The Swedish Pregnancy Register Michaela Granfors Vice register holder, Pregnancy Register Consultant in Fetal medicine and Obstetrics, Karolinska University Hospital PhD, post doc Clinical Epidemiology Unit, KI

Contents of presentation Perinatal care in Sweden The Swedish Pregnancy Register Data from the Register / new Dashboards Time for questions

Contents of presentation Perinatal care in Sweden The Swedish Pregnancy Register Data from the Register Time for questions

Perinatal care in Sweden Perinatal care in Sweden is standardized free of charge almost all women attend

Perinatal care in Sweden During pregnancy Maternity care centers Midwives are the main providers of antenatal care Referral to Obstetrician just if needed Ultrasound all women offered one ultrasound at 18-19 weeks of gestation 1 trimester ultrasound: ~ 50%

Perinatal care in Sweden Deliveries Deliveries occur at hospitals, led by midwifes Around 115 000 deliveries / year Gothenburg University Hospital: ~ 10 000/y Lycksele Hospital: ~ 350/y Deliveries are centralized when needed Births before 27 weeks of gestation to University Hospitals Small hospitals: ≥ 37 weeks of gestation, uncomplicated pregnancies ….

Perinatal care in Sweden Postnatal care Hospital stay Around 50% ≤ 48 hours, 50% > 48 hours Aftercare visit (6-8 weeks after delivery) Maternity care center, midwife

Contents of presentation Perinatal care in Sweden The Swedish Pregnancy Register Data from the Register Time for questions

Our vision is to improve the health of mothers and babies

The Swedish Pregnancy Register a certified national quality register initiated by the Swedish Healthcare Quality tool Decisionsupport KUB Research

The Swedish Pregnancy Register Start 2013 With around 115,000 births in Sweden per year, the registry is a great source of knowledge and development www.graviditetsregistret.se

Covers the complete chain of care Neonatal care - SNQ 3 month before conception Conception Prenatal care Ultrasound Childbirth Check-up at prenatal care Assisterad befruktning Q-IVF ”Bristningsregistret”- Register of obstetric lacerations

Who works for the Pregnancy Register? Olof Stephansson, register holder Michaela Granfors, vice register holder 3 working groups Maternity care, head: Kerstin Petersson Fetal diagnostics, head: Peter Conner Delivery, head: Anna-Karin Wikström Jonas Söderling and John Moshtaghi-Svensson, statisticians Else Friis, administrator Petra Ryman och Linda Rilby, midwifes Control group Camilla Björk, managing director for MedSciNet

Transfer of data into the register Manually web-entered at antenatal care - pregnancy week 12+ - 2 months after delivery + Directly from KUB+ (decision support as well) From medical records* Antenatal care Ultrasound Delivery Pregnancy Register Trigger points for automatic transfer to the register: Delivery Final signing Archive signing + Data is entered directly into the register

92% of all deliveries are transferred directly from electronic medical records

Eliminating double registration

How often is the data updated? Twice a day

Which women are registered? Information at first visit at maternity care center All pregnant women who do not actively opt out

Who can see the data? Public dashboards (homepage, vården i siffror, mm) All midwifes, nurses and doctors who work within obstetrics and gynecology in Sweden can log into the Register Different permissions

Medical birth register Is the Pregnancy Register the same as the medical birth register (MFR)? No! Medical birth register National Board of Health and Welfare Compulsory for health care providers to report Data since 1973 Delay for presentation of data Fewer variables

Some ongoing projects Pregnancy survey Education New Dashboards

Pregnancy survey - pilot Survey to women (1177, health care guide) Pregnancy week 25 2 months and 1 year after delivery Questions PROM (patient reported outcome measures) PREM (patient reported experience measures)

Transfer of data into the register Manually web-entered Directly from KUB+ (decision support as well) From medical records* Antenatal care Ultrasound Delivery - gest week 12 + Pregnancy survey Week v 25 + 2 months after delivery + 1 year after delivery + - 2 months after delivery + Pregnancy Register Trigger points for automatic transfer to the register: Delivery Final signing Archive signing + Data is entered directly into the register

Education initiative 2 midwives work 40% for the register since januari Education delivery units – use of Pregnancy Register

New dashboards New design Updated every day!

Contents of presentation Perinatal care in Sweden The Swedish Pregnancy Register Data from the Register / new dashboards Time for questions

Årsrapporten finns tillgänglig för alla på hemsidan

Data - Cesarean frequency in total

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