Identifying Maternal Deaths in Texas Using an Enhanced Method, 2012
| Autor: | Natalie P. Archer, John Hellerstedt, Debra L Saxton, Michelle L Kormondy, Manda Hall, Sonia Baeva, Lisa M. Hollier, Karen Ruggiero |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Population MEDLINE 03 medical and health sciences 0302 clinical medicine International Classification of Diseases Pregnancy Cause of Death Data accuracy medicine Humans 030212 general & internal medicine education Cause of death education.field_of_study 030219 obstetrics & reproductive medicine business.industry Obstetrics and Gynecology Data matching medicine.disease Quality Improvement Texas Data Accuracy Obstetrics Pregnancy Complications Maternal Mortality Standardized mortality ratio Population Surveillance Emergency medicine Maternal Death Female Forms and Records Control business |
| Zdroj: | Obstetrics & Gynecology. 131:762-769 |
| ISSN: | 0029-7844 |
| DOI: | 10.1097/aog.0000000000002565 |
| Popis: | To more accurately estimate the 2012 maternal mortality ratio for Texas using an enhanced method for identifying maternal deaths.This population-based descriptive study used both data matching and record review to verify pregnancy or delivery within 42 days for 147 deaths with obstetric cause-of-death codes, and used data matching alone to identify additional maternal deaths within the same timeframe. Crude maternal mortality ratios were calculated for confirmed maternal deaths overall, by race and ethnicity, and by age. These maternal mortality ratios were compared with maternal mortality ratios computed using obstetric cause-of-death codes alone (standard method).Fifty-six maternal deaths were confirmed to have occurred during pregnancy or within 42 days postpartum. Using our enhanced method, the 2012 maternal mortality ratio for Texas was 14.6 maternal deaths per 100,000 live births, less than half that obtained using the standard method (n=147). Approximately half (50.3%) of obstetric-coded deaths showed no evidence of pregnancy within 42 days, and a large majority of these incorrectly indicated pregnancy at the time of death. Insufficient information was available to determine pregnancy for 15 obstetric-coded deaths, which were excluded from the 2012 maternal mortality ratio estimate; however, had these deaths been included, the resulting maternal mortality ratio would still be significantly lower than that reported using the standard method.Relying solely on obstetric codes for identifying maternal deaths appears to be insufficient and can lead to inaccurate maternal mortality ratios. A method enhanced with data matching and record review yields more accurate ratios. Results likely have national implications, because miscoding of obstetric deaths with the standard method may affect the accuracy of other states' maternal mortality ratios. |
| Databáze: | OpenAIRE |
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