Adverse Outcome Index components before and after closure of local planned obstetric services in British Columbia, 1998–2014
| Adverse Outcome Index component | Severity points per adverse event | No. (risk per 100)* | ||
|---|---|---|---|---|
| Communities without closures | Communities with closures | |||
| Preclosure | Postclosure | |||
| No. of deliveries | 8925 | 5796 | 6153 | |
| Maternal | ||||
| Maternal death† | 750 | < 5 (< 0.06) | < 5 (< 0.09) | < 5 (< 0.08) |
| Uterine rupture† | 100 | 9 (0.10) | < 5 (< 0.09) | 5 (0.08) |
| Maternal ICU admission† | 65 | < 5 (< 0.06) | < 5 (< 0.09) | < 5 (< 0.08) |
| Unanticipated operative procedure | 40 | 57 (0.64) | 74 (1.28) | 70 (1.14) |
| Blood transfusion | 20 | 74 (0.83) | 53 (0.91) | 46 (0.75) |
| Third- or fourth-degree perineal tear | 5 | 208 (2.33) | 136 (2.35) | 174 (2.83) |
| Fetal/neonatal | ||||
| Intrapartum stillbirth or in-hospital death of newborn ≥ 2500 g with no congenital anomalies or fetal hydrops | 400 | 15 (0.17) | 11 (0.19) | < 5 (< 0.08) |
| Birth trauma | 60 | 24 (0.27) | 22 (0.38) | 12 (0.20) |
| Neonatal ICU admission > 2 d or transfer within 24 h of birth to a facility with an ICU for newborn ≥ 2500 g | 35 | 76 (0.85) | 68 (1.17) | 28 (0.46) |
| 5-minute Apgar score < 7 | 25 | 149 (1.67) | 71 (1.22) | 85 (1.38) |
| Weighted Adverse Outcome Score, mean‡ | 2.19 | 2.69 | 1.67 | |