Factors contributing to maternal birth-related trauma.
The Agency for Healthcare Research and Quality Quality Indicator tools were used to identify risk factors for maternal birth-related trauma rates in the 2003 Nationwide Inpatient Sample and the 2002-2004 Iowa State Inpatient Database. Risk-adjusted analyses of these datasets isolated salient risk factors for maternal trauma. The rates of Iowa's risk factors for the most serious types of trauma--third/fourth-degree lacerations--were compared with national rates. The comparisons suggest that episiotomy, artificial rupture of membranes, obstructed labor, and late pregnancies are the most salient risk factors for third/fourth-degree lacerations within Iowa. Thus, this research suggested that a combination of maternal, baby, and episiotomy factors contributed to the high prevalence of third/fourth-degree lacerations in vaginal deliveries in Iowa. Finally, our risk-adjustment methodology could be used in a similar manner to analyze other discharge datasets for opportunities to improve maternal outcomes.
Roberts
Lance L
LL
Department of Health Management and Policy, University of Iowa, Iowa City 52242, USA. lance-l-roberts@uiowa.edu
Ely
John W
JW
Ward
Marcia M
MM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000706:statistics & numerical data*; D004841:Episiotomy / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D022125:Lacerations / Q000453:epidemiology*; D007744:Obstetric Labor Complications / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011787:Quality of Health Care / Q000706:statistics & numerical data; D044469:Racial Groups; D012307:Risk Factors; D012449:Safety