The mother during pregnancy and the puerperium: Detailed data abstracted from the clinical obstetric records of ALSPAC pregnancies

Abstract

Background: When the Avon Longitudinal Study of Parents and Children (ALSPAC) was planned, it was assumed that the clinical obstetric data would be easily accessible from the newly developed National Health Service computerised ‘STORK’ system. Pilot studies, however, showed that, although fairly accurate in regard to aspects of labour and delivery, it was, at the time (1990-2), inadequate for identifying the full antenatal and postnatal details of clinical complications and treatments of the women in the Study. Methods: A scheme was therefore developed to train research staff to find and abstract relevant details from clinical records onto proformas designed for the purpose. Extracting such data proved very time consuming (up to six hours for complicated pregnancies) and consequently expensive. Funding for the enterprise was obtained piecemeal using specific focussed grants to extract data for subsamples of the Study, including a random sample to serve as controls. Results: To date, detailed records have been completed for 8369 pregnancies, and a further 5336 (13,705 in total) have complete details on specific prenatal areas, including serial measures of maternal blood pressure, proteinuria and weight. In this Data Note we describe the information abstracted from the obstetric medical records concerning the mother during pregnancy, labour, delivery and the first two weeks of the puerperium. Information abstracted relating to the fetus (including fetal monitoring, presentation, method of delivery) and neonate (signs of asphyxia, resuscitation, treatment and well-being) will be described in a further Data Note. Conclusions: These data add depth to ALSPAC concerning ways in which the signs and symptoms, procedures and treatments of the mother prenatally, intrapartum and postnatally, may impact on the long-term health and development of both mother and child. They augment the data collected from the mothers’ questionnaires and the ‘STORK’ digital hospital data.

The ALSPAC fetal and neonatal resource: detailed data abstracted from the clinical records of the new-born

“…Therefore, we have described here the information covering the health of the fetus that has been abstracted from obstetric records and the treatment and health of the neonate that has been abstracted from paediatric records. The data described in this Data Note differ from that in a published Data Note which describes the mother during pregnancy and the puerperium ( Birmingham et al ., 2021a ; subsequently referred to as the Obstetric Data Note). In the currrent Data Note we describe the individual data relating to the fetuses/births rather than pregnancies, thus allowing for different answers for different members of a multiple pregnancy.…”

Mode of delivery and maternal sexual wellbeing: A longitudinal study

“…Index pregnancy mode of delivery was abstracted from routine antenatal records by trained research midwives and nurses, where it was recorded as spontaneous vaginal delivery (SVD), caesarean section, assisted breech, breech extraction, forceps, vacuum extraction, or other. 15 Women with ‘other’ mode of delivery ( n = 157) or conflicting modes of delivery ( n = 4) were excluded (Figure 1 ), to limit exposure misclassification. For the primary exposure, we dichotomised mode of delivery into vaginal delivery (SVD, breech extraction and assisted, forceps and vacuum) ( n = 9230) and caesarean section ( n = 1094).…”

Maternal reports of morbidity during the index ALSPAC pregnancy

“…The latter exclude admissions after the onset of labour. It should be noted that these details are also recorded in the dataset of information extracted from the medical records ( Birmingham et al , 2021 ).…”

“…In addition, details of the reasons for the use of medications and the frequency with which she took analgesics such as paracetamol (acetaminophen) and aspirin. Elsewhere the actual medications the mother reported taking during pregnancy are detailed [ Headley et al , 2004 ], as are details of other sources of information such as the data abstracted from the medical records [ Birmingham et al , 2021 ] and the midwife recorded data on the STORK database [ Mummé et al , 2020 ].…”