Data collection

The NPID audit is a continuous data collection, maternity services can register at any point during the year and start to submit data, a start date for entering pregnancies is chosen locally. Participating services collect and record data on each pre-gestational diabetic pregnancy. Data is submitted securely online to the NHS England Clinical Audit Platform. The data is then linked with data items from

Core National Diabetes Audit (NDA) primary and specialist adult secondary care collections
maternity data taken from Hospital Episode Statistics (HES) containing details of all admissions, outpatient appointments and A&E attendances at NHS hospitals in England
maternity data taken from Patient Episode Data for Wales (PEDW) which contains details of all episodes of inpatient care and day case activity in NHS hospitals in Wales
data taken from the National Neonatal Research Database (NNRD)

Linkage of the collected data to data from the sources listed above will create the full dataset for analysis and reporting for the NPID audit.

The NPID team notify users each year for when data for that calendar year must be submitted for it to be included in the next report. For pregnancies with an outcome of the 31 December 2023 or earlier, the deadline for submission into the Clinical Audit Platform is February 2024.

What data is collected

A list of the items for data collection, including mandatory fields and in-built validations in the clinical audit platform can be found in Table 1.

Table 1: NPID audit data items collected for each pregnancy

National Pregnancy in Diabetes Audit - data items

This table shows the data items collected as part of the National Pregnancy in Diabetes Audit.

Data is entered for mother and baby into the clinical audit platform.

The structure of the data items with the clinical audit platform is shown within the NPID model tab.

Section A: Participant and pre-pregnancy details

Data item	Definition	Mandatory	Options and validations	Record within CAP
Mothers NHS number	This is a unique 10-digit number. It is essential for data linkage with other related datasets such as Hospital Episode Statistics (HES) and Patient Episode Data for Wales (PEDW).	Yes	Must be 10 digits	Mother
Height (cm)	Record the height of the patient at time of booking.	Yes	This must be recorded in cm (no decimal places).	Mother
Weight (kg)	Record the height of the patient at time of booking.	Yes	This must be recorded in kg (to one decimal place)	Mother
Date of birth	Record the date of birth of the mother. This is required to check that the details of the correct patient are identified. It is also used to calculate the mother’s age.	Yes	DDMMYY	Mother
Booking hospital	Record the hospital name. If your hospital does not appear in the drop-down list on the online tool then please contact the NPID Team.	Yes	Select from drop down list	Mother
Diabetes type	Mother's type of diabetes as diagnosed prior to pregnancy	Yes	Type 1 Type 2 MODY Not specified	Mother
First contact with specialist antenatal diabetes team after LMP:	Record the date of the first contact with specialist antenatal diabetes team after last menstrual period (LMP) (i.e. excluding any pre-conception clinic contact).	Yes	DDMMYY Date must be after date of birth	Pre-pregnancy
Estimated delivery date	Record the earliest estimated delivery date following 7-12/40 scan	Yes	DDMMYY Date must be after first contact	Pre-pregnancy
Folic acid used prior to LMP	Whether folic acid has been used before pregnancy, prior to LMP only include if given as a specific supplement not as part of multivitamin preparation	Yes	Yes No Not known	Pre-pregnancy
Folic acid dose prior to LMP	Record the highest dose given prior to LMP	Conditional: If folic acid used prior to LMP = Yes	400mcg 5mg Not known	Pre-pregnancy
Folic acid used since LMP	Whether Folic Acid has been used since LMP only include if given as a specific supplement not as part of multivitamin preparation	Yes	Yes No Not known	Pre-pregnancy
Folic acid dose since LMP	Record the highest dose given within the first 12 weeks after conception.	Conditional: If folic acid used since LMP = Yes	Conditional: If folic acid used since LMP = Yes	Pre-pregnancy
Diabetes treatment regimen at 1st day of LMP	Record the diabetes treatment regimen on the first day of LMP. Please tick all that apply. Oral agents: metformin, sulphonylurea or glitinide, gliptin, pioglitazone (BNF sections 6.1.2.1 – 6.1.2.3). GLP-1 analogues: e.g. Exenatide, Liraglutide (BNF section 6.1.2.3). Basal bolus insulin regimen: Any regimen involving a combination of background insulin (BNF section 6.1.1.2) either once or twice daily in combination with a prandial (mealtime) short acting insulin (BNF section 6.1.1.1). Mixed insulin or basal insulin only regimes: Any regimen using biphasic insulins and/or background insulin exclusively (i.e. without additional prandial insulin) as listed in BNF section 6.1.1.2. Regimes using combinations of mixed and prandial insulins should be recorded as ‘Other’. Insulin pump therapy: This does not refer to a type of insulin, or to a brief intercurrent i.v. insulin infusion, but to a regime whereby short acting insulin (BNF section 6.1.1.1) is administered subcutaneously and continuously long term using an infusion device. Diet only: no diabetes medications, diet management only Other: Any other insulin regimen.	yes	Metformin Sulphonylurea or glitinide Gliptin GLP-1 analogue Basal Bolus Insulin Regimen Mixed Insulin or Basal insulin only Insulin pump therapy Pioglitazone Other Diet only	Pre-pregnancy
Treated hypertension prior to 1st day of LMP	Record whether the patient has a history of treated hypertension prior to the first day of LMP. Please tick one box only. This refers to historical evidence of consistent BP > 125/70 prior to pregnancy and antihypertensive treatment (BNF section 2.5).	Yes	no known hypertension treated hypertension not known	Pre-pregnancy
ACE inhibitor /ARB at 1st day of LMP	Record whether the patient is on ACE inhibitor/ARB at first day of LMP. Please tick one box only. ACE inhibitor: Angiotensin Convertase Inhibitor treatment –treatments listed in BNF section 2.5.5.1. ARB: Angiotensin-II Receptor Blocking agents –treatments listed in BNF section 2.5.5.2.	Yes	not on ACE inhibitor/ARB on ACE inhibitor/ARB not known	Pre-pregnancy
Statins on 1st day of LMP	Record whether the patient is on statins at first day of LMP. Please tick one box only. Statin: All HMGCoA reductase inhibitor agents (BNF section 2.12). Note: Data is not being collected on other cholesterol lowering agents in this audit.	Yes	not on statins on statins not known	Pre-pregnancy
Ischaemic heart disease prior to 1st day of LMP	Record whether the patient has a history of ischaemic heart disease (IHD) prior to the first day of LMP. Please tick one box only. Clinical or proven past or current ischaemic heart disease (ICD.10; I.20-I.25) recorded in the primary or secondary care record.	yes	no known IHD known IHD not known	Pre-pregnancy
Smoking Status at Booking	Record the patient's current smoking status at the time of the booking appointment	Yes	current smoker ex-smoker never smoked unknown patient declined to say	Pre-pregnancy
Method of Glucose monitoring used at booking	To record the patient’s method of glucose monitoring at delivery	Yes	Capillary Finger Prick Monitoring Continuous Monitoring N/A	Pre-pregnancy
Method of Insulin delivery at booking	To record the patient’s method of insulin administration at booking	Yes	Twice Daily Multiple Injection Therapy Insulin Pump Therapy no Insulin Hybrid closed loop	Pre-pregnancy
Continuous Glucose Monitoring offered to mother	To record if patient was offered CGM and if accepted		Y/N/already on offered date accepted Y/N start date	Pre-pregnancy

Section B: Pregnancy details

Data item	Definition	Mandatory	Options and validations	Record within CAP
First HbA1c in pregnancy	Record the first HbA1c reading taken during the pregnancy	-	mmol/mol	Pregnancy
Date of first HbA1c	Date of first reading	Conditional: if value for first HbA1c in pregnancy entered	DDMMYY	Pregnancy
Last HbA1c in pregnancy	Record the last HbA1c reading taken during the pregnancy	-	mmol/mol	Pregnancy
Date of last HbA1c	Date of last reading	Conditional: If value for last HbA1c in pregnancy entered	DDMMYY	Pregnancy
Retinal screening grade in first trimester - retinopathy grade	Retinal screening is recorded and reported in the same way by all UK accredited digital retinal photography eye screening programmes. For specific information refer to NHS diabetic eye screening (DES) programme		R0 No retinopathy R1 Background retinopathy R2 Pre-proliferative retinopathy R3 Proliferative retinopathy R3A Active proliferative retinopathy R3S Stable proliferative retinopathy not known Not done	Pregnancy
Retinal screening grade in first trimester - maculopathy grade	As Above		M0 No maculopathy M1 Maculopathy Not known Not done	Pregnancy
Retinal screening grade in last trimester - retinopathy grade	As Above		R0 No retinopathy R1 Background retinopathy R2 Pre-proliferative retinopathy R3 Proliferative retinopathy R3A Active proliferative retinopathy R3S Stable proliferative retinopathy Not known Not done	Pregnancy
Retinal screening grade in last trimester - maculopathy grade	As above		M0 No maculopathy M1 Maculopathy Not known Not done	Pregnancy
Smoking Status at delivery	Record the patient's current smoking status at the time of delivery	Yes	Current smoker ex-smoker never smoked Unknown Patient declined to say	Pregnancy
Method of Glucose monitoring used at 28 weeks	To record the patient’s method of glucose monitoring at 28 weeks	Yes	Capillary Finger Prick Monitoring Continuous Monitoring N/A	Pregnancy
Method of Insulin delivery at 28 weeks	To record the patient’s method of insulin administration at 28 weeks	Yes	Twice daily Multiple Injection Therapy Insulin Pump Therapy no Insulin Hybrid closed loop	Pregnancy
Did the mother have gestational diabetes in her previous pregnancy/pregnancies?	To record if the mother had GDM in previous pregnancies		Yes/No/Not applicable	Pregnancy

Section C: Pregnancy outcome

Data item	Definition	Mandatory	Questions and validations	Record within CAP
Baby NHS number	For live and stillbirths, record the NHS number of the baby (forms for live births and stillbirths cannot be submitted without this information.)	Conditional: If pregnancy outcome = live birth or stillbirth	Must be 10 digits	Baby
Date pregnancy ended	Record the data the pregnancy ended	Yes	MMDDYY Must be after first contact	Baby
Pregnancy outcome	Record the outcome of the pregnancy. Please tick one box only.	Yes	Live birth Stillbirth Termination of pregnancy Miscarriage	Baby
Congenital malformation	Record whether any congenital malformation was present and if there was one or more congenital malformation, provide a description.	Yes	Yes No Not known	Baby
Congenital malformation code	Please refer to ICD-10 Chapter XVII or your local clinical coding specialist for further assistance.	Conditional: If congenital malformation = Yes		Baby
Delivery hospital	If the hospital does not appear on the drop-down list on the web data entry system then please contact the NPID Team.	Conditional: If pregnancy outcome = live birth or stillbirth	Select from drop down list	Baby
Sex	Sex of the baby	Conditional: If pregnancy outcome = live birth or stillbirth	male female indeterminate	Baby
Neonatal care	Special Care Admission = Level 2: special care new-born nursery Intensive Care Admission = Level 3: Intensive neonatal care For further information please refer to Categories of Care (2011) \| British Association of Perinatal Medicine (bapm.org)	Conditional: If pregnancy outcome = live birth	normal special care intensive care admission	Baby
Weight	Record the birth weight of the baby. This must be recorded in kg (to three decimal places).	Conditional: If pregnancy outcome = live birth or stillbirth	Kg	Baby
Baby alive at 28 days	Please note that for a live birth, the record will only be treated as complete and included in the analysis once this question has been answered. Cannot be completed before 28 days after pregnancy end date	Conditional: If pregnancy outcome= live birth	yes No not known	Baby

Last edited: 28 September 2023 10:54 am