Please use this identifier to cite or link to this item: https://hdl.handle.net/10216/143592
Author(s): Chantry, AA
Berrut, S
Donati, S
Gissler, M
Goldacre, R
Knight, M
Maraschini, A
Monteath, K
Morris, A
Teixeira, C
Wood, R
Zeitlin, J
Deneux-Tharaux, C
Title: Monitoring severe acute maternal morbidity across Europe: A feasibility study
Publisher: Wiley
Issue Date: 2020
Abstract: Background: Monitoring severe acute maternal morbidity (SAMM) appears essential for optimising care and informing health care policies, especially given changes in obstetric practices and mother profiles. International comparisons can identify areas where improvement is needed, but the comparability of indicators must be evaluated. Objective: To assess the feasibility of monitoring SAMM using common definitions from hospital discharge databases across Europe. Methods: We used hospital discharge data in eight countries (2 826 868 deliveries) to identify women with SAMM among all hospitalisations of women of reproductive age admitted for antenatal or delivery care. Five SAMM indicators were investigated: eclampsia, septicaemia, hysterectomy, hysterectomy associated with a diagnosis of obstetric haemorrhage, and red blood cell (RBC) transfusion associated with a diagnosis of obstetric haemorrhage. Between-country variation was described, by the ratio of the highest to lowest rates, while external validation was assessed by comparing with population-based studies on maternal morbidity. Results: Ratios for hysterectomy and red blood cell (RBC) transfusion in the context of obstetric haemorrhage were 1:2.1 and 1:3.5, respectively. High values of hysterectomy and low values of transfusion were both consistent with high maternal mortality from haemorrhage (France, Italy, Portugal). Ratios across countries were relatively low for eclampsia (1:3.4) but very high for septicaemia (1:22.5). Compared to population-based morbidity estimates, eclampsia was over-reported in hospital databases whereas the two indicators of severe haemorrhage had good external validity. Conclusions: In association with diagnosis codes indicating obstetric haemorrhage, hysterectomy and RBC transfusion appear to be good candidates for surveillance of maternal morbidity in Europe.
Subject: Europe
hospital discharge databases
maternal health surveillance
obstetric complications
severe acute maternal morbidity.
URI: https://hdl.handle.net/10216/143592
Source: Paediatr Perinat Epidemiol. 2020 Jul;34(4):416-426
Document Type: Artigo em Revista Científica Internacional
Rights: restrictedAccess
License: https://creativecommons.org/licenses/by/4.0/
Appears in Collections:ISPUP - Artigo em Revista Científica Internacional

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