Classification differences and maternal mortality: a European study. MOMS Group. MOthers' Mortality and Severe morbidity

B Salanave, M H Bouvier-Colle, N Varnoux, S Alexander, A Macfarlane, Lene Sperling

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVES: To compare the ways maternal deaths are classified in national statistical offices in Europe and to evaluate the ways classification affects published rates.

METHODS: Data on pregnancy-associated deaths were collected in 13 European countries. Cases were classified by a European panel of experts into obstetric or non-obstetric causes. An ICD-9 code (International Classification of Diseases) was attributed to each case. These were compared to the codes given in each country. Correction indices were calculated, giving new estimates of maternal mortality rates.

SUBJECTS: There were sufficient data to complete reclassification of 359 or 82% of the 437 cases for which data were collected.

RESULTS: Compared with the statistical offices, the European panel attributed more deaths to obstetric causes. The overall number of deaths attributed to obstetric causes increased from 229 to 260. This change was substantial in three countries (P < 0.05) where statistical offices appeared to attribute fewer deaths to obstetric causes. In the other countries, no differences were detected. According to official published data, the aggregated maternal mortality rate for participating countries was 7.7 per 100,000 live births, but it increased to 8.7 after classification by the European panel (P < 0.001).

CONCLUSION: The classification of pregnancy-associated deaths differs between European countries. These differences in coding contribute to variations in the reported numbers of maternal deaths and consequently affect maternal mortality rates. Differences in classification of death must be taken into account when comparing maternal mortality rates, as well as differences in obstetric care, underreporting of maternal deaths and other factors such as the age distribution of mothers.

OriginalsprogEngelsk
TidsskriftInternational Journal of Epidemiology
Vol/bind28
Udgave nummer1
Sider (fra-til)64-9
Antal sider6
ISSN0300-5771
StatusUdgivet - feb. 1999

Fingeraftryk

Maternal Mortality
Obstetrics
Mothers
International Classification of Diseases
Age Distribution
Live Birth

Citer dette

Salanave, B ; Bouvier-Colle, M H ; Varnoux, N ; Alexander, S ; Macfarlane, A ; Sperling, Lene . / Classification differences and maternal mortality : a European study. MOMS Group. MOthers' Mortality and Severe morbidity. I: International Journal of Epidemiology. 1999 ; Bind 28, Nr. 1. s. 64-9.
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abstract = "OBJECTIVES: To compare the ways maternal deaths are classified in national statistical offices in Europe and to evaluate the ways classification affects published rates.METHODS: Data on pregnancy-associated deaths were collected in 13 European countries. Cases were classified by a European panel of experts into obstetric or non-obstetric causes. An ICD-9 code (International Classification of Diseases) was attributed to each case. These were compared to the codes given in each country. Correction indices were calculated, giving new estimates of maternal mortality rates.SUBJECTS: There were sufficient data to complete reclassification of 359 or 82{\%} of the 437 cases for which data were collected.RESULTS: Compared with the statistical offices, the European panel attributed more deaths to obstetric causes. The overall number of deaths attributed to obstetric causes increased from 229 to 260. This change was substantial in three countries (P < 0.05) where statistical offices appeared to attribute fewer deaths to obstetric causes. In the other countries, no differences were detected. According to official published data, the aggregated maternal mortality rate for participating countries was 7.7 per 100,000 live births, but it increased to 8.7 after classification by the European panel (P < 0.001).CONCLUSION: The classification of pregnancy-associated deaths differs between European countries. These differences in coding contribute to variations in the reported numbers of maternal deaths and consequently affect maternal mortality rates. Differences in classification of death must be taken into account when comparing maternal mortality rates, as well as differences in obstetric care, underreporting of maternal deaths and other factors such as the age distribution of mothers.",
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Classification differences and maternal mortality : a European study. MOMS Group. MOthers' Mortality and Severe morbidity. / Salanave, B; Bouvier-Colle, M H; Varnoux, N; Alexander, S; Macfarlane, A; Sperling, Lene .

I: International Journal of Epidemiology, Bind 28, Nr. 1, 02.1999, s. 64-9.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Classification differences and maternal mortality

T2 - a European study. MOMS Group. MOthers' Mortality and Severe morbidity

AU - Salanave, B

AU - Bouvier-Colle, M H

AU - Varnoux, N

AU - Alexander, S

AU - Macfarlane, A

AU - Sperling, Lene

PY - 1999/2

Y1 - 1999/2

N2 - OBJECTIVES: To compare the ways maternal deaths are classified in national statistical offices in Europe and to evaluate the ways classification affects published rates.METHODS: Data on pregnancy-associated deaths were collected in 13 European countries. Cases were classified by a European panel of experts into obstetric or non-obstetric causes. An ICD-9 code (International Classification of Diseases) was attributed to each case. These were compared to the codes given in each country. Correction indices were calculated, giving new estimates of maternal mortality rates.SUBJECTS: There were sufficient data to complete reclassification of 359 or 82% of the 437 cases for which data were collected.RESULTS: Compared with the statistical offices, the European panel attributed more deaths to obstetric causes. The overall number of deaths attributed to obstetric causes increased from 229 to 260. This change was substantial in three countries (P < 0.05) where statistical offices appeared to attribute fewer deaths to obstetric causes. In the other countries, no differences were detected. According to official published data, the aggregated maternal mortality rate for participating countries was 7.7 per 100,000 live births, but it increased to 8.7 after classification by the European panel (P < 0.001).CONCLUSION: The classification of pregnancy-associated deaths differs between European countries. These differences in coding contribute to variations in the reported numbers of maternal deaths and consequently affect maternal mortality rates. Differences in classification of death must be taken into account when comparing maternal mortality rates, as well as differences in obstetric care, underreporting of maternal deaths and other factors such as the age distribution of mothers.

AB - OBJECTIVES: To compare the ways maternal deaths are classified in national statistical offices in Europe and to evaluate the ways classification affects published rates.METHODS: Data on pregnancy-associated deaths were collected in 13 European countries. Cases were classified by a European panel of experts into obstetric or non-obstetric causes. An ICD-9 code (International Classification of Diseases) was attributed to each case. These were compared to the codes given in each country. Correction indices were calculated, giving new estimates of maternal mortality rates.SUBJECTS: There were sufficient data to complete reclassification of 359 or 82% of the 437 cases for which data were collected.RESULTS: Compared with the statistical offices, the European panel attributed more deaths to obstetric causes. The overall number of deaths attributed to obstetric causes increased from 229 to 260. This change was substantial in three countries (P < 0.05) where statistical offices appeared to attribute fewer deaths to obstetric causes. In the other countries, no differences were detected. According to official published data, the aggregated maternal mortality rate for participating countries was 7.7 per 100,000 live births, but it increased to 8.7 after classification by the European panel (P < 0.001).CONCLUSION: The classification of pregnancy-associated deaths differs between European countries. These differences in coding contribute to variations in the reported numbers of maternal deaths and consequently affect maternal mortality rates. Differences in classification of death must be taken into account when comparing maternal mortality rates, as well as differences in obstetric care, underreporting of maternal deaths and other factors such as the age distribution of mothers.

KW - Cause of Death

KW - Delivery, Obstetric

KW - Epidemiologic Methods

KW - Europe

KW - Female

KW - Forms and Records Control

KW - Humans

KW - Maternal Mortality

KW - Medical Record Linkage

KW - Medical Records

KW - Pregnancy

KW - Registries

M3 - Journal article

C2 - 10195666

VL - 28

SP - 64

EP - 69

JO - International Journal of Epidemiology

JF - International Journal of Epidemiology

SN - 0300-5771

IS - 1

ER -