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The acute presentation of pregnant women to non-maternity Emergency departments

Population Size

1,035

People

Population Size statistic card

Years

2015 - 2020

Years statistic card

Associated BioSamples

None/not available

Associated BioSamples statistic card

Geographic coverage

United Kingdom

England

Geographic coverage statistic card

Lead time

1-2 months

Lead time statistic card

Summary

Patients admitted with a pregnancy related event. Granular care pathways. Multi-morbidity, investigations, interventions and treatments. Serial physiology, blood biomarkers, physiotherapy, outcome. Deeply phenotyped.

Documentation

Each year, there are audits to assess maternal & foetal outcomes across the UK. In 2016-18, 217 women died during or up to six weeks after pregnancy, from causes associated with their pregnancy, among 2,235,159 women giving birth in the UK. 9.7 women per 100k died during pregnancy or up to six weeks after childbirth or the end of pregnancy. There was an increase in the overall maternal death rate in the UK between 2013-15 & 2016-18. Assessors judged that 29% of women who died had good care. However, improvements in care which may have made a difference to the outcome were identified for 51% of women who died. Birmingham has a higher than average maternal & foetal death rate. This dataset includes detailed information about the reasons pregnant women seek acute care, & their care pathways & outcomes. PIONEER geography: The West Midlands (WM) has a population of 5.9m & includes a diverse ethnic, socio-economic mix. There is a higher than average % of minority ethnic groups. WM has the youngest population in the UK with a higher than average birth rate. There are particularly high rates of physical inactivity, obesity, smoking & diabetes. 51.2% of babies born in Birmingham have at least one parent born outside of the UK, this compares with 34.7% for England. Each day >100k people are treated in hospital, see their GP or are cared for by the NHS. EHR: University Hospitals Birmingham NHS Foundation Trust (UHB) is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & 100 ITU beds. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”. Scope: Pregnant or post-partum women from 2015 onwards who attended A&E in Queen Elizabeth hospital. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes highly granular patient demographics (including gestation & postpartum period), co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to process of care (admissions, wards, practitioner changes & discharge outcomes), presenting complaints, physiology readings (temperature, blood pressure, NEWS2, SEWS, AVPU), referrals, all prescribed & administered treatments & all outcomes. Available supplementary data: More extensive data including granular serial physiology, bloods, conditions, interventions, treatments. Ambulance, 111, 999 data, synthetic data. Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.

Dataset type

Health and disease, Treatments/Interventions

Dataset sub-type

Maternity and neonatology

Dataset population size

1035

Keywords

Observations

Observed Node

Disambiguating Description

Measured Value

Measured Property

Observation Date

Persons

1035 maternity spells in this dataset from 01.01.2015 to 31.12.2020

1035

Count

17 Feb 2020

Provenance

Purpose of dataset collection

Care

Source of data extraction

EPR

Collection source setting

Secondary care - Accident and Emergency, Secondary care - In-patients

Patient pathway description

The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic, socio-economic mix. There is a higher than average percentage of minority ethnic groups with Birmingham having a population which is >40% non-white. Birmingham is one of the youngest cities in Europe and has a birth rate that is higher than average (The General Fertility Rate was 69.7 births per thousand population and the Total Fertility Rate was 2.04 children per woman in 2016, both higher than the average for the UK). Unfortunately Birmingham also has a higher than average infant mortality rate and a higher than average incidence of maternal complications. There is social deprivation and Birmingham’s population suffers with particularly high rates of physical inactivity, obesity, smoking & diabetes. There are also high levels of rare diseases, especially immunometabolic conditions. The patients included in this dataset are representative of this diverse population and also include a wide age-range. University Hospitals Birmingham NHS Foundation Trust (UHB) is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & 100 ITU beds. UHB runs a fully electronic healthcare record (EHR) (PICS Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”. This dataset includes the patient journey from admission to hospital to outcome for pregnant and post-partum patients admitted to a general hospital. The data includes granular demography and co-morbidity, presenting symptoms and diagnoses, serial physiology and blood biomarkers, all investigations, all prescribed and administered treatments and outcomes. It can be supplemented with preceding and following health care contacts, to understand the risk for the acute admission during pregnancy and the subsequent impact on health after discharge. Although primarily secondary care, this dataset can be supplemented with ambulance and primary care data on request. PIONEER can also offer synthetic data, images and access to a secure Trusted Research Environment for analytics and AI. PIONEER can assist with analytics, model build, validation & refinement A.I. Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.

Image contrast

Not stated

Biological sample availability

None/not available

Structural Metadata

Details

Publishing frequency

Quarterly

Version

1.0.0

Modified

08/10/2024

Distribution release date

17/02/2020

Citation Requirements

This publication uses data from PIONEER, an ethically approved database and analytical environment (East Midlands Derby Research Ethics 20/EM/0158)

Coverage

Start date

01/01/2015

End date

31/12/2020

Time lag

Less than 1 week

Geographic coverage

United Kingdom, England, West Midlands

Minimum age range

10

Maximum age range

55

Follow-up

Other

Accessibility

Language

en

Alignment with standardised data models

LOCAL

Controlled vocabulary

OPCS4, SNOMED CT, ICD10

Format

SQL

Data Access Request

Dataset pipeline status

Available

Time to dataset access

1-2 months

Access request cost

www.pioneerdatahub.co.uk/data/data-services-costs/

Access method category

TRE/SDE

Access service description

Trusted Research Environments (TRE) are built using Microsoft Azure services and hosted in the UK to provide research teams a safe, secure and agile environment which allows users to quickly analyse, interpret and form an enriched view of primary care information through a range of integrated datasets.

Health data collated from multiple sources is ingested into a secure data lake which will then allow subsets of data to be made available to research teams on approval of a data request. Once approved a customer specific TRE is made available with a standard set of leading analytical tools from Microsoft including Azure Databricks, Azure Machine Learning, Azure SQL and Azure Synapse (for large-scale data warehouses). Specific tools can be provided at an additional cost over the standard platform data access charge and the PIONEER team will work with you to determine your exact needs.

Access to the TRE is managed using the latest virtual desktop technology to provide a safe and secure end-user experience. By utilising leading edge design PIONEER are able to create TREs rapidly to enable us to service any customer requirement.

Data use limitation

General research use

Data use requirements

Project-specific restrictions

Data Controller

University Hospitals Birmingham NHS Foundation Trust

Dataset Types: Health and disease, Treatments/Interventions

Dataset Sub-types: Maternity and neonatology


Collection Sources: Secondary care - Accident and Emergency, Secondary care - In-patients

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