Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

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48 Maternal Intensive Care in Belgium KCE Reports 94 The data in the report (2007) from the College of Physicians for Mother and Newborn estimates the IUT rate in Belgium 0.9% and the neonatal transfers at 0.28% (total 1.18%). F. Maternal mortality Fortunately, maternal mortality 45 is a very rare phenomenon in our regions. As we have two years of deliveries available for analysis, we used both years to analyze maternal mortality. Among the 198,502 women available for analysis in the database, 26 women died during the period 2003 and 2004. From these 26 deaths, 12 deaths were maternal deaths (deaths within 42 days post-partum) and 14 late maternal deaths (deaths from direct or indirect causes that occur more than 42 days but less than a year following delivery) according to ICD-10 definitions of maternal deaths. One woman died during pregnancy, 7 women during the in-patient stay of the delivery, 1 died within 1 month of delivery and 3 within 2 months of delivery (no data on exact date due to privacy-reasons). The cause of mortality is not known for women that died outside the hospital, we only know the diagnostic attributed to the in-patient stays. The incidence is measured on the 198.502 women from the cohort. Theoretically, the women who delivered in the last six weeks of the study period may have died after the study period and are, thus, not included in the numbers. This could have lead to a slight underestimation of the incidence. Although unlikely to be of clinical significance (incidence is very low), it must be mentioned. In total we thus registered 9 to 12 maternal deaths over the two years, accounting for a maternal death rate of 4.5 to 6.0 /100,000. G. Neonates Between 01/10/2003 and 30/09/2004, a total of 98,240 neonates were born from the mothers with merged data. The specific information about the location of the birth indicates that 2% (N= 1,976) of the neonates were transferred from another hospital and 94 were transferred from ambulatory care. It is important to note that most of the newborn babies transferred to NIC units in another hospitals figure in the database of unmerged stays. (Figures can be find in annex). A total of 4,174 (4.3%) neonates were admitted to a NIC-service and 17,068 (17.4%) to an N*-service. In total more than 20% of the neonates were admitted to either a NICunit or N*-service. It is interesting to note that in the FPS questionnaire, 81 (65%) hospital declare that the phototherapy is realized in the N*-service. This could partially explain the high neonatal admission rate. 45 A maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes (WHO, 2000).
KCE Reports 94 Maternal Intensive Care in Belgium 49 Table 18: General data newborns Status N Proportion born alive 97,617 99.4 Still born 433 0.4 Died during hospital stay 181 0.2 Type of pregnancy N Proportion single 94,490 96.2 twins 3,220 3.3 multiple (more than 2) 76 0.1 missing data 21 0.0 Birth weight N Proportion 500 - 999 : Extreme low birth weight ELBW 444 0.5 1000 - 1499 : Very low birth weight VLBW 630 0.6 1500 - 2499 : Low birth weight LBW 6,104 6.2 2500 - 3999 : Normal birth weight NBW 83,748 85.3 >=4000 : High birth weight HBW 7,235 7.4 Missing information 79 0.1 Gestational age N Proportion 22-28 : Extreme prematurity 563 0.6 29-32 : Very preterm 995 1.0 33-36 : Preterm delivery 6,558 6.7 37-42 : Term delivery 90,099 91.7 >=42 : Prolonged pregnancy 9 0.0 missing information 16 0.0 Apgar score at 1 min N Proportion 0-3 2,156 2.2 4-6 5,538 5.6 7-10 90,535 92.2 Apgar score at 5 min N Proportion 0-3 741 0.8 4-6 1,194 1.2 7-10 96,291 98.0 Stay in a NIC department N Proportion No 94,066 95.8 Yes 4,174 4.3 Stay in a N* department N Proportion No 81,172 82.6 Yes 17,068 17.4 All 98,240 100.0 Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004
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35. Etude relative aux coûts poten
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