Data Source

1
Maternal Morbidity in American Indian and Alaska
Native Women, 2002-2004 Stephen J. Bacak1, Judith
Thierry2, Myra Tucker1, Edna Paisano3 1Division
of Reproductive Health, Centers for Disease
Control and Prevention, 2Office of Clinical and
Preventive Services, 3Office of Public Health
Planning and Support, Indian Health Service
Conclusion
Background
Table III. Prevalence rates of selected maternal
morbidity in American Indian and Alaska Native
women, National Patient Information Reporting
System, 2002-2004
Table I. ICD-9 morbidity codes, National Patient
Information Reporting System, 2002-2004

• Cesarean section rates in this population were
  lower than the general US population
• Midwives play a significant role in AI/AN
  pregnancies
• Compared to women in the US, AI/AN women are at
  an increased risk for some complications during
  delivery hospitalizations, particularly
  postpartum hemorrhage, gestational diabetes, and
  all preeclampsia
• In general, infection rates among AI/AN women are
  similar to women in the general US population

• Maternal morbidity is a significant public health
  and economic burden in the United States
• There is little published information on maternal
  morbidity among American Indian and Alaska Native
  (AI/AN) women
• Some evidence suggests that AI/AN women have
  higher rates of morbidity compared to other race
  groups, including pregnancy-related hypertension,
  hemorrhage, and gestational diabetes

Objectives
Limitations

• No information on important variables such as
  parity, obesity, urban/rural status, and health
  behaviors (e.g. smoking, drinking)
• Unable to determine the week of prenatal care
  initiation and the number of antepartum visits
• Unable to link with infant hospitalizations to
  investigate neonatal outcomes (e.g. gestational
  age, APGAR scores)
• Morbidity data limited to ICD-9 codes

• To determine the prevalence of selected maternal
  morbidities during delivery hospitalizations in
  AI/AN women

Data Source

• National Patient Information Reporting System
• July 2002- June 2004
• International Classification of Disease, 9th
  Revision (ICD-9) codes

Table II. Demographic characteristics of American
Indian and Alaska Native women, National Patient
Information Reporting System, 2002-2004
Table IV. Mean length of delivery hospitalization
among American Indian and Alaska Native women,
National Patient Information Reporting System,
2002-2004
Public Health Impact

• Our findings stress the importance of
  comprehensive preconception and prenatal care in
  AI/AN women to prevent maternal morbidity and
  improve maternal health
• There is a need for continual surveillance and
  etiologic research to further understand the
  elevated health risk among AI/AN women
• Local and regional use of data should be used to
  inform policy and intervention strategies to
  improve access to care and public health messages
  regarding maternal morbidity

Methods

• Definitions
• Delivery hospitalizations
• ICD-9 V27 code listed in any of the 15 diagnosis
  fields
• N6761
• Maternal morbidity
• Selected ICD-9 pregnancy codes (640-677) listed
  in any of the 15 diagnosis fields
• Related ICD-9 codes outside of the 640-677 range
• Analysis
• Prevalence rates and 95 CI were calculated using
  SAS 8.2

Contact Info
Stephen J. Bacak, MPH Division of Reproductive
Health Centers for Disease Control and
Prevention 4770 Buford Highway, NE, Mailstop
K-23 Atlanta, GA 30341 Ph 770-488-6271 Email
sbacak_at_cdc.gov