Report Summary - Perinatal Health Indicators 2013: a Surveillance Report by the Public Health Agency of Canada’s Perinatal Surveillance System

Irvine, Brittany; Dzakpasu, Susie; León, Juan Andrés

doi:10.24095/hpcdp.35.1.05

Cited by 19 publications

(13 citation statements)

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“…12 Although maternal mortality is relatively rare in developed nations, PPH may be implicated in up to 27% of all cases. 13 Economic burden of PPH Unfortunately, there is a paucity of published data on the true economic impact of maternal haemorrhage.…”

Section: Open Accessmentioning

confidence: 99%

“…9 Following these trends, the overall severe maternal morbidity rate between 2003 and 2011 has increased from 14.2 to 15.4 cases per 1000 deliveries in Canada. 12 Protocol for a pilot, randomised, doubleblinded, placebo-controlled trial of prophylactic use of tranexamic acid for preventing postpartum haemorrhage (TAPPH-1) Asim Alam, 1,2 Ameya Bopardikar, 1 Shelly Au, 1 Jon Barrett, 3 Jeannie Callum, 4 Alex Kiss, 5 Stephen Choi 1 …”

Section: Introductionmentioning

confidence: 99%

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Protocol for a pilot, randomised, double-blinded, placebo-controlled trial of prophylactic use of tranexamic acid for preventing postpartum haemorrhage (TAPPH-1)

Alam

Bopardikar

et al. 2017

BMJ Open

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IntroductionPostpartum haemorrhage (PPH) is the leading cause of maternal morbidity and mortality worldwide. Despite the availability of multiple uterotonic agents, the incidence of PPH continues to rise. Tranexamic acid (TXA) has been shown to be a safe, effective and inexpensive therapeutic option for the treatment of PPH, however, its use prophylactically in mitigating the risk of PPH is unknown. This pragmatic randomised prospective trial assesses the feasibility and safety of administering TXA at the time of delivery for the prevention of PPH.Methods and analysisA pilot pragmatic randomised double-blinded placebo-controlled trial will be performed. 58 singleton parturients at term >32 weeks, undergoing either spontaneous vaginal delivery, or caesarean section will be randomised to receive 1 g of TXA or placebo (0.9% saline) intravenously. The primary outcome assessed will be the feasibility of administrating TXA, along with collecting data regarding safety of drug administration. The groups will also be analysed on efficacy of mitigating the onset of PPH and clinically relevant variables. Demographic, feasibility, safety and clinical endpoints will be summarised and the appropriate measures of central tendency and dispersion will be presented.Ethics and disseminationThis protocol was approved by the Sunnybrook Health Sciences Centre Research Ethics Board (number: 418-2016). The results will be disseminated in a peer-reviewed journal and at scientific meetings.Trial registration number NCT03069859; Pre-results.

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Section: Open Accessmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Protocol for a pilot, randomised, double-blinded, placebo-controlled trial of prophylactic use of tranexamic acid for preventing postpartum haemorrhage (TAPPH-1)

Alam

Bopardikar

et al. 2017

BMJ Open

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“…According to 2016 Census data, 4.8 million Canadians are living in poverty and 1.2 million (20%) children live in low-income households [ 24 ]. It has been estimated that in Canada each year at least 50,000 children are born into poverty and 1 of 80–100 infants are born with CHD in Canada [ 4 , 25 ]. Considering Ontario consists of 39% of Canada’s population, social inequity would be a major concern in prenatal health if pregnant women with a lower SES have an increased risk of CHD [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease

Miao

Dunn

Wen

et al. 2021

BMC Pregnancy Childbirth

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Background This study aimed to examine the relationships between various maternal socioeconomic status (SES) indicators and the risk of congenital heart disease (CHD). Methods This was a population-based retrospective cohort study, including all singleton stillbirths and live births in Ontario hospitals from April 1, 2012 to March 31, 2018. Multivariable logistic regression models were performed to examine the relationships between maternal neighbourhood household income, poverty, education level, employment and unemployment status, immigration and minority status, and population density and the risk of CHD. All SES variables were estimated at a dissemination area level and categorized into quintiles. Adjustments were made for maternal age at birth, assisted reproductive technology, obesity, pre-existing maternal health conditions, substance use during pregnancy, rural or urban residence, and infant’s sex. Results Of 804,292 singletons, 9731 (1.21%) infants with CHD were identified. Compared to infants whose mothers lived in the highest income neighbourhoods, infants whose mothers lived in the lowest income neighbourhoods had higher likelihood of developing CHD (adjusted OR: 1.29, 95% CI: 1.20–1.38). Compared to infants whose mothers lived in the neighbourhoods with the highest percentage of people with a university or higher degree, infants whose mothers lived in the neighbourhoods with the lowest percentage of people with university or higher degree had higher chance of CHD (adjusted OR: 1.34, 95% CI: 1.24–1.44). Compared to infants whose mothers lived in the neighbourhoods with the highest employment rate, the odds of infants whose mothers resided in areas with the lowest employment having CHD was 18% higher (adjusted OR: 1.18, 95% CI: 1.10–1.26). Compared to infants whose mothers lived in the neighbourhoods with the lowest proportion of immigrants or minorities, infants whose mothers resided in areas with the highest proportions of immigrants or minorities had 18% lower odds (adjusted OR: 0.82, 95% CI: 0.77–0.88) and 16% lower odds (adjusted OR: 0.84, 95% CI: 0.78–0.91) of CHD, respectively. Conclusion Lower maternal neighbourhood household income, poverty, lower educational level and unemployment status had positive associations with CHD, highlighting a significant social inequity in Ontario. The findings of lower CHD risk in immigrant and minority neighbourhoods require further investigation.

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“…National statistics were used both by The Lancet Ending Preventable Stillbirths study group, The Lancet Stillbirths in High-Income Countries Investigator Group [60–65] to compare the incidence of asphyxia on an international level and by other studies for epidemiological research in perinatal medicine [3, 7, 62, 64–73]. …”

Section: Discussionmentioning

confidence: 99%

Asphyxia in the Newborn: Evaluating the Accuracy of ICD Coding, Clinical Diagnosis and Reimbursement: Observational Study at a Swiss Tertiary Care Center on Routinely Collected Health Data from 2012-2015

et al. 2017

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BackgroundThe ICD-10 categories of the diagnosis “perinatal asphyxia” are defined by clinical signs and a 1-minute Apgar score value. However, the modern conception is more complex and considers metabolic values related to the clinical state. A lack of consistency between the former clinical and the latter encoded diagnosis poses questions over the validity of the data. Our aim was to establish a refined classification which is able to distinctly separate cases according to clinical criteria and financial resource consumption. The hypothesis of the study is that outdated ICD-10 definitions result in differences between the encoded diagnosis asphyxia and the medical diagnosis referring to the clinical context.MethodsRoutinely collected health data (encoding and financial data) of the University Hospital of Bern were used. The study population was chosen by selected ICD codes, the encoded and the clinical diagnosis were analyzed and each case was reevaluated. The new method categorizes the diagnoses of perinatal asphyxia into the following groups: mild, moderate and severe asphyxia, metabolic acidosis and normal clinical findings. The differences of total costs per case were determined by using one-way analysis of variance.ResultsThe study population included 622 cases (P20 “intrauterine hypoxia” 399, P21 “birth asphyxia” 233). By applying the new method, the diagnosis asphyxia could be ruled out with a high probability in 47% of cases and the variance of case related costs (one-way ANOVA: F (5, 616) = 55.84, p < 0.001, multiple R-squared = 0.312, p < 0.001) could be best explained. The classification of the severity of asphyxia could clearly be linked to the complexity of cases.ConclusionThe refined coding method provides clearly defined diagnoses groups and has the strongest effect on the distribution of costs. It improves the diagnosis accuracy of perinatal asphyxia concerning clinical practice, research and reimbursement.

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Report Summary - Perinatal Health Indicators 2013: a Surveillance Report by the Public Health Agency of Canada’s Perinatal Surveillance System

Cited by 19 publications

References 0 publications

Protocol for a pilot, randomised, double-blinded, placebo-controlled trial of prophylactic use of tranexamic acid for preventing postpartum haemorrhage (TAPPH-1)

Protocol for a pilot, randomised, double-blinded, placebo-controlled trial of prophylactic use of tranexamic acid for preventing postpartum haemorrhage (TAPPH-1)

Neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease

Asphyxia in the Newborn: Evaluating the Accuracy of ICD Coding, Clinical Diagnosis and Reimbursement: Observational Study at a Swiss Tertiary Care Center on Routinely Collected Health Data from 2012-2015

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