Temporal Trends and Regional Variations in Severe Maternal Morbidity in Canada, 2003 to 2007

for the Maternal Health Study Group of the Canadian Perinatal Surveillance System

doi:10.1016/S1701-2163(16)34656-4

Temporal Trends and Regional Variations in Severe Maternal Morbidity in Canada, 2003 to 2007

for the Maternal Health Study Group of the Canadian Perinatal Surveillance System

Medicine

Résultat de recherche: Article › examen par les pairs

60 Citations (Scopus)

Résumé

Objective: To identify temporal trends and regional variations in severe maternal morbidity in Canada using routine hospitalization data. Methods: We used a previously identified set of International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10CA) and Canadian Classification of Interventions (CCI) codes to estimate rates of severe maternal morbidity in Canada (excluding Quebec) for 2003 to 2007 using the Discharge Abstract Database of the Canadian Institute for Health Information (CIHI). Rates and 95% confidence intervals were calculated by year and within each province and territory and contrasted using the chi-square or Fisher exact test. Results: The overall rate of severe maternal morbidity was 13.8 per 1000 deliveries (95% CI 13.6 to 14.0). Five provinces or territories had rates that were significantly higher than those in the rest of the country: Newfoundland and Labrador (19.0 per 1000; 95% CI 17.2 to 20.8), Saskatchewan (16.9 per 1000; 95% CI 15.9 to 18.0), Alberta (15.4 per 1000; 95% CI 14.9 to 15.9), Northwest Territories (22.5 per 1000; 95% CI 18.0 to 27.7), and Nunavut (20.2 per 1000; 95% CI 14.2 to 27.8). Rates of some illnesses declined (e.g., eclampsia rates decreased from 12.4 in 2003 to 5.7 per 10 000 deliveries in 2007, P < 0.001), while others increased (e.g., postpartum hemorrhage with blood transfusion rates increased from 36.6 in 2003 to 44.3 per 10 000 deliveries in 2007, P < 0.001). Interprovincial/ territorial contrasts showed several disparities with respect to specific maternal illnesses. Conclusion: The observed temporal trends and regional disparities in severe maternal morbidity may represent important population health phenomena, and further investigation is required to assess their importance. Objectif: Méthodes: Résultats: Conclusion:

Langue d'origine	English
Pages (de-à)	847-855
Nombre de pages	9
Journal	Journal of Obstetrics and Gynaecology Canada
Volume	32
Numéro de publication	9
DOI	https://doi.org/10.1016/S1701-2163(16)34656-4
Statut de publication	Published - 2010

Note bibliographique

Funding Information:
We are grateful to the Canadian Institute for Health Information for access to the data. Dr Joseph’s work is supported by the Child and Family Research Institute of British Columbia. Contributing members of the Maternal Health Study Group include Dr Russell Kirby, University of South Florida, Tampa, Florida and Juan Andrés León of the Maternal and Infant Health Section of the Public Health Agency of Canada, Ottawa.

Publisher Copyright:
© 2010 Society of Obstetricians and Gynaecologists of Canada.

ASJC Scopus Subject Areas

Obstetrics and Gynaecology

PubMed: MeSH publication types

Journal Article
Research Support, Non-U.S. Gov't

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10.1016/S1701-2163(16)34656-4

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@article{3950e090bf5d42ac87743f967809d4bb,

title = "Temporal Trends and Regional Variations in Severe Maternal Morbidity in Canada, 2003 to 2007",

abstract = "Objective: To identify temporal trends and regional variations in severe maternal morbidity in Canada using routine hospitalization data. Methods: We used a previously identified set of International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10CA) and Canadian Classification of Interventions (CCI) codes to estimate rates of severe maternal morbidity in Canada (excluding Quebec) for 2003 to 2007 using the Discharge Abstract Database of the Canadian Institute for Health Information (CIHI). Rates and 95% confidence intervals were calculated by year and within each province and territory and contrasted using the chi-square or Fisher exact test. Results: The overall rate of severe maternal morbidity was 13.8 per 1000 deliveries (95% CI 13.6 to 14.0). Five provinces or territories had rates that were significantly higher than those in the rest of the country: Newfoundland and Labrador (19.0 per 1000; 95% CI 17.2 to 20.8), Saskatchewan (16.9 per 1000; 95% CI 15.9 to 18.0), Alberta (15.4 per 1000; 95% CI 14.9 to 15.9), Northwest Territories (22.5 per 1000; 95% CI 18.0 to 27.7), and Nunavut (20.2 per 1000; 95% CI 14.2 to 27.8). Rates of some illnesses declined (e.g., eclampsia rates decreased from 12.4 in 2003 to 5.7 per 10 000 deliveries in 2007, P < 0.001), while others increased (e.g., postpartum hemorrhage with blood transfusion rates increased from 36.6 in 2003 to 44.3 per 10 000 deliveries in 2007, P < 0.001). Interprovincial/ territorial contrasts showed several disparities with respect to specific maternal illnesses. Conclusion: The observed temporal trends and regional disparities in severe maternal morbidity may represent important population health phenomena, and further investigation is required to assess their importance. Objectif: M{\'e}thodes: R{\'e}sultats: Conclusion:",

author = "{for the Maternal Health Study Group of the Canadian Perinatal Surveillance System} and Shiliang Liu and Joseph, {K. S.} and Sharon Bartholomew and John Fahey and Lily Lee and Allen, {Alexander C.} and Kramer, {Michael S.} and Reg Sauve and Young, {David C.} and Liston, {Robert M.} and Russell Kirby and Le{\'o}n, {Juan Andr{\'e}s}",

note = "Funding Information: We are grateful to the Canadian Institute for Health Information for access to the data. Dr Joseph{\textquoteright}s work is supported by the Child and Family Research Institute of British Columbia. Contributing members of the Maternal Health Study Group include Dr Russell Kirby, University of South Florida, Tampa, Florida and Juan Andr{\'e}s Le{\'o}n of the Maternal and Infant Health Section of the Public Health Agency of Canada, Ottawa. Publisher Copyright: {\textcopyright} 2010 Society of Obstetricians and Gynaecologists of Canada.",

year = "2010",

doi = "10.1016/S1701-2163(16)34656-4",

language = "English",

volume = "32",

pages = "847--855",

journal = "Journal of Obstetrics and Gynaecology Canada",

issn = "1701-2163",

publisher = "Healthcare & Financial Pub.",

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TY - JOUR

T1 - Temporal Trends and Regional Variations in Severe Maternal Morbidity in Canada, 2003 to 2007

AU - for the Maternal Health Study Group of the Canadian Perinatal Surveillance System

AU - Liu, Shiliang

AU - Joseph, K. S.

AU - Bartholomew, Sharon

AU - Fahey, John

AU - Lee, Lily

AU - Allen, Alexander C.

AU - Kramer, Michael S.

AU - Sauve, Reg

AU - Young, David C.

AU - Liston, Robert M.

AU - Kirby, Russell

AU - León, Juan Andrés

N1 - Funding Information: We are grateful to the Canadian Institute for Health Information for access to the data. Dr Joseph’s work is supported by the Child and Family Research Institute of British Columbia. Contributing members of the Maternal Health Study Group include Dr Russell Kirby, University of South Florida, Tampa, Florida and Juan Andrés León of the Maternal and Infant Health Section of the Public Health Agency of Canada, Ottawa. Publisher Copyright: © 2010 Society of Obstetricians and Gynaecologists of Canada.

PY - 2010

Y1 - 2010

N2 - Objective: To identify temporal trends and regional variations in severe maternal morbidity in Canada using routine hospitalization data. Methods: We used a previously identified set of International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10CA) and Canadian Classification of Interventions (CCI) codes to estimate rates of severe maternal morbidity in Canada (excluding Quebec) for 2003 to 2007 using the Discharge Abstract Database of the Canadian Institute for Health Information (CIHI). Rates and 95% confidence intervals were calculated by year and within each province and territory and contrasted using the chi-square or Fisher exact test. Results: The overall rate of severe maternal morbidity was 13.8 per 1000 deliveries (95% CI 13.6 to 14.0). Five provinces or territories had rates that were significantly higher than those in the rest of the country: Newfoundland and Labrador (19.0 per 1000; 95% CI 17.2 to 20.8), Saskatchewan (16.9 per 1000; 95% CI 15.9 to 18.0), Alberta (15.4 per 1000; 95% CI 14.9 to 15.9), Northwest Territories (22.5 per 1000; 95% CI 18.0 to 27.7), and Nunavut (20.2 per 1000; 95% CI 14.2 to 27.8). Rates of some illnesses declined (e.g., eclampsia rates decreased from 12.4 in 2003 to 5.7 per 10 000 deliveries in 2007, P < 0.001), while others increased (e.g., postpartum hemorrhage with blood transfusion rates increased from 36.6 in 2003 to 44.3 per 10 000 deliveries in 2007, P < 0.001). Interprovincial/ territorial contrasts showed several disparities with respect to specific maternal illnesses. Conclusion: The observed temporal trends and regional disparities in severe maternal morbidity may represent important population health phenomena, and further investigation is required to assess their importance. Objectif: Méthodes: Résultats: Conclusion:

AB - Objective: To identify temporal trends and regional variations in severe maternal morbidity in Canada using routine hospitalization data. Methods: We used a previously identified set of International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10CA) and Canadian Classification of Interventions (CCI) codes to estimate rates of severe maternal morbidity in Canada (excluding Quebec) for 2003 to 2007 using the Discharge Abstract Database of the Canadian Institute for Health Information (CIHI). Rates and 95% confidence intervals were calculated by year and within each province and territory and contrasted using the chi-square or Fisher exact test. Results: The overall rate of severe maternal morbidity was 13.8 per 1000 deliveries (95% CI 13.6 to 14.0). Five provinces or territories had rates that were significantly higher than those in the rest of the country: Newfoundland and Labrador (19.0 per 1000; 95% CI 17.2 to 20.8), Saskatchewan (16.9 per 1000; 95% CI 15.9 to 18.0), Alberta (15.4 per 1000; 95% CI 14.9 to 15.9), Northwest Territories (22.5 per 1000; 95% CI 18.0 to 27.7), and Nunavut (20.2 per 1000; 95% CI 14.2 to 27.8). Rates of some illnesses declined (e.g., eclampsia rates decreased from 12.4 in 2003 to 5.7 per 10 000 deliveries in 2007, P < 0.001), while others increased (e.g., postpartum hemorrhage with blood transfusion rates increased from 36.6 in 2003 to 44.3 per 10 000 deliveries in 2007, P < 0.001). Interprovincial/ territorial contrasts showed several disparities with respect to specific maternal illnesses. Conclusion: The observed temporal trends and regional disparities in severe maternal morbidity may represent important population health phenomena, and further investigation is required to assess their importance. Objectif: Méthodes: Résultats: Conclusion:

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Temporal Trends and Regional Variations in Severe Maternal Morbidity in Canada, 2003 to 2007

Résumé

Note bibliographique

ASJC Scopus Subject Areas

PubMed: MeSH publication types

Accès au document

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