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Unexpected Newborn Complications in Term Infants

CBE ID
0716
1.5 Project
Endorsement Status
1.0 New or Maintenance
1.1 Measure Structure
Previous Endorsement Cycle
Is Under Review
Yes
Next Maintenance Cycle
Spring 2025
1.6 Measure Description

This measure identifies moderate and severe complications among term infants who enter labor without preexisting fetal conditions (morbidity outcome measure).  The scope of the measure includes both maternal and neonatal care and is appropriate for all levels of hospital care and is collected for a full year time period.  The measure is designed to highlight processes of both obstetric and neonatal care that can be improved while recognizing that not all complications can be avoided.  As an infant outcome measure it can also serve as a balancing measure for interventions targeting maternal outcomes such as reducing cesarean birth.  It has been in use by the California Maternal Quality Care Collaborative in 3 states (California, Oregon, and Washington) for over 10 years and over 5 years by The Joint Commission (PC-06).

Measure Specs
General Information
1.7 Measure Type
1.3 Electronic Clinical Quality Measure (eCQM)
1.8 Level of Analysis
1.9 Care Setting
1.10 Measure Rationale

The most important childbirth outcome for families is bringing home a healthy baby. While there have been measures developed to assess clinical practices and outcomes in preterm infants, there is a complete lack of metrics that assess the health outcomes and guide quality improvement activities for term infants who represent over 90% of all births. 

The Unexpected Complications in Term Newborns metric addresses this gap and measures adverse outcomes resulting in severe or moderate morbidity in otherwise healthy term infants without preexisting conditions. Importantly, this metric also serves as a balancing measure for other maternal measures such as Nulliparous Term Singleton Vertex (NTSV) Cesarean, third- and fourth-degree lacerations, early elective delivery rates, and neonatal practices such as admissions to rule out sepsis for all infants exposed to chorioamnionitis.  The purpose of a balancing measure is to guard against any unanticipated or unintended consequences of quality improvement activities for these measures.

1.20a Other Data Source
Birth certificate data
1.20d Format: Other Data Source
Digital
1.25 Data Source Details

This measure utilizes either patient discharge data alone or a linked dataset that combines patient discharge data with clinical information (gestational age and birthweight) from EMR or birth certificate records.

 

All three approaches have been extensively used in CA, WA, and OR.

 

Patient discharge Data: 

Obtained from the California Department of Health Care Access and Information (HCAI). This dataset does not include data on births from military/naval hospitals, as they do not submit data to HCAI.

 

Linked to: 

 

Birth certificate Data:

Obtained from the Center for Health Statistics