{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:31:29Z","timestamp":1784035889843,"version":"3.55.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":44,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["U01TR003629"],"award-info":[{"award-number":["U01TR003629"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Center for Advancing Translational Sciences (NCATS), National Institutes of Health","award":["UM1TR004406"],"award-info":[{"award-number":["UM1TR004406"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Severe maternal morbidity and mortality are higher in the United States than in other high-income countries, and unacceptable disparities persist. To facilitate research on these outcomes, we developed a standardized approach for extracting perinatal data from electronic health records (EHRs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>To support data model building and validation, we harmonized perinatal EHR data in a common data model, building on lessons learned from multiple prior projects.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We developed an Entity Relationship Diagram (ERD) that aggregates perinatal EHR data at appropriate granularities (ie, mothers, infants, encounters) with indexing of observations to gestational age and time from delivery. We then developed a standard approach to extract, transform, and load pregnancy-related observations from EHRs for inclusion in PCORnet\u00ae Common Data Model tables.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Our ERD can facilitate cross-institutional research to identify populations at risk and prompt interventions to improve perinatal outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A structured approach can accelerate the use of EHR data for perinatal research.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamiaopen\/ooaf117","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T16:41:50Z","timestamp":1760632910000},"source":"Crossref","is-referenced-by-count":1,"title":["Development and implementation of an entity relationship diagram for perinatal data"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1228-4587","authenticated-orcid":false,"given":"Alison M","family":"Stuebe","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, UNC School of Medicine, Maternal and Child Health, Gillings School of Global Public Health , Chapel Hill, NC, 27599,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall","family":"Blanco","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Perinatal Research Service Center, UNC School of Medicine , Chapel Hill, NC, 27599,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Horvath","sequence":"additional","affiliation":[{"name":"Wake Forest Clinical and Translational Science Institute, Wake Forest University School of Medicine , Winston-Salem, NC, 27101,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Golam","family":"Kibria","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Wake Forest University School of Medicine , Winston-Salem, NC, 27101,","place":["United States"]},{"name":"Obstetrics and Gynecology, UNC School of Medicine , Chapel Hill, NC, 27599,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Kucirka","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, UNC School of Medicine, UNC School of Data Science and Society , Chapel Hill, NC, 27599,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Shieh","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, UNC School of Medicine , Chapel Hill, NC, 27599,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Page","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Duke University School of Medicine , Durham, NC, 27710,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Metin N","family":"Gurcan","sequence":"additional","affiliation":[{"name":"Center for Artificial Intelligence Research, Wake Forest University School of Medicine , Winston-Salem, NC, 27101,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Ed Hammond","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Duke Center for Health Informatics, Duke University School of Medicine , Durham, NC, 27710,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"2025101612414138400_ooaf117-B1","volume-title":"Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017\u20132019","author":"Trost","year":"2022"},{"key":"2025101612414138400_ooaf117-B2","article-title":"Maternal mortality rates in the United States, 2021","author":"Hoyert","year":"2023","journal-title":"NCHS Health E-Stats"},{"key":"2025101612414138400_ooaf117-B3","doi-asserted-by":"crossref","DOI":"10.1093\/jamia\/ocae195","article-title":"Pregnancy episodes in all of us: harnessing multi-source data for pregnancy-related research","author":"Smith","year":"2024","journal-title":"J Am Med Inform Assoc"},{"key":"2025101612414138400_ooaf117-B4","doi-asserted-by":"crossref","first-page":"e2036148","DOI":"10.1001\/jamanetworkopen.2020.36148","article-title":"Assessment of incidence and factors associated with severe maternal morbidity after delivery discharge among women in the US","volume":"4","author":"Chen","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2025101612414138400_ooaf117-B5","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1111\/ppe.12762","article-title":"Severe maternal morbidity at delivery and postpartum readmission in the United States","volume":"35","author":"Matas","year":"2021","journal-title":"Paediatr Perinat Epidemiol"},{"key":"2025101612414138400_ooaf117-B6","doi-asserted-by":"crossref","first-page":"435.e1","DOI":"10.1016\/j.ajog.2013.11.039","article-title":"Racial and ethnic disparities in severe maternal morbidity: a multistate analysis, 2008-2010","volume":"210","author":"Creanga","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"2025101612414138400_ooaf117-B7","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1097\/AOG.0b013e3182a603bb","article-title":"Development of a comorbidity index for use in obstetric patients","volume":"122","author":"Bateman","year":"2013","journal-title":"Obstet Gynecol"},{"key":"2025101612414138400_ooaf117-B8","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2022-002151","article-title":"Systematic review of validated case definitions to identify hypertensive disorders of pregnancy in administrative healthcare databases","volume":"10","author":"Johnston","year":"2023","journal-title":"Open Heart"},{"key":"2025101612414138400_ooaf117-B9","doi-asserted-by":"crossref","first-page":"2234","DOI":"10.1080\/14767058.2020.1783229","article-title":"Measurement of hemorrhage-related severe maternal morbidity with billing versus electronic medical record data","volume":"35","author":"Friedman","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"key":"2025101612414138400_ooaf117-B10","author":"Epic"},{"key":"2025101612414138400_ooaf117-B11","doi-asserted-by":"crossref","first-page":"e0276923","DOI":"10.1371\/journal.pone.0276923","article-title":"Temporal events detector for pregnancy care (TED-PC): a rule-based algorithm to infer gestational age and delivery date from electronic health records of pregnant women with and without COVID-19","volume":"17","author":"Lyu","year":"2022","journal-title":"PLoS One"},{"key":"2025101612414138400_ooaf117-B12","first-page":"1096","article-title":"Computational phenotyping of OMOP CDM normalized EHR for prenatal and postpartum episodes: an informatics framework and clinical implementation on all of Us","volume":"2023","author":"Lyu","year":"2023","journal-title":"AMIA Annu Symp Proc"},{"key":"2025101612414138400_ooaf117-B13","doi-asserted-by":"crossref","first-page":"e70106","DOI":"10.1002\/pds.70106","article-title":"Expanding the OMOP common data model to support perinatal research in network studies","volume":"34","author":"Abellan","year":"2025","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"2025101612414138400_ooaf117-B14","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1089\/heq.2022.0085","article-title":"Racial disparities in donor human milk feedings: a study using electronic medical records","volume":"6","author":"Palmquist","year":"2022","journal-title":"Health Equity"},{"key":"2025101612414138400_ooaf117-B15","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1038\/s41372-021-01171-x","article-title":"Perinatal morbidity and health utilization among mothers of medically fragile infants","volume":"42","author":"Stuebe","year":"2022","journal-title":"J Perinatol"},{"key":"2025101612414138400_ooaf117-B16","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1089\/heq.2022.0180","article-title":"Standardized order sets do not eliminate racial or ethnic inequities in postpartum pain management","volume":"7","author":"Green","year":"2023","journal-title":"Health Equity"},{"key":"2025101612414138400_ooaf117-B17","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1097\/AOG.0000000000003505","article-title":"Racial and ethnic inequities in postpartum pain evaluation and management","volume":"134","author":"Johnson","year":"2019","journal-title":"Obstet Gynecol"},{"key":"2025101612414138400_ooaf117-B18","doi-asserted-by":"crossref","first-page":"e3313","DOI":"10.1055\/a-2223-6292","article-title":"Hemoglobin on admission for childbirth and postpartum acute care use in a southeastern health care system","volume":"41","author":"Bruce","year":"2024","journal-title":"Am J Perinatol"},{"key":"2025101612414138400_ooaf117-B19","first-page":"e380","article-title":"Postpartum acute care utilization in a health care system in the southeastern United States","volume":"34","author":"Busse","year":"2025","journal-title":"J Womens Health (Larchmt)"},{"key":"2025101612414138400_ooaf117-B20","author":"Oracle"},{"key":"2025101612414138400_ooaf117-B21","volume-title":"reVITALize: Obstetrics Data Definitions (Version 1.0)","author":"American College of Obstetricians and Gynecologists","year":"2014"},{"key":"2025101612414138400_ooaf117-B22","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2019-0076","article-title":"A 2017 US reference for singleton birth weight percentiles using obstetric estimates of gestation","volume":"144","author":"Aris","year":"2019","journal-title":"Pediatrics"},{"key":"2025101612414138400_ooaf117-B23","author":"Division of Public Health NC State Center for Health Statistics","year":"2025"},{"key":"2025101612414138400_ooaf117-B24","year":"2018"},{"key":"2025101612414138400_ooaf117-B25","doi-asserted-by":"crossref","first-page":"e140","DOI":"10.1097\/AOG.0000000000002633","article-title":"ACOG committee opinion No. 736: Optimizing postpartum care","volume":"131","author":"American College of Obstetricians and Gynecologists","year":"2018","journal-title":"Obstet Gynecol"},{"key":"2025101612414138400_ooaf117-B26","first-page":"e1","article-title":"ACOG practice bulletin No. 202: Gestational hypertension and preeclampsia","volume":"133","author":"American College of Obstetricians and Gynecologists","year":"2019","journal-title":"Obstetr Gynecol"},{"key":"2025101612414138400_ooaf117-B27","author":"Shenkman","year":"2023"},{"key":"2025101612414138400_ooaf117-B28","doi-asserted-by":"crossref","first-page":"ooad067","DOI":"10.1093\/jamiaopen\/ooad067","article-title":"Who is pregnant? Defining real-world data-based pregnancy episodes in the national COVID cohort collaborative (N3C)","volume":"6","author":"Jones","year":"2023","journal-title":"JAMIA Open"},{"key":"2025101612414138400_ooaf117-B29","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.ajog.2020.10.030","article-title":"Prediction of obstetrical and fetal complications using automated electronic health record data","volume":"224","author":"Escobar","year":"2021","journal-title":"Am J Obstet Gynecol"},{"key":"2025101612414138400_ooaf117-B30","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.ajog.2019.01.208","article-title":"Automated early detection of obstetric complications: theoretic and methodologic considerations","volume":"220","author":"Escobar","year":"2019","journal-title":"Am J Obstet Gynecol"}],"container-title":["JAMIA Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jamiaopen\/article-pdf\/8\/5\/ooaf117\/64719185\/ooaf117.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jamiaopen\/article-pdf\/8\/5\/ooaf117\/64719185\/ooaf117.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T16:41:54Z","timestamp":1760632914000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamiaopen\/article\/doi\/10.1093\/jamiaopen\/ooaf117\/8287825"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,2]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,9,2]]}},"URL":"https:\/\/doi.org\/10.1093\/jamiaopen\/ooaf117","relation":{},"ISSN":["2574-2531"],"issn-type":[{"value":"2574-2531","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,10]]},"published":{"date-parts":[[2025,9,2]]},"article-number":"ooaf117"}}