Special Reports & Database Analysis

Special Reports & Database Analysis

Special Reports are drill down analyses on perinatal “hot topics” or areas of clinical interest to member hospitals and the perinatal community.


Severe Maternal Morbidity (SMM)

Severe maternal morbidity (SMM) is a constellation of pregnancy factors that negatively impact a woman’s health. Nearly one-half of maternal mortality and morbidity is preventable and readiness and recognition of severe events is critical. The National Perinatal Information Center began reporting on Severe Maternal Morbidity (SMM) in 2015, particularly surrounding AIM measures SMM Among Hemorrhage Cases and SMM Among Preeclampsia Cases. This Special Analysis is an intentional focus on SMM.
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Pre-COVID-19: Selected Characteristics and Comorbidities
of the Maternal Patient Population
Jul. 2020
The COVID-19 pandemic has had a significant impact on healthcare systems and continues to result in the hospitalization of sick and critically ill patients, including pregnant women and those presenting for delivery. Pre-existing comorbidities within the obstetric population include; obesity, diabetes, hypertension, and pulmonary involvement, such as asthma. There continues to be emphasis and interest in how existing comorbidities may impact the severity and outcomes of COVID-19 within the obstetric population. This Special Report provides an in-depth exploration of a hospital’s comorbidity profile based upon the most frequently reported within the literature to date
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Maternal Hypertension Complicating Pregnancy
Apr. 2020
Hypertensive disease continues to be a leading cause of maternal mortality and severe maternal morbidity. Preeclampsia, eclampsia and other hypertensive disorders during pregnancy not only potentially impact the mother and fetus/newborn, but can also impact women’s health far beyond pregnancy. This Special Report is designed to assist hospitals and their care teams with identification of the frequency of hypertension within their perinatal population, as well as opportunities for improvement in outcomes, such as education and readmission for hypertension.
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Induction of Labor and Cesarean Birth
Jan. 2020
The long-awaited results of the ARRIVE Trial created discussion surrounding elective induction of labor, particularly induction of labor at 39 weeks gestation. There has been continued discussion surrounding induction of labor and cesarean delivery within NPIC’s membership, and several requests to explore this information in more detail. For this Special Report, NPIC wanted to be responsive to recent requests for additional data related to induction of labor and cesarean delivery, particularly trended data over time.
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Distribution of Race and Ethnicity in Maternal and Neonatal Outcomes
Nov. 2019
The recent and heightened awareness of racial and ethnic disparity in maternal mortality has created tremendous urgency for this national health crisis. In July, NPIC introduced a Special Report that focused on maternal metrics by race and ethnicity. As we continue to partner with member hospitals in reducing preventable maternal morbidity and mortality, it is essential that highlighting and addressing racial and ethnic disparities is a standard approach to quality improvement initiatives.
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Maternal Metrics by Race and Ethnicity
Jul. 2019
Narrowing or eliminating racial and ethnic disparities in maternal and neonatal outcomes is a difficult task being undertaken by many clinicians and national programs. In an attempt to ensure that analyses which include race/ethnicity reflect a hospital’s population as accurately as possible, NPIC has implemented an initiative to improve the quality of the race and ethnicity data being submitted to us by our member hospitals.
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Maternal Hypertension Complicating Pregnancy
Apr. 2019
This Special Report is designed to present an overview of maternal cases with hypertension coding with a specific focus on the AIM Severe Hypertension in Pregnancy bundle outcome measures, Severe Maternal Morbidity among Preeclampsia Cases and Severe Maternal Morbidity among Preeclampsia Cases excluding Blood Transfusions.
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Postpartum Readmissions - What Drives Your Rate?
Jan. 2019
Clapp recently reported on a study they conducted using State Inpatient databases from California, Florida and New York to determine the relative effects of patient and hospital factors on maternal postpartum readmissions. This Special Report does not attempt to replicate the Clapp study. It is designed to show readmission rates for each member hospital compared to the readmission rates of all eight NPIC peer subgroups and the NPIC overall average.
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Substance Use Disorder (SUD) Analysis
Jul. 2018
Substance Use Disorder (SUD) is a critical concern for the perinatal community. It is estimated that 5% of women use illicit drugs during pregnancy and 49%-94% of infants exposed to opioids in utero experience neonatal abstinence syndrome (NAS).
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Maternal Obesity Analysis
Mar. 2018
A review of the V17.3 NPIC Database revealed that 32,265 delivery discharges (10.1% of all deliveries) were coded with Obesity Complicating Pregnancy, Childbirth and Puerperium (ICD-10 code O99.21x), the majority coded as complicating childbirth. This special report presents an analysis of maternal and neonatal outcomes for cases coded with obesity complicating childbirth at your hospital compared to the NPIC Database.
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Perinatal Chorioamnionitis Analysis
Aug. 2017
This Special Report was in response to the observed increase in cases coded with P02.7: Newborn affected by Chorioamnionitis, and our curiosity as to how maternal chorioamnionitis and the newborn impact presents in your hospital’s data.
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Perinatal Risk Assessment
Jan. 2017
This Special Report is designed to be an additional risk management tool to look at more timely data on adverse events and those outcomes that may generate a claim. By giving risk managers and C-suite leaders the opportunity to proactively identify areas or trends of concern, they can review cases and design responses that will continually reduce their exposure.
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Primary Cesarean Delivery Rate, Uncomplicated (IQI 33) and
Unexpected Newborn Complications (NQF #0716)-Linked Analysis
Apr. 2016
This Special Report is designed to look at the potential interaction between a hospital's Primary Cesarean Delivery Rate, Uncomplicated (IQI33) and the hospital's Unexpected Newborn Complications (NQF #0716), using a linked mother-baby analysis.
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Alliance for Innovation on Maternal Health (AIM) Outcome Metrics
Jan. 2016
This Special Report focuses on selected outcome metrics that are designed to support the national QI project: the Alliance for Innovation on Maternal Health (AIM) initiative. It also describes the opportunities for NPIC members to participate in this project.
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Linked Analysis-Neonatal Abstinence Syndrome
Oct. 2015
This Special Report provides data related to neonatal abstinence syndrome for inborns, including a 5 year trend graph, linked inborn/mother analysis and relevant maternal variables.
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Postpartum Hemorrhage
Jan. 2015
This special report is an update of the V10.4 special report by NPIC on the topic, provided in July 2011. Obstetric complications, including hemorrhage, contribute to a significant number of maternal deaths.
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NPIC Perinatal Quality Improvement Dashboard
Oct. 2014
This dashboard was developed from feedback and other sample dashboards we received from NPIC member hospitals, particularly related to how they were using data from the NPIC Quarterly Report.
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Clinical and Utilization Profile for Term Inborns by Gestational Age
Jul. 2014
This report profiles the hospital's term infants subdivided into the reVITALize definitions of Early Term, Full Term, Late Term and Post Term. It looks at the volume, utilization and clinical profile for each category of term inborn using numeric gestational age.
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Maternal Hypertension Complicating Pregnancy and Neonatal Outcomes
Jan. 2014
This report provides data related to maternal hypertension complicating pregnancy and neonatal outcomes, including a linked mother-baby analysis. Hypertensive disorders of pregnancy (HDP) are major causes of maternal and perinatal morbidity and mortality.
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Low Risk Primary C-section Analysis AHRQ Inpatient Quality
Indicator (IQI) # 33: Primary Cesarean Delivery Rate, Uncomplicated
Oct. 2013
The objective for providing this analysis is to further assist hospitals in looking critically at their AHRQ IQI # 33 rate. This report is designed to focus attention on the cesarean section rate of hospitals' low risk population.
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Induction Coding Analysis
Oct. 2018
In July 2016, The Alliance for Innovation on Maternal Health (AIM) identified labor induction as an important area for quality improvement in obstetrics and created the ICD-10-PCS Coding Guidelines for Labor Inductions in an effort for promote more accurate ICD-10 coding. This special report  reviews induction coding in the NPIC database and adherence to the AIM guidelines two years after their creation.
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Existing vs. Revised ICD-10-CM Specifications
for Unexpected Newborn Complications
Jan. 2018
NPIC has reported on UNC rates for member and contract hospitals since shortly after the measure was approved by the National Quality Forum in 2011. We have found the measure to be a widely accepted method for tracking newborn complications in the lowest risk newborn population.
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Comparative Birth Trends
Oct. 2017
This Special Report is designed to look at the birth trends for NPIC's Trend Data Base in comparison to the CDC rates.
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Comparative C-Section Analysis
Apr. 2017
The Society for Maternal-Fetal Medicine (SMFM) has sought to refine the definition of low-risk cesarean delivery rate. The issue addressed by SMFM is that the AHRQ measure, IQI 33 (Primary Cesarean Delivery Rate, Uncomplicated) does not exclude some well-established contradictions to vaginal birth including conditions that most likely result in cesarean delivery such as HIV infection. The NPIC V16.3 Special Report focuses on the comparison of two rates: AHRQ IQI 33 and the SMFM rate. The two measures were selected because The Joint Commission PC 02 rate is calculated on nulliparous women only unlike the IQI 33 and SMFM rates.
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Updates for the New Reporting Year
Oct. 2016
This Special Report provides an overview of the changes to the NPIC Quarterly Report and further addresses implications of the transition to ICD-10 coding - specifically, coding for inductions.
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ICD-10 Data Transition
Jul. 2016
This Special Report provides a brief summary of the initial effect of the transition on data quality and measure reporting. NPIC will continue to monitor the status of ICD-10 information and plan to update member hospitals on a quarterly basis.
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Severe Maternal Morbidity
Apr. 2015
This special report profiles the rate of severe maternal morbidity (SMM) as introduced by Callaghan, et. al, in November 2012. Callaghan and his colleagues identified twenty-five severe morbidity indicators based on ICD-9-CM diagnostic codes associated with higher in-hospital mortality.
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Standardizing OB Data Definitions:
Report of the National reVITALize Conference
Apr. 2014
This report provided information on the reVITALize work and brought awareness to the goal of the conference, which was to standardize clinical obstetric data definitions for use in registries, electronic medical record systems, and vital statistics.
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Unexpected Newborn Complications Update
Jul. 2013
An analysis based on the California Maternal Quality Care Collaborative updates to their endorsed National Quality Forum measure Healthy Term Newborn (#0716). This report is designed to provide an understanding of the data and analysis of unexpected severe and moderate newborn complications.
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The Adverse Outcome Index (AOI) Update:
Ten Years After the Original Study
Apr. 2013
This report is designed to provide an understanding of the data and analysis of adverse outcome events potentially modifiable through improved teamwork. This report displays samples of the tables and graphs that are provided in our quarterly monitoring AOI reports.
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Perinatal Complications Associated with
Gestational and Pregestational Diabetes
Jan. 2013
An analysis of maternal and neonatal complications for diabetic mothers. The tables display data for delivered mothers subdivided into the following categories: gestational diabetes (abnormal glucose tolerance), pre-gestational diabetes (diabetes mellitus), non-diabetic, and all cases.
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Very Low Birthweight Neonates
Oct. 2012
An analysis of special care utilization and complications for neonates less than 1500 grams. This report is designed to provide member hospitals with a focused analysis of their highest risk neonates in comparison to the averages found in each of the NPIC subgroups and the NPIC Database.
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Changes in Labor Induction and Cesarean Delivery
Between 2006 and 2010 in NPIC Member Hospitals
Jul. 2012
This report utilizes the NPIC database to examine trends in delivery methods and the potential impact of recent guidelines to reduce non-medically indicated late preterm and early term births. The report is based on a manuscript which will be submitted for publication.
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Late Preterm Births
Apr. 2012
This analysis provides data on the hospital's Late Preterm Birth infants in comparison to the NPIC Database average rates. This is similar to a report developed for the Maintenance of Certification (MOC) Part 4 program participants.
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Neonatal Abstinence Syndrome (NAS)
Jan. 2012
This linked analysis provides data related to neonatal abstinence syndrome for inborns, including a linked inborn/mother analysis and relevant maternal variables.
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Maternal Mortality Review
Oct. 2011
This report provides a descriptive overview of maternal mortality including statistics from the NPIC trend database.
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Maternal Hemorrhage
Jul. 2011
An analysis of antepartum and postpartum hemorrhage for calendar year 2010 data.
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Expanded Set of Perinatal Indicators
Jan. 2011
This report is designed to consolidate the OB Quality Indicators (on Table OB 10) and Neonatal Quality Indicators (on Table N 11) of the standard quarterly report, eliminate indicators that are no longer relevant, and expand to include new indicators that are tracked by other national groups (AHRQ), National Quality Forum (NQF) and are currently or have been tracked by NPIC.
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Maternal Obesity & Complications of Mothers, Fetuses and Newborns
Oct. 2010
A linked trend analysis 2007-2010 (Q1) of the coded complications of mothers whose delivery discharge record included diagnosis code 649.1x, (obesity complicating pregnancy, childbirth, or the puerperium) compared to mothers without diagnosis code 649.1x, as well as the percent change from 2007-2009.
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Maternal Shoulder Dystocia and Inborn Birth Trauma
Jul. 2010
A five year linked trend analysis (2004-2009) of mothers who had a vaginal delivery, a shoulder dystocia code on their record and a birth trauma code on their ≥ 2500 gram baby's record.
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Incidence of Episiotomy
Apr. 2010
An analysis of National Quality Forum (NQF) measure #0470, Incidence of Episiotomy, the rate of vaginal deliveries without shoulder dystocia that had an episiotomy.
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Joint Commission New Perinatal Care Measure Set
Jan. 2010
This report provides background information on the new Joint Commission perinatal care measures, links to resource/reference materials and an analysis of the initial patient populations for the maternal and newborn measures.
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Maternal Obesity & Complications of Mothers, Fetuses and Newborns
Oct. 2009
A linked trend analysis 2007-2009 (Q1) of the coded complications of mothers whose delivery discharge record included diagnosis code 649.1x, (obesity complicating pregnancy, childbirth, or the puerperium) compared to mothers without diagnosis code 649.1x.
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Late Preterm Births
Jul. 2009
An aggregate profile of preterm births. This analysis provides a comparison of calendar year 2006 to 2008 data using the NPIC Trend Database.
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Inductions by Gestational Age
Apr. 2009
A linked Mother/Baby analysis of inductions ≥ 37 weeks and < 39 weeks completed gestation with and without coded medical indications for induction.
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Member Hospitalist Survey Analysis
Apr. 2009
An analysis of survey responses from member hospitals regarding their use of "laborists" or "OB hospitalists".
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