Statistical Measures in Maternity Care

Statistical Measures in Maternity Care

Emma Parry (The University of Auckland, New Zealand)
Copyright: © 2009 |Pages: 12
DOI: 10.4018/978-1-60566-078-3.ch007
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Abstract

Pregnancy is unique in medicine in providing a discrete event with a fixed end. It is well suited to data collection and statistical assessment. This chapter systematically reviews the antenatal, intrapartum, and postnatal (both maternal and neonatal) aspects of care. The range of events that can occur and their classification is discussed. In many cases there is variation in classification around the world and between different organizations. These complexities are discussed. Once data is collected there are a number of ways to analyze it depending on what is wanted. Issues of appropriate numerator and denominator are discussed and the pitfalls which can occur. Use of data, both original and derived, is discussed in terms of type of use: planning, benchmarking, process review and research, and by whom: individual, local unit, country level, or internationally.
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Maternity Variables

Antenatal

At the time of booking a number of demographic variables will be recorded. These will usually include data on the woman’s age, ethnicity, contact details and primary health care physician. Previous pregnancies, their progress and outcome will be recorded. In many ‘booking forms’ there will be a series of general health questions for the woman and her family eg ‘do you have diabetes or is there any history of diabetes in your family?’ ‘Have you had any surgery?’

There will be a large section of questions devoted to the current pregnancy. These will include information on last menstrual period (LMP), estimated date of delivery (EDD), confirmation of pregnancy method (urine test, scan). Was the pregnancy planned and if so was folic acid or vitamins taken periconceptually in countries where this is recommended? Where there has been a scan is the pregnancy confirmed to be singleton or multiple? Any problems so far?

Information on factors which may affect pregnancy and where modification is advised will usually be included. This includes smoking, alcohol intake and recreational drug use. Adherence to primary health strategies such as pap smears and sexually transmitted diseases (STD) swabs will often be included.

Most booking regimes will include some basic assessment of socio-economic status such as highest level of qualification or postcode/zipcode assessment.

As pregnancy progresses a series of visits will take place and investigations and screening options offered. The visits will usually include regular checks of blood pressure, urinalysis and abdominal palpation (to check the fetal growth and position). The woman’s height and weight will often also be recorded. Routine blood tests will usually include a complete blood count (CBC), screening for hepatitis B, syphilis, HIV and checks for blood group and rubella immunity. In many countries women are offered scans and/or blood tests to assess the risk of Trisomy 21 (Down syndrome) and general fetal anatomy. Some countries also offer additional blood tests for screening. Some women may have invasive diagnostic tests such as amniocentesis.

All this information gathering and testing has evolved as part of the management of pregnancy over the last 100 years. For an individual woman it allows detection of problems in a timely fashion to allow appropriate intervention. However, with the advent of computerization, this information gathering has become a powerful tool to provide statistical measurement of many areas of maternity care delivery. Clearly though, the accuracy of the data depends on the care with which it is entered.

Commonly generated data include: pregnancy rate, average age of mothers and range, parity and gravidity, distribution of ethnicity and/or socio-economic group, smoking, drugs and alcohol use rates. Analyses of uptake of screening and diagnostic interventions may be evaluated. In addition there maybe an analysis of fetal abnormality and termination of pregnancy rates.

Complete Chapter List

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Editorial Advisory Board
Table of Contents
Foreword
Neil Pattison
Preface
Emma Parry, David Parry
Acknowledgment
Emma Parry, David Parry
Chapter 1
Peter Stone
Improving women’s health is a vital task for the world. The consequences of obstetric and gynecological disease are serious both for the women... Sample PDF
An Introduction to Women's Health and Informatics
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Chapter 2
Premila Fade
Principlism (derived from common sense morality) is the most common theory used within the healthcare sphere. The elements of this theory are... Sample PDF
Women's Health Informatics: The Ethical and Legal Issues
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Chapter 3
David Parry
Recording information about symptoms, observations, actions, and outcomes is a key task of health informatics. Standardization of records is vital... Sample PDF
Coding and Messaging Systems for Women's Health Informatics
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Chapter 4
Gareth Parry
Women’s health in primary care is a large part of the generalist’s practice. Information technology (IT) is now an integral part of the generalist’s... Sample PDF
Women's Health Informatics in the Primary Care Setting
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Chapter 5
Emma Parry
The seamless electronic health record is often hailed as the holy grail of health informatics. What is an electronic health record? This question is... Sample PDF
The Electronic Health Record to Support Women's Health
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Chapter 6
Graham Parry
Information technology and communication systems have made imaging in women’s health easier at many levels. There are now many commercial systems on... Sample PDF
Imaging and Communication Systems in Obstetrics and Gynecology
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Chapter 7
Emma Parry
Pregnancy is unique in medicine in providing a discrete event with a fixed end. It is well suited to data collection and statistical assessment.... Sample PDF
Statistical Measures in Maternity Care
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Chapter 8
Kiran Massey, Tara Morris, Robert M. Liston
Our ultimate goal as obstetric and neonatal care providers is to optimize care for mothers and their babies. As such, we need to identify practices... Sample PDF
Building Knowledge in Maternal and Infant Care
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Chapter 9
Malcolm Battin, David Knight, Carl Kuschel
Neonatal care is an extremely data-intensive activity. Physiological monitoring equipment is used extensively along with web-based information tools... Sample PDF
Informatics Applications in Neonatology
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Chapter 10
Jenny Westgate
During pregnancy the fetus requires an adequate supply of oxygen and clearance of carbon dioxide which is a waste product of metabolism. In fetal... Sample PDF
Computerizing the Cardiotocogram (CTG)
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Chapter 11
Liron Pantanowitz
Automation and emerging information technologies are being adopted by cytology laboratories around the world to augment Pap test screening and... Sample PDF
Computer Assisted Cervical Cytology
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Chapter 12
Laurie Elit, Susan Bondy, Michael Fung-Kee-Fung, Prafull Ghatage, Tien Le, Barry Rosen, Bohdan Sadovy
Ovarian cancer affects 2,400 women annually in Canada with a case fatality ratio of 0.70. There are several practice guidelines that indicate women... Sample PDF
Informatics and Ovarian Cancer Care
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Chapter 13
Jamila Abuidhail
Information and communication technologies include computers, telecommunication, digital networks, and television. Using informatics in healthcare... Sample PDF
Women's Health and Health Informatics: Perinatal Care Health Education
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Chapter 14
Shona Kirtley
In an age where health professionals lead very busy working lives, electronic information sources provide ease of access to vast amounts of health... Sample PDF
Electronic Information Sources for Women's Health Knowledge for Professionals
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Chapter 15
David Parry
Decision analysis techniques attempt to utilize mathematical data about outcomes and preferences to help people make optimal decisions. The... Sample PDF
Computerised Decision Support for Women's Health Informatics
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Chapter 16
Michelle Brear
The influence of organizational factors on the success of informatics interventions in healthcare has been clearly demonstrated. This health... Sample PDF
Organizational Factors: Their Role in Health Informatics Implementation
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Chapter 17
Josipa Kern
When things go well then often it is because they conform to standards (ISO, 2005). According to the Oxford Dictionary of Modern English, there is a... Sample PDF
Standardization in Health and Medical Informatics
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Chapter 18
Elske Ammenwerth, Stefan Gräber, Thomas Bürkle, Carola Iller
This chapter summarizes the problems and challenges which occur when health information systems are evaluated. The main problem areas presented are... Sample PDF
Evaluation of Health Information Systems: Challenges and Approaches
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Chapter 19
Pirkko Nykänen
eHealth refers to use of information and communication technologies to improve or enable health and healthcare. eHealth broadens the scope of health... Sample PDF
eHealth Systems, Their Use and Visions for the Future
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Chapter 20
Nilmini Wickramasinghe, Santosh Misra, Arnold Jenkins, Douglas R. Vogel
Superior access, quality and value of healthcare services has become a national priority for healthcare to combat the exponentially increasing costs... Sample PDF
The Competitive Forces Facing E-Health
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About the Contributors