B4 Maternity and neonatal discharges
Key Points 2006/07
Overview
- Note that a greater number of births than maternities can be
recorded as multiple births are recorded as only one maternity.
- In 2006/07 there were 566 maternities for which drug misuse was
recorded, a rate of 10.4 per 1,000 maternities (Table B4.1).
- Nearly three-quarters (74%) of maternities recording drug misuse
were for mothers aged under 30 years. For all maternities just over
half (52%) are mothers aged under 30 years (Table B4.1).
- Of the 572 births recording drug misuse 71% were recorded as
full-term normal birthweight (405). For all births 90% were
recorded as full-term normal birthweight (49,729). Nineteen percent
of the births recording drug misuse were preterm (110) compared to
8% of all births (4,216) (Table B4.3).
- The majority of births recording drug misuse, 53% (305), were
recorded as being in the fifth deprivation category (most
deprived). For all births 25% (13,707) were recorded as being in
the most deprived category. The rate of births recording drug
misuse per 1,000 births increased from 1.0 per 1,000 births in the
least deprived category (category 1) through to 22.3 per 1,000
births in the most deprived category (category 5) (Table B4.4).
- 240 neonatal discharges recorded drug misuse, 4.4 per 1,000 live
births. It should be noted that neonatal discharge information is
only recorded for babies who require medical care, or who have a
congenital anomaly (Table B4.5).
Five year trends — 2002/03 to 2006/07
- The number of maternities recording drug misuse increased from
339 in 2002/03 to 566 in 2006/07 (Table B4.1).
- The rate of maternities recording drug misuse per 1,000
maternities showed a similar pattern, rising from 6.7 per 1,000
maternities in 2002/03 to 10.4 per 1,000 maternities in 2006/07
(Table B4.1).
- The proportion of maternities recording drug misuse which
recorded opioid use increased from 57% in 2002/03 (192) to 74% in
2005/06 (359) and then decreased to 65% in 2006/07 (370) (Table
B4.2).
Drugs recorded
- Opioids were recorded in 65% (370) of the maternities for which
drug misuse was recorded. Other drugs recorded were cannabinoids in
29% (162) and sedatives in 11% (60) (Table B4.2).
Background information
Data on individual patients are collected by ISD Scotland as a
series of Scottish Morbidity Records (SMR).
The SMR datasets are a significant local and national
information resource, and are used for epidemiological monitoring,
health needs assessment, national and local planning and a range of
other applications.
Pregnancy
Since 1976 data has been collected on pregnancies relating to
antenatal, delivery, postnatal care and abortions managed in
Scottish hospitals on the SMR02 (Scottish Morbidity Record -
Maternity Discharges). Deliveries account for more than half of
SMR02 discharges each year (antenatal, postnatal and abortion
episodes make up the remaining discharges) and a national coverage
of up to 98% of all births has been achieved (some home births may
not be included).
The SMR02 discharge summary is completed at the end of the
episode from patient's case notes and hospital discharge letters.
Information collected includes: demographics of the mother, details
of the delivery (mode, induction, presentation etc) and on the baby
(gestation, birth-weight, etc). Details of up to and including
three babies are recorded. In addition up to six diagnoses, a main
diagnosis and five secondary diagnoses (using the ICD10 coding
classification) can also be recorded. Specific questions are asked
about the mother smoking prior to and during pregnancy. Drugs
misuse is recorded on the SMR02 using the following ICD10
codes:
| Read code |
Read code description |
ICD10 |
Description |
F11 |
Opioids |
F12 |
Cannabinoids |
F13 |
Sedatives or Hypnotics |
F14 |
Cocaine |
F15 |
Other Stimulants |
F16 |
Hallucinogens |
F18 |
Volatile Solvents |
F19 |
Multiple / Other Psychoactive
Substances |
O35.5 |
Maternal care for suspected damage
to foetus by drugs |
Additionally drug misuse can be
recorded as a hard-coded data item, which was introduced in April
2003. However, not all hospitals are able to submit using the
hard-coded data item, as their patient administration system (PAS)
has not been modified to allow this.
Neonatal discharges
Neonatal discharges were originally recorded using SMR11 records
(including from neonatal units and postnatal cots), with records
being generated for sick babies who fall into one of the following
categories:
Babies who require medical care (other than resuscitation
immediately after birth or routine screening).
Babies who have a congenital anomaly (whether or not medical
treatment is given at that time).
The SMR11, which was completed only for sick babies admitted to
neonatal units, was replaced by the Scottish Birth Record (SBR)
from April 2003. The SBR has been incrementally implemented across
Scotland from 2003, with all areas (except Inverclyde) now using
SBR to record information for sick babies, and the majority of
areas now recording information on all births.
Drugs misuse is recorded on the SMR11 and the SBR returns using
the following ICD10 codes in addition to those listed for
SMR02.
Read code |
Read code description |
ICD10 |
Description |
P04.4 |
Foetus and newborn affected by
maternal use of drugs of addiction |
P96.1 |
Neonatal withdrawal symptoms from
maternal use of drug addiction |
The figures presented here cover the
five years, 2002/03 to 2006/07. Data for all years shown are
revised, so may be different from previously published figures.
Care should be taken when comparing numbers over time, as there has
been an improvement in drug misuse recording over the last five
years. However, it is also worth noting that recording practice of
drug misuse diagnoses may vary between hospitals, which may explain
some of the variation between NHS boards or council areas. The
replacement of SMR11 with the SBR, which occurred incrementally
across Scotland, may also have had an impact on these
figures.
Further information
Information on the background of the Scottish Birth Record and
current development is available at: http://www.sbr.scot.nhs.uk/
Further statistics relating to births are available at: http://www.isdscotland.org/births
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