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Assessment of Maternal Vascular Remodeling During Pregnancy in the Mouse Uterus
Published on: December 5, 2015
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Identifying cardiovascular severe maternal morbidity in epidemiologic studies
Isabelle Malhamé1, Niharika Mehta1,2, Christina A Raker2
1Department of Medicine of the Warren Alpert Medical School of Brown University, Women & Infants Hospital, Providence, Rhode Island, USA.
Paediatric and Perinatal Epidemiology
|January 24, 2020
Summary
Cardiovascular severe maternal morbidity (CSMM) is a growing cause of death. A new composite variable shows promise for identifying CSMM cases in administrative data, aiding research to reduce maternal mortality.
Area of Science:
- Maternal Health
- Cardiovascular Health
- Epidemiology
Background:
- Cardiovascular severe maternal morbidity (CSMM) is increasing and is the leading cause of maternal mortality.
- Administrative data sets offer potential for understanding CSMM.
Purpose of the Study:
- To validate a composite variable for identifying CSMM in administrative data for epidemiologic studies.
Main Methods:
- Utilized ICD codes and expert clinician review to develop and validate a CSMM composite variable.
- Analyzed delivery hospitalizations from 2007-2017 at an obstetric teaching hospital.
- Assessed validity by reviewing cases with severe preeclampsia and a random sample.
Main Results:
- The composite variable identified 65 true CSMM cases from 113 potential cases (57.5% positive predictive value).
- High true-positive rates were observed for acute myocardial infarction, cardiac arrest, and cardioversion indicators.
- Additional CSMM cases were identified in severe preeclampsia and random samples, yielding a 29.0% sensitivity and 100% specificity.
Conclusions:
- A novel composite variable for CSMM demonstrates reasonable positive predictive value but limited sensitivity.
- This tool may facilitate epidemiologic research aimed at reducing maternal morbidity and mortality.
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