{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T06:09:59Z","timestamp":1771913399471,"version":"3.50.1"},"reference-count":38,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T00:00:00Z","timestamp":1656374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Freiwillige Akademische Gesellschaft Basel (Fonds zur F\u00f6rderung von Lehre und Forschung)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>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. We conducted a nationwide observational cross-sectional study (2012\u20132018) using data from the Swiss Hospital Medical Statistics (MS) dataset. To quantify the recording of chronic diseases and adverse maternal obstetric outcomes during delivery in hospitals or birthing centers (delivery hospitalization), we identified women who delivered a singleton live-born infant. We quantified the prevalence of 23 maternal chronic diseases (ICD-10-GM) and compared results to a nationwide Danish registry study. We further quantified the prevalence of adverse maternal obstetric outcomes (ICD-10-GM\/CHOP) during the delivery hospitalization and compared the results to existing literature from Western Europe. We identified 577,220 delivery hospitalizations, of which 4.99% had a record for \u22651 diagnosis of a chronic disease (versus 15.49% in Denmark). Moreover, 13 of 23 chronic diseases seemed to be substantially under-recorded (8 of those were &gt;10-fold more frequent in the Danish study). The prevalence of three of the chronic diseases was similar in the two studies. The prevalence of adverse maternal obstetric outcomes was comparable to other European countries. 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 regarding whether a disease generates billable effort for a hospital. Adverse maternal obstetric outcomes seemed to be more completely captured.<\/jats:p>","DOI":"10.3390\/ijerph19137922","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T23:59:22Z","timestamp":1656460762000},"page":"7922","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["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"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4688-8223","authenticated-orcid":false,"given":"Carole A.","family":"Marxer","sequence":"first","affiliation":[{"name":"Hospital Pharmacy, University Hospital Basel, 4031 Basel, Switzerland"},{"name":"Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, 4056 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlene","family":"Rauch","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy, University Hospital Basel, 4031 Basel, Switzerland"},{"name":"Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, 4056 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clementina","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Gynecology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6086-2401","authenticated-orcid":false,"given":"Alice","family":"Panchaud","sequence":"additional","affiliation":[{"name":"Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland"},{"name":"Service of Pharmacy, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland"},{"name":"Materno-Fetal and Obstetrics Research Unit, Department \u201cFemme-M\u00e8re-Enfant\u201d, University Hospital, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph R.","family":"Meier","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy, University Hospital Basel, 4031 Basel, Switzerland"},{"name":"Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, 4056 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1632-1928","authenticated-orcid":false,"given":"Julia","family":"Spoendlin","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy, University Hospital Basel, 4031 Basel, Switzerland"},{"name":"Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, 4056 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"key":"ref_1","unstructured":"Bundesamt f\u00fcr Statistik (2019). Entbindungen und Gesundheit der M\u00fctter im Jahr 2017\u2014Medizinische Statistik der Krankenh\u00e4user|Publikation. Medizinische Statistik der Krankenh\u00e4user, Swiss Federal Statistical Office."},{"key":"ref_2","unstructured":"Statista Research Department (2021, December 13). Durchschnittsalter der Mutter bei der Geburt in der Schweiz von 2009 bis 2019. Available online: https:\/\/de.statista.com\/statistik\/daten\/studie\/411905\/umfrage\/durchschnittsalter-der-mutter-bei-der-geburt-in-der-schweiz."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S0889-8545(05)70152-2","article-title":"Advances in Assisted Reproductive Technologies","volume":"27","author":"Thornton","year":"2000","journal-title":"Obstet. Gynecol. Clin. N. Am."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e199875","DOI":"10.1001\/jamanetworkopen.2019.9875","article-title":"Association of Maternal Age with Severe Maternal Morbidity and Mortality in Canada","volume":"2","author":"Aoyama","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"E21","DOI":"10.5888\/pcd15.170397","article-title":"Obstetric Outcomes and Delivery-Related Health Care Utilization and Costs among Pregnant Women with Multiple Chronic Conditions","volume":"15","author":"Admon","year":"2018","journal-title":"Prev. Chronic Dis."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kersten, I., Lange, A.E., Haas, J.P., Fusch, C., Lode, H., Hoffmann, W., and Thyrian, J.R. (2014). Chronic diseases in pregnant women: Prevalence and birth outcomes based on the SNiP-study. BMC Pregnancy Childbirth, 14.","DOI":"10.1186\/1471-2393-14-75"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/j.1471-0528.2010.02743.x","article-title":"Chronic heart disease and severe obstetric morbidity among hospitalisations for pregnancy in the USA: 1995\u20132006","volume":"118","author":"Kuklina","year":"2010","journal-title":"Int. J. Obstet. Gynaecol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"134.e1","DOI":"10.1016\/j.ajog.2011.10.878","article-title":"Prevalence, trends, and outcomes of chronic hypertension: A nationwide sample of delivery admissions","volume":"206","author":"Bateman","year":"2012","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.3109\/14767058.2014.966677","article-title":"Maternal and neonatal outcomes in pregnancies complicated by gestational diabetes. A nation-wide study","volume":"28","author":"Ovesen","year":"2015","journal-title":"J. Matern. Neonatal. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1111\/j.1365-3016.2012.01260.x","article-title":"Secular trends in the epidemiology of pre-eclampsia throughout 40 years in Norway: Prevalence, risk factors and perinatal survival","volume":"26","author":"Morken","year":"2012","journal-title":"Paediatr. Perinat. Epidemiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1097\/HCO.0000000000000190","article-title":"Hypertension in pregnancy","volume":"30","author":"Raio","year":"2015","journal-title":"Curr. Opin. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.ijgo.2007.10.007","article-title":"Psychiatric illness and adverse pregnancy outcome","volume":"101","author":"Sheiner","year":"2008","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_13","first-page":"100209","article-title":"Pregnancy, delivery and neonatal complications in women with schizophrenia: A national population-based cohort study","volume":"10","author":"Fabre","year":"2021","journal-title":"Lancet Reg. Health-Eur."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1002\/jppr.1605","article-title":"Navigating off-label and unlicensed medicines use in obstetric and paediatric clinical practice","volume":"49","author":"Gray","year":"2019","journal-title":"J. Pharm. Pract. Res."},{"key":"ref_15","first-page":"S5","article-title":"Preconception care: Screening and management of chronic disease and promoting psychological health","volume":"11","author":"Lassi","year":"2014","journal-title":"Reprod. Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1111\/aogs.13007","article-title":"Prevalence of maternal chronic diseases during pregnancy\u2014A nationwide population based study from 1989 to 2013","volume":"95","author":"Jolving","year":"2016","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_17","unstructured":"Federal Office of Public Health (FOPH) (2021, December 13). Gesundheit2020\u2014Health2020\u2014A Comprehensive Health Care Strategy, Available online: https:\/\/www.bag.admin.ch\/bag\/en\/home\/strategie-und-politik\/gesundheit-2020\/eine-umfassende-strategie-fuer-das-gesundheitswesen.html."},{"key":"ref_18","unstructured":"Federal Office of Public Health (FOPH) (2021, December 13). Health2030, Available online: https:\/\/www.bag.admin.ch\/bag\/en\/home\/strategie-und-politik\/gesundheit-2030.html."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"w20386","DOI":"10.4414\/smw.2021.20386","article-title":"Use of valproate in pregnancy and in women of childbearing age between 2014 and 2018 in Switzerland: A retrospective analysis of Swiss healthcare claims data","volume":"151","author":"Spoendlin","year":"2021","journal-title":"Swiss Med. Wkly."},{"key":"ref_20","unstructured":"Bundesamt f\u00fcr Statistik (2021, December 13). Medizinische Statistik der Krankenh\u00e4user 1998\u20132018, Available online: https:\/\/www.bfs.admin.ch\/bfs\/de\/home\/statistiken\/gesundheit\/erhebungen\/ms.html."},{"key":"ref_21","unstructured":"Federal Statistical Office (2021, August 05). Medizinische Statistik der Krankenh\u00e4user: Steckbrief, Available online: https:\/\/www.bfs.admin.ch\/bfs\/de\/home\/statistiken\/gesundheit\/erhebungen\/ms.assetdetail.7369.html."},{"key":"ref_22","unstructured":"Federal Statistical Office (2021, December 01). Medizinisches Kodierungshandbuch. Der offizielle Leitfaden der Kodierrichtlinien in der Schweiz, Available online: https:\/\/www.bfs.admin.ch\/bfs\/de\/home\/statistiken\/kataloge-datenbanken\/publikationen.assetdetail.12887004.html."},{"key":"ref_23","unstructured":"Van Rossum, G., and Drake, F.L. (2009). Python 3 Reference Manual, CreateSpace."},{"key":"ref_24","unstructured":"Federal Office of Public Health (FOPH) (2022, January 04). Health Insurance: Maternity Services, Available online: https:\/\/www.bag.admin.ch\/bag\/en\/home\/versicherungen\/krankenversicherung\/krankenversicherung-leistungen-tarife\/Leistungen-bei-Mutterschaft.html."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S107","DOI":"10.1016\/j.whi.2008.06.003","article-title":"Prevalence of Chronic Illness in Pregnancy, Access to Care, and Health Care Costs. Implications for Interconception Care","volume":"18","author":"Chatterjee","year":"2008","journal-title":"Women\u2019s Health Issues"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1177\/1403494811401482","article-title":"The Danish national patient register","volume":"39","author":"Lynge","year":"2011","journal-title":"Scand. J. Public Health"},{"key":"ref_27","unstructured":"Venkatraman, V., Mani, P., and Ussing, A. (2021, December 13). Mapping the Healthcare Landscape in Denmark. Leapcraft. Available online: http:\/\/www.leapcraft.dk\/healthtech."},{"key":"ref_28","unstructured":"Einzeldaten, A., Der Datenanfragen, Z., and Der Datenanfragen, S.A. (2021, December 13). Bundesamt f\u00fcr Statistik: READ ME. Available online: https:\/\/dam-api.bfs.admin.ch\/hub\/api\/dam\/assets\/6067371\/master."},{"key":"ref_29","unstructured":"Euro-Peristat Project with SCPE and EUROCAT (2021, December 13). European Perinatal Health Report. Core Indicators of the Health and Care of Pregnant Women and Babies in Europe in 2015. Available online: www.europeristat.com."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e218401","DOI":"10.1001\/jamanetworkopen.2021.8401","article-title":"Preeclampsia Prevalence, Risk Factors, and Pregnancy Outcomes in Sweden and China","volume":"4","author":"Yang","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S1262-3636(07)70205-7","article-title":"Gestational diabetes mellitus and the risk of metabolic syndrome: A population-based study in Lausanne, Switzerland","volume":"31","author":"Noussitou","year":"2005","journal-title":"Diabetes Metab."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"561","DOI":"10.3109\/09513590.2013.879853","article-title":"Incidence of gestational diabetes and birth complications in Switzerland: Screening in 1042 pregnancies","volume":"30","author":"Orecchio","year":"2014","journal-title":"Gynecol. Endocrinol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"International Association of Diabetes and Pregnancy Study Groups Consensus Panel (2010). International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in Pregnancy. Diabetes Care, 33, 676\u2013682.","DOI":"10.2337\/dc09-1848"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1515\/jpm-2016-0099","article-title":"Fourfold increase in prevalence of gestational diabetes mellitus after adoption of the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria","volume":"45","author":"Huhn","year":"2017","journal-title":"J. Perinat. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/j.1600-0412.2010.01030.x","article-title":"Placental abruption: Epidemiology, risk factors and consequences","volume":"90","author":"Tikkanen","year":"2011","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_36","first-page":"w14175","article-title":"Incidence of preeclampsia in pregnant Swiss women","volume":"145","author":"Purde","year":"2015","journal-title":"Swiss Med. Wkly."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"w30048","DOI":"10.4414\/SMW.2021.w30048","article-title":"Use of drugs to treat symptoms and acute conditions during pregnancy in outpatient care in Switzerland between 2014 and 2018: Analysis of Swiss healthcare claims data","volume":"151","author":"Gerbier","year":"2021","journal-title":"Swiss Med. Wkly."},{"key":"ref_38","unstructured":"OECD (2022, May 18). OECD Family Database: SF 2.3 Age of Mothers at Childbirth. OECD, Available online: https:\/\/www.oecd.org\/els\/family\/database.htm."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/13\/7922\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:39:44Z","timestamp":1760139584000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/13\/7922"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,28]]},"references-count":38,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["ijerph19137922"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19137922","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,28]]}}}