Canadian Perinatal Surveillance System

Overview

What is CPSS?

The Canadian Perinatal Surveillance System (CPSS) is part of Health Canada's initiative to strengthen national health surveillance capacity. The CPSS is an ongoing national health surveillance program delivered through the Maternal and Infant Health Section in the Public Health Agency of Canada (PHAC). Its mission is to contribute to improved health for pregnant women, mothers and infants in Canada. The CPSS is guided by a multidisciplinary and multisectoral Steering Committee that provides guidance to the Maternal and Infant Health Section with respect to the development and operation of the CPSS. Steering Committee members include expert representatives of national health professional associations, the provincial and territorial governments, consumer and advocacy groups and federal government departments, as well as Canadian and international experts in perinatal health and epidemiology.

The CPSS is based on the concept of health surveillance as a systematic, ongoing process that provides timely, relevant information about trends and patterns in the health status of a population and the factors that influence health status. The components of surveillance are data collection, expert analysis and interpretation, and response (communication of information for action).

CPSS Indicators

The CPSS identified 52 perinatal health indicators, consisting of measures of maternal, fetal and infant health determinants and outcomes. The complete list of these indicators can be found in the document, Perinatal Health Indicators for Canada.

The CPSS is currently reporting on 27 perinatal health indicators. They are listed below and are separated in two major categories with four subcategories.

A: Determinants of Maternal, Fetal and Infant Health

1. Behaviours and Practices
   
   Rate of Maternal Smoking during Pregnancy
   Rate of Maternal Alcohol Consumption during Pregnancy
   Rate of Breastfeeding
   Rate of Low Maternal Education
   Rate of Live Births to Teenage Mothers
   Rate of Live Births to Older Mothers

2. Health Services
   
   Rate of Labour Induction
   Rate of Cesarean Delivery
   Rate of Operative Vaginal Delivery
   Rate of Trauma to the Perineum
   Rate of Early Maternal Discharge from Hospital after Childbirth
   Rate of Early Neonatal Discharge from Hospital after Birth

B: Maternal, Fetal and Infant Health Outcomes

3. Maternal Health Outcomes
   
   Maternal Mortality Ratio
   Severe Maternal Morbidity Ratio
   Induced Abortion Ratio
   Rate of Ectopic Pregnancy
   Rate of Maternal Readmission after Discharge following Childbirth

4. Fetal and Infant Health Outcomes
   
   Preterm Birth Rate
   Postterm Birth Rate
   Small-for-Gestational-Age Rate
   Large-for-Gestational-Age Rate
   Fetal Mortality Rate
   Infant Mortality Rate and Causes of Death
   Severe Neonatal Morbidity Rate
   Multiple Birth Rate
   Prevalence of Congenital Anomalies
   Rate of Neonatal Hospital Readmission after Discharge following Birth

CPSS Cycle

The aim of the CPSS is to collect and analyze data on all recognized pregnancies, regardless of their outcome - abortion, ectopic pregnancy, stillbirth or live birth - and on the health of the baby during the first year of life. The principal data sources of the CPSS are the Statistics Canada Vital Statistics System, the Canadian Institute for Health Information, Discharge Abstract Database (CIHI DAD), the 'Système de maintenance et d'exploitation des données pour l'étude de la clientèle hospitalière) MED-ECHO, the Population and Health Research Unit, Dalhousie University in Nova Scotia, the Manitoba Hospital Abstract System and the National Longitudinal Survey of Children and Youth (NLSCY). These data are analyzed collaboratively with perinatal health surveillance partners.

The response component of the CPSS consists of communication of information that will serve as an evidence base for action to improve the effectiveness and efficiency of clinical care and guide the development of public health policies and programs for maternal and infant health. The mechanisms and vehicles for information dissemination vary according to the target audience (which includes policy makers, health care providers, the public and researchers), and include national reports, fact sheets, peer-reviewed publications and the World Wide Web.

CPSS Publications

The most recent CPSS publications include the Canadian Perinatal Health Report, 2003, the Congenital Anomalies in Canada: A Perinatal Health Report, 2002, the Canadian Perinatal Health Report, 2000, and the Perinatal Health Indicators for Canada. Fact sheet on physical abuse during pregnancy are also available. Many articles have been published by the CPSS collaborators. Please refer to the Canadian Perinatal Health Report, 2003 for a listing of these publications.

CPSS Goals

The CPSS has established short, medium and long-term goals. In the short and medium term, the CPSS will:

• Continue to analyze and report on existing national perinatal health data - vital statistics, hospitalization databases and national surveys (e.g. National Longitudinal Survey of Children and Youth) - using a set of national perinatal health indicators.

• Work collaboratively with partners to standardize definitions of perinatal health variables across the country, and promote the addition of key variables to existing databases.

• Strengthen and expand surveillance in priority areas, e.g: (1) congenital anomalies and (2) women's knowledge, perspectives, practices and experiences in pregnancy, birth and parenthood.

The long term goal of the CPSS is to establish a comprehensive national perinatal database through electronic transfer of data from vital event registration, hospital services and community-based services.

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