Identification of pregnancies and infants within a United States commercial healthcare administrative claims database

Authors

Monica L. Bertoia, Optum Epidemiology, Boston, MA, USA.
Kelesitse Phiri, GlaxoSmithKline, Collegeville, PA, USA.
C Robin Clifford, Optum Epidemiology, Boston, MA, USA.
Michael Doherty, Optum Epidemiology, Boston, MA, USA.
Li Zhou, Optum Epidemiology, Boston, MA, USA.
Laura T. Wang, Department of Obstetrics and Gynecology, Prisma Health/University of South Carolina School of Medicine, Columbia, SC, USA.
Natalie A. Bertoia, Rochester Regional HealthFollow
Florence T. Wang, Optum Epidemiology, Boston, MA, USA.
John D. Seeger, Optum Epidemiology, Boston, MA, USA.

Department

OB/GYN

Document Type

Article

Publication Title

Pharmacoepidemiology and Drug Safety

Abstract

PURPOSE: Health care insurance claims databases are becoming a more common data source for studies of medication safety during pregnancy. While pregnancies have historically been identified in such databases by pregnancy outcomes, International Classification of Diseases, 10 revision Clinical Modification (ICD-10-CM) Z3A codes denoting weeks of gestation provide more granular information on pregnancies and pregnancy periods (i.e. start and end dates). The purpose of this study was to develop a process that uses Z3A codes to identify pregnancies, pregnancy periods, and links infants within a commercial health insurance claims database.

METHODS: We identified pregnancies, gestation periods, pregnancy outcomes, and linked infants within the United States (US)-based Optum Research Database (ORD) between 2015 and 2020 via a series of algorithms utilizing diagnosis and procedure codes on claims. The diagnosis and procedure codes included ICD-10-CM codes, Current Procedural Terminology (CPT) codes, and Healthcare Common Procedure Coding System (HCPCS) codes.

RESULTS: We identified 1,030,874 pregnancies among 841,196 women of reproductive age. Of pregnancies with livebirth outcomes, 84% were successfully linked to infants. The prevalence of pregnancy outcomes (livebirth, stillbirth, ectopic, molar, abortion) was similar to national estimates.

CONCLUSIONS: This process provides an opportunity to study drug safety and care patterns during pregnancy and may be replicated in other claims databases containing ICD-10-CM, CPT, and HCPCS codes. Work is underway to validate and refine the various algorithms.

This article is protected by copyright. All rights reserved.

First Page

863

Last Page

874

DOI

10.1002/pds.5483

Volume

31

Issue

8

Publication Date

8-2022

PubMed ID

35622900

Recommended Citation

Bertoia, M. L., Phiri, K., Clifford, C. R., Doherty, M., Zhou, L., Wang, L. T., Bertoia, N. A., Wang, F. T., & Seeger, J. D. (2022). Identification of pregnancies and infants within a United States commercial healthcare administrative claims database. Pharmacoepidemiology and Drug Safety, 31 (8), 863-874. https://doi.org/10.1002/pds.5483