This is a hospital level performance score reported as the percent of infants with Unexpected Newborn Complications among full term newborns with no preexisting conditions, typically calculated per year.
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).
Denominator
1.15 Denominator
The denominator is comprised of singleton, live born babies who are at least 37.0 weeks of gestation, and over 2500g in birth weight. The denominator excludes most serious fetal conditions that are “preexisting” (present before labor), including prematurity, multiple gestations, poor fetal growth, congenital malformations, genetic disorders, other specified fetal and maternal conditions and infants exposed to maternal drug use in-utero. The final denominator population consists of babies who are expected to do well following labor and delivery and go home routinely with their mothers.
Exclusions
Exclusions
a) Babies not born in hospitals are excluded as this is a hospital quality performance measure b) Babies who are part of multiple gestation pregnancies are excluded. c) Premature infants (babies born before 37 weeks gestational age) are excluded d) Low birth weight babies (<=2500g) are excluded e) Babies with congenital malformations and genetic diseases are excluded f) Babies with pre-existing fetal conditions such as IUGR are excluded g) Babies who were exposed to maternal drug use in-utero are excluded
Measure Record
Most Recent Endorsement Activity
Endorsed Perinatal and Women's Health Spring Cycle 2020
Public Comments