Data Compilation for the WHO Global Survey of Mode of Delivery and Maternal and Perinatal Outcomes
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Although in many circumstances, caesarean birth is chosen by the health care provider to improve maternal and/or neonatal outcomes, the procedure is generally connected with increased incidences of mortality or morbidity for both mother and infant. Nevertheless, the exploding numbers of c-sections in both developing and developed countries necessitates the need to reexamine the circumstances surrounding caesarean birth outcomes. The WHO is conducting a global survey of mode of delivery and maternal and perinatal outcomes that aims to enhance and improve maternal and neonatal outcomes through informed and appropriate use of cesarean section. This project focused on data collected from April 1, 2008 to March 31, 2009 from hospitals recording 1000 or more births annually. The survey consists of eight categories: personal data of the women, reproductive history, current pregnancy, labour and delivery, neonatal data, caesarean section, neonatal outcome, and maternal outcome. To commence work on the project, a data mart was created by Nova Scotia Reproductive Care Program (RCP). In addition to the given data mart, access to the 12th edition of the Nova Scotia Atlee Perinatal Database (NSAPD) Coding Manual, the 10th revision of International Statistical Classification of Diseases and Related Health Problems (ICD-10-CA), and the Canadian Classification of Health Interventions (CCI) was provided in order to do the mapping between the WHO variables and the codes. The project went through two steps: The first step, involving manual searching to find the appropriate mapping between the variable and the code sources, was a chance to explore and learn about the RCP coding system, ICD-10-CA, and CCI. The second step, using SAS to create an SAS data set that answers the survey questions, provided an opportunity to learn about new SAS functions beyond the statistical analysis functions. In the process, 73 variables were mapped directly and 75 variables were mapped indirectly. Lumping two or more codes was one of the ways to answer the survey questions. Some variables are mapped but the variables are defined differently by WHO and NSAPD. Some variables mapped to codes but there are no recorded cases in the NSAPD. Other variables are not captured in the database. The answers to some questions contain identifiable data. In order to maintain confidentiality and privacy, some answers that breach the patient privacy and confidentiality were modified or removed, depending on the joint data access committee’s decision. A joint data access committee will ensure that no unique identifier is released. Also, any type of data which can be used to identify individuals will not be released. Moreover, the investigators should commit to using a secure system for data management and analysis to ensure confidentiality and privacy. For further protection, the investigator should commit to a joint data access committee pre-submission review of publication The final product of this project was a SAS data set that answers the WHO global survey questions and will enable the researchers and investigators to perform the required research and 4 investigations about the informed and appropriate use of cesarean section in order to improve maternal and neonatal outcomes.