The primary outcome was an ED visit for interpersonal violence during pregnancy or from the person’s delivery date to 365 days postpartum, identified using ICD-10 codes X85-Y09 and Y87.1 in any diagnostic field.29 This approach follows the proposed framework from the United States Centers for Disease Control and Prevention for presenting injury data using ICD-10 codes related to external causes of injury.30 A systematic review of these codes in hospital records found that broad groupings of external causes (as our primary outcome is defined) are 85% accurate.31 (link) We were unable to measure whether interpersonal violence was inflicted specifically by an intimate partner or spouse because use of the ICD-10 codes that identify the perpetrator is not mandatory.
Secondary outcomes included screening for interpersonal violence and disclosure of violence in response to screening. In the BIS clinical registry, health care providers (e.g., midwives, obstetricians, primary care providers) are required to ask about “the self-disclosed threat of or actual physical, sexual, psychological, emotional, or financial abuse” and input the results directly into the patient’s standardized provincial antenatal care record form as follows: “asked, with disclosure,” “asked, with no disclosure,” or “unable to ask.”32 Providers may or may not have used a standardized screening tool when screening women for interpersonal violence as part of this process. We considered responses of “asked, with disclosure” or “asked, with no disclosure” as signifying that a participant was screened for interpersonal violence. Those coded as “unable to ask” and those for whom data were missing were recorded as “not screened.” Among those screened, we determined whether interpersonal violence was disclosed (i.e., “asked, with disclosure”).
Secondary outcomes included screening for interpersonal violence and disclosure of violence in response to screening. In the BIS clinical registry, health care providers (e.g., midwives, obstetricians, primary care providers) are required to ask about “the self-disclosed threat of or actual physical, sexual, psychological, emotional, or financial abuse” and input the results directly into the patient’s standardized provincial antenatal care record form as follows: “asked, with disclosure,” “asked, with no disclosure,” or “unable to ask.”32 Providers may or may not have used a standardized screening tool when screening women for interpersonal violence as part of this process. We considered responses of “asked, with disclosure” or “asked, with no disclosure” as signifying that a participant was screened for interpersonal violence. Those coded as “unable to ask” and those for whom data were missing were recorded as “not screened.” Among those screened, we determined whether interpersonal violence was disclosed (i.e., “asked, with disclosure”).
