Electronic Delivery Book: Structured Database Enables Analysis of Perinatal Risk Factors

Abstract

The Electronic Delivery Book (EDB), an electronic information system, was developed in cooperation with obstetricians, midwives, and neonatologists from the University Hospital in Brno. The main aim was to create structured electronic documentation of selected delivery-related parameters based on the existing paper-based documentation. The system contains information from the different stages of delivery: parameters of the pregnancy, medications/interventions during the birth, outcome measures for the newborn(s), and primary attributes from neonatology. The EDB also allows creating overviews and basic statistics for everyday clinical needs and offers structured data for retrospective as well as prospective studies. One of the first results based on data collected using the EDB was the analysis aimed at identification of potential risk factors for low umbilical cord artery pH in term, singleton pregnancies. The data selected from EDB represents a basis for the retrospective case-control study. Cases were deliveries characterized by umbilical cord artery pH ≤7.05, controls were with no sign of hypoxia. In the database of 10637 deliveries, collected between 2014 and 2015 at the University Hospital in Brno, we identified 99 cases. Univariate analysis of clinical features was performed. The following risk factors were associated with low pH: the length of the first stage (odds ratio (OR) 1.40; 95% CI 1.04–1.89) and the length of the second stage of labor (OR 2.86; 1.70–4.81), primipara (OR 2.99; 1.90–4.71) and meconium stained fluid (OR 1.60; 1.07–2.38).