(203) Recording of Chronic Diseases and Adverse Obstetric Outcomes During Hospitalizations for a Delivery in The National Swiss Hospital Medical Statistics Dataset Between 2012 and 2018: An Observational Cross-Sectional Study

Friday, August 26, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 534

Presenting Author(s)

Carole Marxer, MSc
– University Hospital Basel, Basel, Basel-Stadt, Switzerland

Co-Author(s)

Marlene Rauch
– Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Switzerland
Clementina Lang
– University Hospital Zurich, Switzerland
Alice PANCHAUD
– Institute of Primary Health Care (BIHAM), University of Bern, Switzerland, Switzerland
Christoph Meier, Prof Dr
– Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland, Switzerland
Julia Spoendlin
– Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland, Switzerland

Background: The prevalence of chronic diseases during pregnancy and adverse maternal obstetric outcomes in Switzerland has been insufficiently studied. Data sources, which reliably capture these events, are scarce.

Objectives: This study aimed to evaluate completeness of recording of chronic diseases and adverse maternal obstetric outcomes during hospitalizations for a delivery in the Swiss Hospital Medical Statistics (MS) dataset.

Methods: We conducted a nationwide observational cross-sectional study (2012-2018) based on the Swiss MS dataset. We identified hospitalizations of women who delivered a singleton live-born infant (ICD-10-GM) in an inpatient setting in Switzerland and quantified the prevalence of 23 chronic diseases (ICD-10-GM). We compared our results to a nationwide Danish registry study, which used the same disease definition to quantify disease prevalence during pregnancy. We further quantified the prevalence of adverse maternal obstetric outcomes (ICD-10-GM and CHOP) during the delivery hospitalization and compared our results to existing literature.

Results: We identified 577’220 delivery hospitalizations, of which 4.99% had a record for a least one diagnosis for a chronic disease (versus 15.49% in Denmark). In total, 13 of 23 chronic diseases were substantially under-recorded, and eight of those diseases were more than 10-fold more frequent in the Danish study than in ours, including psychiatric diagnoses, chronic lung disease (including asthma), rheumatoid arthritis, ischemic heart disease, and cerebrovascular disease. Thyroid disorders (2.65% vs 2.29%), non-ischemic cardiovascular disease (0.17% vs 0.14%), and coagulation disorders (1.07% vs 0.73%) were recorded similarly often. The prevalence of adverse maternal obstetric outcomes was comparable to other European countries (gestational diabetes: 6.85%, gestational hypertension: 1.02%, pre-eclampsia/HELLP-syndrome: 1.79%, postpartum hemorrhage: 7.95%, placental abruption: 0.60%, and preterm delivery: 4.11%).

Conclusions: Our results suggest that chronic diseases are under-recorded during delivery hospitalizations in the MS dataset, which may be due to specific coding guidelines and aspects of whether or not a disease generates billable effort to a hospital. Adverse maternal obstetric outcomes are more completely captured, but future studies need to confirm their true prevalence.