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Table 4 Adjusted outcomes (individual and composite) by assisted vaginal delivery rates outlier status

From: Risk-adjusted operative delivery rates and maternal-neonatal outcomes as measures of quality assessment in obstetric care: a multicenter prospective study

  Assisted vaginal delivery outlier
  Within expected Above expected Below expected
Maternal complications % (95% CI) % (95% CI) % (95% CI)
Major PPH 0.43 (0.41-0.45) 0.49 (0.47-0.51) 0.20 (0.19-0.22)
Hysterectomy 0.06 (0.05-0.07) 0.04 (0.03-0.04) 0.04 (0.03-0.05)
Wound hematoma 0.31 (0.31-0.33) 0.34 (0.33-0.36) 0.32 (0.31-0.34)
TED 0.04 (0.03-0.04) 0.03 (0.02-0.03) 0.06 (0.05-0.07)
Uterine rupture 0.01 (0.01-0.01) 0.02 (0.02-0.02) 0.01 (0.01-0.01)
Life threatening composite 0.76 (0.74-0.78) 0.80 (0.78-0.83) 0.53 (0.51-0.55)
Minor PPH 2.38 (2.34-2.42) 2.97 (2.91-3.04) 1.91 (1.86-1.95)
III-IV degree tears 0.32 (0.31-0.33) 0.39 (0.37-0.40) 0.29 (0.28-0.30)
Wound Dehiscence 0.17 (0.16-0.17) 0.15 (0.14-0.15) 0.17 (0.16-0.18)
Endometritis-Infection 0.46 (0.45-0.47) 0.46 (0.44-0.48) 0.43 (0.41-0.44)
Bowel or bladder injury 0.03 (0.03-0.03) 0.03 (0.02-0.03) 0.03 (0.02-0.03)
Anaesthesiological 0.04 (0.04-0.04) 0.05 (0.05-0.06) 0.05 (0.05-0.05)
Other* 0.13 (0.12-0.14) 0.14 (0.12-0.16) 0.10 (0.09-0.12)
Non-life threatening composite 3.22 (3.17-3.26) 3.83 (3.76-3.91) 2.45 (2.41-2.50)
Overall composite 3.96 (3.91-4.01) 4.61 (4.52-4.70) 2.97 (2.91-3.03)
Neonatal complications % (95% CI) % (95% CI) % (95% CI)
Mortality <7 days 0.10 (0.08-0.11) 0.20 (0.17-0.23) 0.04 (0.03-0.03)
Mortality <28 days 0.07 (0.05-0.09) 0.16 (0.13-0.20) 0.06 (0.05-0.07)
Neurologic symptoms 0.19 (0.17-0.22) 0.47 (0.39-0.53) 0.05 (0.05-0.06)
Life threatening composite 0.22 (0.19-0.24) 0.65 (0.54-0.76) 0.10 (0.08-0.11)
Pulmonary disorders 1.46 (1.37-1.54) 2.65 (2.45-2.84) 0.66 (0.61-0.70)
Bacterial infections 0.55 (0.52-0.58) 1.10 (0.98-1.22) 0.43 (0.40-0.46)
pH < 7.00 0.48 (0.46-0.49) 0.36 (0.33-0.38) 0.65 (0.61-0.69)
BD > 12 mmol/L 1.31 (1.28-1.34) 1.50 (1.46-1.54) 1.26 (1.22-1.30)
Apgar < 7 0.70 (0.67-0.72) 1.03 (0.91-1.15) 0.61 (0.57-0.64)
Other** 5.04 (4.81-5.27) 7.83 (7.33-8.33) 1.65 (1.49-1.82)
Non-life threatening composite 6.34 (6.11-6.58) 9.02 (8.52-9.52) 3.37 (3.15-3.58)
Overall composite 6.52 (6.34-6.71) 9.77 (9.38-10.16) 3.52 (3.35-3.68)
  1. Footnotes. Outcomes were adjusted by maternal age, maternal body mass index, gestational age at delivery, pregnancy at risk, parity, fetal presentation, number of fetuses, presence of previous CD, neonatal birth weight, grade of urgency (e.g. maternal or fetal compromise requiring immediate delivery) and cluster variables: centers with NICU and obstetric volume per center (number of deliveries/year).
  2. PPH, post-partum hemorrhage; TED, thromboembolic disease; BD, base deficit.
  3. *Any other condition requiring admission to Intensive Care Unit.
  4. **Any other condition requiring admission to Neonatal Intensive Care Unit in term neonates (37–42 weeks).