Unexpected Newborn Complications in Term Infants

Numerator: The numerator is divided into two categories: Severe complications and moderate complications.
Severe complications include neonatal death, transfer to another hospital for higher level of care, , severe birth injuries such as intracranial hemorrhage or nerve injury, neurologic damage, severe respiratory and infectious complications such as sepsis. Parents of such babies may often worry about short or long term infant outcomes.
Moderate complications include diagnoses or procedures that raise concern but at a lower level than the list for severe (e.g. use of CPAP or bone fracture). For inclusion in the numerator, most require an infant length of stay that exceeds that of the mother, validating that these are indeed significant complications. Examples include less severe respiratory complications (e.g. Transient Tachypnea of the Newborn), or infections with a longer length of stay not including sepsis. As a “safety net” to capture cases who were under-coded, the numerator also includes infants who have a prolonged length of stay of over 5 days to capture the “seemingly normal” infants with neither any form of jaundice nor a social reason for staying in the hospital (e.g. family disruption or adoption).