{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T07:10:59Z","timestamp":1777792259619,"version":"3.51.4"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,1,24]],"date-time":"2020-01-24T00:00:00Z","timestamp":1579824000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite increased research using large administrative databases to identify determinants of maternal morbidity and mortality, the extent to which these databases capture obstetric co\u2010morbidities is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the impact that the time window used to assess obstetric co\u2010morbidities has on the completeness of ascertainment of those co\u2010morbidities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a five\u2010year analysis of inpatient hospitalisations of pregnant women from 2010\u20102014 using the Nationwide Readmissions Database. For each woman, using discharge diagnoses, we identified 24 conditions used to create the Obstetric Comorbidity Index. Using various assessment windows for capturing obstetric co\u2010morbidities, including the delivery hospitalisation only and all weekly windows from 7 to 280\u00a0days, we calculated the frequency and rate of each co\u2010morbidity and the degree of underascertainment of the co\u2010morbidity. Under each scenario, and for each co\u2010morbidity, we also calculated the all\u2010cause, 30\u2010day readmission rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were over 3 million delivery hospitalisations from 2010 to 2014 included in this analysis. Compared with a full 280\u2010day window, assessment of obstetric co\u2010morbidities using only diagnoses made during the delivery hospitalisation would result in failing to identify over 35% of cases of chronic renal disease, 28.5% cases in which alcohol abuse was documented during pregnancy, and 23.1% of women with pulmonary hypertension. For seven other co\u2010morbidities, at least 1 in 20 women with that condition would have been missed with exclusive reliance on the delivery hospitalisation for co\u2010morbidity diagnoses. Not only would reliance on delivery hospitalisations have resulted in missed cases of co\u2010morbidities, but for many conditions, estimates of readmission rates for women with obstetric co\u2010morbidities would have been underestimated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An increasing proportion of maternal and child health research is based on large administrative databases. This study provides data that facilitate the assessment of the degree to which important obstetric co\u2010morbidities may be underascertained when using these databases.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12593","type":"journal-article","created":{"date-parts":[[2020,1,24]],"date-time":"2020-01-24T12:02:22Z","timestamp":1579867342000},"page":"440-451","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Estimating the obstetric co\u2010morbidity burden using administrative data: The impact of the pregnancy\u2010related assessment window"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0077-6023","authenticated-orcid":false,"given":"Jason L.","family":"Salemi","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine Baylor College of Medicine Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine Baylor College of Medicine Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjukta","family":"Modak","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine Baylor College of Medicine Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Matas","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine Baylor College of Medicine Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George J.","family":"Germanos","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine Baylor College of Medicine Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed Ahsan","family":"Raza","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine Baylor College of Medicine Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denny Fe G.","family":"Agana","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine Baylor College of Medicine Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judette M.","family":"Louis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Morsani College of Medicine University of South Florida Tampa FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,1,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002357"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13245"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301583"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318233042d"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182a06f4e"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31826d60c5"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182a603bb"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13297"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13254"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2018.1446077"},{"key":"e_1_2_7_12_1","unstructured":"Healthcare Cost and Utilization Project (HCUP).NRD Description of Data Elements.www.hcup-us.ahrq.gov\/db\/nation\/nrd\/nrddde.jsp. 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