The value of intrapartum factors in predicting maternal morbidity

Abstract

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Intrapartum Risk Factors and Prediction of Obstetric Hemorrhage–Related Morbidity

“…13 Although recent research has shown that intrapartum factors are valuable in predicting OBH related severe morbidity and mortality, none of these validation studies have determined how a dynamic approach, with reassessment after admission and inclusion of intrapartum risk factors, may modify risk and, ultimately, clinical decision making. 13,14 We seek to assess our dynamic hemorrhage risk assessment tool, which was built to predict hemorrhage and transfusion using risk factors in the literature, reflected also in recommendations by the CMQCC, the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN), and the Safe Motherhood Initiative (Table 1). 4,6,7 We hypothesize that inclusion of intrapartum risk factors immediately prior to delivery (pre-delivery) increases the sensitivity of…”

“…13 Although recent research has shown that intrapartum factors are valuable in predicting OBH-related severe morbidity and mortality, none of these validation studies have determined how a dynamic approach, with reassessment after admission and inclusion of intrapartum risk factors, may modify risk and, ultimately, clinical decision making. 13 14…”

Comparison of Natural Language Processing of Clinical Notes With a Validated Risk-Stratification Tool to Predict Severe Maternal Morbidity

“… 6 For the prediction of SMM, prior models have focused primarily on maternal comorbidities and pregnancy characteristics, with some of the largest studies based on insurance claims data. 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 These approaches, which use diagnosis codes, are limited by their inability to determine temporality between conditions and outcomes within a delivery hospitalization or understand what was known at the time of admission. 17 , 18 Thus, although these diagnosis code–based risk-stratification tools tend to have good performance characteristics, their ability to be translated to clinical use is not well known.…”

“…The development and application of risk-stratification tools are important in recognizing and preventing morbidity by facilitating risk-appropriate care (ie, ensuring high-risk individuals deliver at a center with the appropriate staff and resources) and increasing health care team awareness of risk . For the prediction of SMM, prior models have focused primarily on maternal comorbidities and pregnancy characteristics, with some of the largest studies based on insurance claims data . These approaches, which use diagnosis codes, are limited by their inability to determine temporality between conditions and outcomes within a delivery hospitalization or understand what was known at the time of admission .…”