Maternal Cardiac Arrest: Where is Our Data Coming From? [4A]

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Abstract

INTRODUCTION:

Maternal Cardiac Arrest (MCA) is a rare event that is estimated to affect 1 in 12,000 admissions in the United States. We surveyed national databases and registries in the United States for in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA), defined by pregnancy or postpartum status.

METHODS:

We reviewed data dictionaries of 8 separate national registries for IHCA, OHCA and maternal deaths, searching for maternal indicators (pregnancy, pregnancy within 42 days, pregnancy within 1 year).

RESULTS:

The largest databases for OHCA in the United States, Cardiac Arrest Registry to Enhance Survival (CARES) and The Resuscitation Outcomes Consortium (ROC) Epistry, do not track pregnant/postpartum data. The National Emergency Services Medical Information System (NEMSIS) database, the largest EMS database in the country on OHCA, tracks pregnancy/childbirth but not postpartum status. Get With the Guidelines ® -Resuscitation, formerly the National Registry for Cardiopulmonary Resuscitation (NRCPR), is the largest database on IHCA and only tracks pregnancy data in relation to neonatal outcome and contraindication for hypothermia. The National Inpatient Sample of the Agency for Healthcare Research and Quality (NIS) includes both pregnancy/postpartum status, although collection of data varies by state. The pregnancy morality surveillance system (PMSS), and the National Vital Statistics both include pregnancy/postpartum data, although data collection is limited deaths during pregnancy.

CONCLUSION:

Current national surveillance of IHCA and OHCA do not consistently account for pregnancy and postpartum status. Standardization of all databases to include pregnancy and postpartum status up to 1 year will allow policymakers better access to performance, trends and outcomes in MCA.

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