Validation of a modified obstetric comorbidity index for prediction of postpartum adverse events including fetal morbidity - a retrospective cohort study from Qatar
<h3>Background</h3><p dir="ltr">The Obstetric Comorbidity Index (OBCMI) is an internationally validated scoring system for maternal risk factors intended to reliably predict the occurrence of severe maternal morbidity (SMM). This retrospective cohort study applied the OBC...
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2024
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| author | Fouad Chaalan (22457797) |
| author2 | Fathima Minisha (16475100) Zehra Zaidi (22457800) Alaa Babekar (22457803) Huda Abullah Hussain Saleh (22457806) Zeena Saeed Bu Shurbak (14586294) Mariam Al Baloushi (22457809) Alaa Alnaama (17039815) Husham Ahmed (22457812) Isaac Babarinsa (5593565) Nader Al Dewik (18394773) Abdulrouf Pallivalapila (5801972) Victor Olagundoye (21722276) Thomas Farrell (3933833) |
| author2_role | author author author author author author author author author author author author author |
| author_facet | Fouad Chaalan (22457797) Fathima Minisha (16475100) Zehra Zaidi (22457800) Alaa Babekar (22457803) Huda Abullah Hussain Saleh (22457806) Zeena Saeed Bu Shurbak (14586294) Mariam Al Baloushi (22457809) Alaa Alnaama (17039815) Husham Ahmed (22457812) Isaac Babarinsa (5593565) Nader Al Dewik (18394773) Abdulrouf Pallivalapila (5801972) Victor Olagundoye (21722276) Thomas Farrell (3933833) |
| author_role | author |
| dc.creator.none.fl_str_mv | Fouad Chaalan (22457797) Fathima Minisha (16475100) Zehra Zaidi (22457800) Alaa Babekar (22457803) Huda Abullah Hussain Saleh (22457806) Zeena Saeed Bu Shurbak (14586294) Mariam Al Baloushi (22457809) Alaa Alnaama (17039815) Husham Ahmed (22457812) Isaac Babarinsa (5593565) Nader Al Dewik (18394773) Abdulrouf Pallivalapila (5801972) Victor Olagundoye (21722276) Thomas Farrell (3933833) |
| dc.date.none.fl_str_mv | 2024-06-08T03:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1186/s12884-024-06612-x |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Validation_of_a_modified_obstetric_comorbidity_index_for_prediction_of_postpartum_adverse_events_including_fetal_morbidity_-_a_retrospective_cohort_study_from_Qatar/30393316 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Reproductive medicine Health sciences Epidemiology Public health Obstetric comorbidity index Severe maternal morbidity OBCMI Maternal risk assessment Fetal morbidity |
| dc.title.none.fl_str_mv | Validation of a modified obstetric comorbidity index for prediction of postpartum adverse events including fetal morbidity - a retrospective cohort study from Qatar |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background</h3><p dir="ltr">The Obstetric Comorbidity Index (OBCMI) is an internationally validated scoring system for maternal risk factors intended to reliably predict the occurrence of severe maternal morbidity (SMM). This retrospective cohort study applied the OBCMI to pregnant women in Qatar to validate its performance in predicting SMM and cumulative fetal morbidity.</p><h3>Methods</h3><p dir="ltr">Data from 1000 women who delivered in July 2021 in a large tertiary centre was extracted from medical records. The OBCMI index included maternal demographics, pre-existing comorbidities, and various current pregnancy risk factors such as hypertension, including preeclampsia, intrauterine fetal death, prolonged rupture of membranes and unbooked pregnancies. SMM was based on the ACOG consensus definition, and the cumulative fetal morbidity (CFM) included fetal distress in labour, low APGAR and umbilical artery (UA) pH, admission to neonatal intensive care (NICU), and hypoxic-ischemic encephalopathy (HIE). A c-statistic or area under curve (AUC) was calculated to determine the ability of OBCMI to predict SMM and CFM.</p><h3>Results</h3><p dir="ltr">The median OBCMI score for the cohort was 1 (interquartile range- 0 to 2); 50% of women scored 0, while 85% (<i>n</i>= 842) had a score ranging from 0 to 2. Ten women (1%) scored ≥ 7; the highest score was 10. The incidence of SMM was 13%. According to the modified scoring system, the mean OBCMI score in those who developed SMM was 2.18 (± 2.20) compared to a mean of 1.04 (± 1.40) in those who did not (median 1, IQR:1–3 versus median 0, IQR: 0–2; <i>p</i> < 0.001). The incidence of CFM was 11.3%. The incidence of low APGAR score, HIE and NICU admission was nearly 1 in 1000. Around 5% of the babies had fetal distress in labour and low UA pH. For every 1 unit increase in OBCMI score, the odds of SMM increased by 44% (OR 1.44 95% CI 1.30–1.59; <i>p</i> < 0.001; AUC 0.66), and CFM increased by 28% (OR 1.28 95% CI 1.15–1.42; <i>p</i> < 0.001; AUC 0.61). A cut-off score of 4 had a high specificity (> 90%); 1 in 4 and 1 in 6 women with OBCMI score ≥ 4 developed SMM and CFM, respectively.</p><h3>Conclusion</h3><p dir="ltr">The OBCMI performed moderately well in predicting SMM in pregnant women of Qatar and can be effectively used as a risk assessment tool to red-flag high-risk cases so that appropriate and timely multidisciplinary care can be initiated to reduce SMM and maternal mortality. The index is also helpful in predicting fetal morbidity; however, further prospective studies are required to validate OBCMI for CFM.</p><h2>Other Information</h2><p dir="ltr">Published in: BMC Pregnancy and Childbirth<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s12884-024-06612-x" target="_blank">https://dx.doi.org/10.1186/s12884-024-06612-x</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_a7a5d7fb0d99d2f0e5fffac6cbdbedff |
| identifier_str_mv | 10.1186/s12884-024-06612-x |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/30393316 |
| publishDate | 2024 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Validation of a modified obstetric comorbidity index for prediction of postpartum adverse events including fetal morbidity - a retrospective cohort study from QatarFouad Chaalan (22457797)Fathima Minisha (16475100)Zehra Zaidi (22457800)Alaa Babekar (22457803)Huda Abullah Hussain Saleh (22457806)Zeena Saeed Bu Shurbak (14586294)Mariam Al Baloushi (22457809)Alaa Alnaama (17039815)Husham Ahmed (22457812)Isaac Babarinsa (5593565)Nader Al Dewik (18394773)Abdulrouf Pallivalapila (5801972)Victor Olagundoye (21722276)Thomas Farrell (3933833)Biomedical and clinical sciencesReproductive medicineHealth sciencesEpidemiologyPublic healthObstetric comorbidity indexSevere maternal morbidityOBCMIMaternal risk assessmentFetal morbidity<h3>Background</h3><p dir="ltr">The Obstetric Comorbidity Index (OBCMI) is an internationally validated scoring system for maternal risk factors intended to reliably predict the occurrence of severe maternal morbidity (SMM). This retrospective cohort study applied the OBCMI to pregnant women in Qatar to validate its performance in predicting SMM and cumulative fetal morbidity.</p><h3>Methods</h3><p dir="ltr">Data from 1000 women who delivered in July 2021 in a large tertiary centre was extracted from medical records. The OBCMI index included maternal demographics, pre-existing comorbidities, and various current pregnancy risk factors such as hypertension, including preeclampsia, intrauterine fetal death, prolonged rupture of membranes and unbooked pregnancies. SMM was based on the ACOG consensus definition, and the cumulative fetal morbidity (CFM) included fetal distress in labour, low APGAR and umbilical artery (UA) pH, admission to neonatal intensive care (NICU), and hypoxic-ischemic encephalopathy (HIE). A c-statistic or area under curve (AUC) was calculated to determine the ability of OBCMI to predict SMM and CFM.</p><h3>Results</h3><p dir="ltr">The median OBCMI score for the cohort was 1 (interquartile range- 0 to 2); 50% of women scored 0, while 85% (<i>n</i>= 842) had a score ranging from 0 to 2. Ten women (1%) scored ≥ 7; the highest score was 10. The incidence of SMM was 13%. According to the modified scoring system, the mean OBCMI score in those who developed SMM was 2.18 (± 2.20) compared to a mean of 1.04 (± 1.40) in those who did not (median 1, IQR:1–3 versus median 0, IQR: 0–2; <i>p</i> < 0.001). The incidence of CFM was 11.3%. The incidence of low APGAR score, HIE and NICU admission was nearly 1 in 1000. Around 5% of the babies had fetal distress in labour and low UA pH. For every 1 unit increase in OBCMI score, the odds of SMM increased by 44% (OR 1.44 95% CI 1.30–1.59; <i>p</i> < 0.001; AUC 0.66), and CFM increased by 28% (OR 1.28 95% CI 1.15–1.42; <i>p</i> < 0.001; AUC 0.61). A cut-off score of 4 had a high specificity (> 90%); 1 in 4 and 1 in 6 women with OBCMI score ≥ 4 developed SMM and CFM, respectively.</p><h3>Conclusion</h3><p dir="ltr">The OBCMI performed moderately well in predicting SMM in pregnant women of Qatar and can be effectively used as a risk assessment tool to red-flag high-risk cases so that appropriate and timely multidisciplinary care can be initiated to reduce SMM and maternal mortality. The index is also helpful in predicting fetal morbidity; however, further prospective studies are required to validate OBCMI for CFM.</p><h2>Other Information</h2><p dir="ltr">Published in: BMC Pregnancy and Childbirth<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s12884-024-06612-x" target="_blank">https://dx.doi.org/10.1186/s12884-024-06612-x</a></p>2024-06-08T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1186/s12884-024-06612-xhttps://figshare.com/articles/journal_contribution/Validation_of_a_modified_obstetric_comorbidity_index_for_prediction_of_postpartum_adverse_events_including_fetal_morbidity_-_a_retrospective_cohort_study_from_Qatar/30393316CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/303933162024-06-08T03:00:00Z |
| spellingShingle | Validation of a modified obstetric comorbidity index for prediction of postpartum adverse events including fetal morbidity - a retrospective cohort study from Qatar Fouad Chaalan (22457797) Biomedical and clinical sciences Reproductive medicine Health sciences Epidemiology Public health Obstetric comorbidity index Severe maternal morbidity OBCMI Maternal risk assessment Fetal morbidity |
| status_str | publishedVersion |
| title | Validation of a modified obstetric comorbidity index for prediction of postpartum adverse events including fetal morbidity - a retrospective cohort study from Qatar |
| title_full | Validation of a modified obstetric comorbidity index for prediction of postpartum adverse events including fetal morbidity - a retrospective cohort study from Qatar |
| title_fullStr | Validation of a modified obstetric comorbidity index for prediction of postpartum adverse events including fetal morbidity - a retrospective cohort study from Qatar |
| title_full_unstemmed | Validation of a modified obstetric comorbidity index for prediction of postpartum adverse events including fetal morbidity - a retrospective cohort study from Qatar |
| title_short | Validation of a modified obstetric comorbidity index for prediction of postpartum adverse events including fetal morbidity - a retrospective cohort study from Qatar |
| title_sort | Validation of a modified obstetric comorbidity index for prediction of postpartum adverse events including fetal morbidity - a retrospective cohort study from Qatar |
| topic | Biomedical and clinical sciences Reproductive medicine Health sciences Epidemiology Public health Obstetric comorbidity index Severe maternal morbidity OBCMI Maternal risk assessment Fetal morbidity |