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Am J Perinatol 2013; 30(01): 021-024
DOI: 10.1055/s-0032-1321493
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Validation of a Scoring System to Identify Women with Near-Miss Maternal Morbidity

Whitney B. You
1   Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
,
Suchitra Chandrasekaran
1   Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
,
John Sullivan
2   Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
,
William Grobman
1   Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
› Author Affiliations
Further Information

Publication History

06 October 2011

25 March 2012

Publication Date:
13 July 2012 (online)

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Abstract

Objective To validate a five-factor scoring system that identifies parturients who experience near-miss morbidity.

Study Design and Setting This study was conducted in an urban, tertiary care hospital over a 2-year period. A narrative case summary was prepared for women with high potential for significant obstetric morbidity. The summary was then reviewed by three physicians, and the extent of morbidity was assigned based on subjective assessment. The same cases were then scored using the proposed five-factor scoring system previously described by Geller et al. Test characteristics of the scoring system were assessed.

Results Eight hundred fifteen cases with a high potential for significant morbidity were identified. Subjective review and the scoring system classified 4.5% and 4.2% as near-miss morbidity, respectively, with the scoring system having a corresponding sensitivity of 81.1% (95% confidence interval 64.8 to 92.0%) and a specificity of 99.5% (95% confidence interval 98.7 to 99.9%).

Conclusion The scoring system produced similar results to those obtained at its initial development and demonstrated acceptable sensitivity and specificity for identifying near-miss morbidity.

Keywords

near-miss morbidity - maternal mortality - scoring system

Notes

Research for this project was done while the author (Whitney B. You, M.D., M.P.H.) was a National Research Service Award postdoctoral fellow at the Institute for Healthcare Studies under an institutional award from the Agency for Healthcare Research and Quality (T-32 HS 000078–11).


A related abstract was presented as a poster at the 2009 Society of Maternal Fetal Medicine meeting in San Diego, California, and the 2009 Academy of Health Annual Meeting in Chicago, Illinois.


 

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