographic characteristics (age, marital status, country of birth, socioeconomic status); obstetric factors (multi-fetal pregnancy, diabetes, hypertension); and maternity hospital. Enhanced and unenhanced identification methods yielded similar odds ratios for placental abruption, preterm birth, stillbirth and low birthweight. Conclusions:Use of linked data improved the identification of pregnant smokers. Studies relying on a single data source should adjust for the under-ascertainment of smokers among certain obstetric populations.

show abstract

Pregnancy Outcomes in Women With Rare Autoimmune Diseases

Chen¹,

Roberts

Simpson

et al. 2015

Arthritis & Rheumatology

View full text Add to dashboard Cite

Objective. To examine pregnancy outcomes and pregnancy-related health service utilization among women with rare autoimmune diseases.Methods. This population-based cohort study of an Australian obstetric population (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011) used birth records linked to hospital records for identification of rare autoimmune diseases including systemic vasculitis, vasculitis limited to the skin, Sj€ ogren's syndrome, systemic sclerosis, Behçet's disease, polymyositis/dermatomyositis, and other systemic involvement of connective tissue. We excluded births in women with systemic lupus erythematosus or rheumatoid arthritis as well as births occurring ‡6 months before the diagnosis of the rare autoimmune disease. Modified Poisson regression was used to compare study outcomes between women with autoimmune diseases and the general obstetric population.Results. There were 991,701 births, including 409 births (0.04%) in 293 women with rare autoimmune diseases. Of the 409 births, 202 (49%) were delivered by cesarean section and 72 (18%) were preterm; these rates were significantly higher than those in the general obstetric population (28% and 7%, respectively). Compared to the general population, women with autoimmune diseases had higher rates of hypertensive disorders, antepartum hemorrhage, and severe maternal morbidity and required longer hospitalization at delivery, more hospital admissions, and tertiary obstetric care. Compared to other infants, those whose mothers had a rare autoimmune disease were at increased risk of admission to a neonatal intensive care unit, severe neonatal morbidity, and perinatal death.Conclusion. While the majority of women with rare autoimmune diseases delivered healthy infants, they were at increased risk of having both maternal complications and adverse neonatal outcomes, suggesting that their pregnancies should be closely monitored.

show abstract

How useful are hospital morbidity data for monitoring conditions occurring in the perinatal period?

Abstract: While hospital administrative data are readily available, data quality is a valid concern. However, if the data are viewed critically and information on accuracy is available, they can be a useful resource for monitoring the health of mothers and babies.

Cited by 99 publications

References 10 publications

Early Discharge of Infants and Risk of Readmission for Jaundice

Early Discharge of Infants and Risk of Readmission for Jaundice

Linking birth records to hospital admission records enhances the identification of women who smoke during pregnancy

Pregnancy Outcomes in Women With Rare Autoimmune Diseases

Contact Info

Product

Resources

About