Risteys · O15_DELIV_FORCEP

Endpoint definition steps	FinnGen
Phenotype data	520210
1. Apply sex-specific rule only females	293373
2. Check conditions None	293373
3. Check pre-conditions, main-only, mode, registry filters Registry filters: Hospital discharge: ICD-10 — O81 Cause of death: ICD-10 — O81 2 out of 7 registries used, show all original rules.	11901
4. Check minimum number of events None	11901
5. Include endpoints None	11901
6. Filter based on genotype QC (FinnGen only)	11901

	All	Female	Male
Number of individuals
Whole population	91460	91460	-
Only index persons	90932	90932	-
Unadjusted period prevalence (%)
Whole population	2.62	2.62	-
Only index persons	3.34	3.34	-
Median age at first event (years)
Whole population	-	29.83	-
Only index persons	-	29.82	-

	All	Female	Male
Number of individuals	11901	11901	-
Unadjusted period prevalence (%)	4.06	4.06	-
Median age at first event (years)	30.37	30.37	-

CodeWAS (R11)

↥

CodeWAS is a tool for exploring the associations between an endpoint and all of the medical codes and drug codes.

This is a new tool, please reach out using the contact form for feedback and improvement ideas.

First, a cohort is built by matching controls to the endpoint cases using year of birth and sex. Then, a Fisher test is done for all the medical codes and drug codes between the cases and controls of this cohort. Codes are reported in the table below if they have −log₁₀(p-value) ≥ 6.

Matched cohort

Matched cases
2247: Matched controls
18281

Code

Vocabulary

Description

Odds Ratio

-log₁₀(p)

N matched cases

N matched controls

SPAT1197

SPAT

Extensive health check-up of expecting family

48.5

323.0

922

258

O63.1

ICD-10 Finland

Prolonged second stage (of labour)

123.8

323.0

681

W78

ICPC

Pregnancy

21.0

323.0

1080

769

MA5AE

NOMESCO Finland

Morphology ultrasound screening, weeks 18+0 to 21+6 of gestation

58.7

323.0

466

Z37.0

ICD-10 Finland

Single live birth

39.3

323.0

461

119

O80.0

ICD-10 Finland

Spontaneous vertex delivery

+∞

323.0

736

Z34.0

ICD-10 Finland

Supervision of normal first pregnancy

37.3

323.0

898

320

MA2AE

NOMESCO Finland

Ultrasound examination of pregnancy (at 12. week of gestaion or later) including basic examination of fetus

48.3

323.0

894

246

MA2HE

NOMESCO Finland

Detailed morfological ultrasound examination of fetus

51.6

323.0

812

198

Z34.9

ICD-10 Finland

Supervision of normal pregnancy, unspecified

61.8

323.0

701

133

Z34.8

ICD-10 Finland

Supervision of other normal pregnancy

84.0

323.0

828

126

O47.0

ICD-10 Finland

False labour before 37 completed weeks of gestation

40.5

323.0

472

119

SPAT1380

SPAT

Postpartum check-up

154.6

323.0

775

O81.4

ICD-10 Finland

Vacuum extractor delivery

4503599627370496.0

323.0

2211

WX307

NOMESCO Finland

Obstetric epidural analgesia

132.3

323.0

544

Z35.8

ICD-10 Finland

Supervision of other high-risk pregnancies

40.1

323.0

459

116

Z39.2

ICD-10 Finland

Routine postpartum follow-up

93.1

323.0

940

140

MA2DE

NOMESCO Finland

Detailed ultrasound examination of fetus including color doppler method

42.6

323.0

468

112

SPAT1379

SPAT

Health check-up of pregnant person

37.2

323.0

990

378

MAE00

NOMESCO Finland

Outlet vacuum delivery

774.2

323.0

1660

MA3AE

NOMESCO Finland

Combined first trimester screening

38.1

323.0

446

118

O68.0

ICD-10 Finland

Labour and delivery complicated by fetal heart rate anomaly

156.5

323.0

888

Z36.3

ICD-10 Finland

Antenatal screening for malformations using ultrasound and other physical methods

55.6

323.0

1442

569

SPAT1399

SPAT

Acceptance of acknowledgement of paternity of child born outside of marriage before the birth of the child at the maternity clinic. Paternity Act, Section 16.

55.9

323.0

412

O24.4

ICD-10 Finland

Diabetes mellitus arising in pregnancy

29.6

310.3

450

153

Z32.1

ICD-10 Finland

Pregnancy confirmed

12.7

305.5

612

521

MA2JE

NOMESCO Finland

Ultrasound screening of fetal nuchal translucency

25.9

240.2

361

134

O99.80

ICD-10 Finland

The fear of childbirth

42.9

237.3

315

O75.0

ICD-10 Finland

Maternal distress during labour and delivery

180.4

230.7

256

MA1AE

NOMESCO Finland

Ultrasound examination of early pregnancy (before 12. postmenstrual week)

8.5

219.8

548

665

Z36.0

ICD-10 Finland

Antenatal screening for chromosomal anomalies

19.8

206.3

337

161

MAX99

NOMESCO Finland

Assistance to normal delivery

172.5

205.4

229

W90

ICPC

Uncompl labour/delivery livebirth

110.0

199.3

231

O70.1

ICD-10 Finland

Second degree perineal laceration during delivery

88.8

198.1

235

TMA00

NOMESCO Finland

Episiotomy

164.2

195.6

219

O64.0

ICD-10 Finland

Obstructed labour due to incomplete rotation of fetal head

71.8

194.3

237

W92

ICPC

Compl labour/ delivery livebirth

78.9

188.5

227

O48

ICD-10 Finland

Prolonged pregnancy

73.7

169.4

206

MA2XE

NOMESCO Finland

Other obstetric ultrasound examination

27.4

167.4

247

W84

ICPC

Pregnancy high risk

31.5

146.3

208

MAC10

NOMESCO Finland

Antepartum dilatation of cervical canal

80.1

143.8

173

Z34

ICD-10 Finland

Supervision of normal pregnancy

39.1

143.4

194

SPAT1200

SPAT

Guidance for breast-feeding and breast care

52.1

142.8

183

Z3232

NOMESCO Finland

Midwife

9.4

142.3

325

323

W85

ICPC

Gestational diabetes

22.0

140.7

221

MBC30

NOMESCO Finland

Repair of partial rupture of perineum

63.3

139.3

173

SPAT1317

SPAT

Planned health check-up monitoring, health check-up performed based on individual need

5.0

138.1

517

1021

XMA22

NOMESCO Finland

General examination of pregnant woman

29.8

137.4

198

SPAT1189

SPAT

Other ultrasound examination during pregnancy

26.6

136.7

203

WX321

NOMESCO Finland

Acute spinal anesthesia for delivery

104.7

133.6

156

O80.8

ICD-10 Finland

Other single spontaneous delivery

+∞

129.3

133

O82.10

ICD-10 Finland

Delivery by emergency caesarean section

+∞

120.4

124

SPAT1195

SPAT

Antenatal classes

34.4

118.6

165

O36.6

ICD-10 Finland

Maternal care for excessive fetal growth

35.0

118.4

164

MBC10

NOMESCO Finland

Repair of obstetric laceration of vagina

97.2

114.7

135

WX230

NOMESCO Finland

Plexus blockade of nervus pudendus

509.1

111.8

119

SPAT1196

SPAT

Monitoring of normal pregnancy

41.4

110.8

148

O42.9

ICD-10 Finland

Premature rupture of membranes, unspecified

37.8

108.7

148

6500B

ICD-9 Finland

Delivery in a completely normal case[PARTUS SINE COMPLICATIONE]

+∞

108.7

112

O47.1

ICD-10 Finland

False labour at or after 37 completed weeks of gestation

60.8

107.2

134

MAC40

NOMESCO Finland

Pharmacological induction or advancement of labor

91.1

107.1

127

O62.1

ICD-10 Finland

Secondary uterine inertia

79.4

107.1

129

O13

ICD-10 Finland

Gestational [pregnancy-induced] hypertension

17.4

103.7

176

Z39.1

ICD-10 Finland

Care and examination of lactating mother

69.9

99.6

122

O72.1

ICD-10 Finland

Other immediate postpartum haemorrhage

56.5

98.9

125

OAA12

SPAT

40.8

95.6

128

Z35.9

ICD-10 Finland

Supervision of high-risk pregnancy, unspecified

22.0

92.8

145

O68.8

ICD-10 Finland

Labour and delivery complicated by other evidence of fetal stress

175.4

92.0

103

SPAT1373

SPAT

Combined screening in early pregnancy

36.4

86.8

119

O47.9

ICD-10 Finland

False labour, unspecified

68.2

84.6

104

O72.0

ICD-10 Finland

Third-stage haemorrhage

26.0

83.3

124

Z35.0

ICD-10 Finland

Supervision of pregnancy with history of infertility

14.9

81.0

145

O26.82

ICD-10 Finland

Exhaustion and fatigue pregnancy-related

37.2

80.0

109

WYA40

NOMESCO Finland

Assessment of oral health and treatment needs for family expecting first child

26.8

76.7

113

W29

ICPC

Pregnancy symptom/complaint other

16.5

73.9

127

WX322

NOMESCO Finland

Combined spinal-epidural analgesia in obstetrics

38.2

73.1

MAC01

NOMESCO Finland

Rupture of aminiotic membrane for induction of labor

68.5

72.5

O82.0

ICD-10 Finland

Delivery by elective caesarean section

+∞

72.5

O75.6

ICD-10 Finland

Delayed delivery after spontaneous or unspecified rupture of membranes

51.9

71.9

O99.89

ICD-10 Finland

Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium

31.5

70.7

100

O23.5

ICD-10 Finland

Infections of the genital tract in pregnancy

629.4

70.7

OAA11

SPAT

6.1

68.3

205

297

O36.8

ICD-10 Finland

Maternal care for other specified fetal problems

64.5

67.9

WX234

NOMESCO Finland

Paracervical blockade

14.9

65.6

117

ZXD05

NOMESCO Finland

Urgent procedure

2.6

64.3

617

2359

MCA10

NOMESCO Finland

Lower uterine segment caesarean section

4.5

62.0

245

485

O99.3

ICD-10 Finland

Mental disorders and diseases of the nervous system complicating pregnancy, childbirth and the puerperium

24.0

58.1

O02.1

ICD-10 Finland

Missed abortion

5.3

56.9

189

309

O34.2

ICD-10 Finland

Maternal care due to uterine scar from previous surgery

6.6

56.8

159

209

O21.9

ICD-10 Finland

Vomiting of pregnancy, unspecified

16.6

56.2

O35.1

ICD-10 Finland

Maternal care for (suspected) chromosomal abnormality in fetus

12.2

55.7

108

O36.5

ICD-10 Finland

Maternal care for poor fetal growth

19.0

55.3

MAA00

NOMESCO Finland

Amniocentesis

14.7

54.2

Z36.8

ICD-10 Finland

Other antenatal screening

31.5

53.2

SPAT1375

SPAT

Structural ultrasound screening, weeks 18+0-21+6

238.7

51.9

O20.9

ICD-10 Finland

Haemorrhage in early pregnancy, unspecified

10.1

51.6

110

Z35.2

ICD-10 Finland

Supervision of pregnancy with other poor reproductive or obstetric history

40.7

51.0

O41.0

ICD-10 Finland

Oligohydramnios

27.0

50.6

O32.1

ICD-10 Finland

Maternal care for breech presentation

9.6

50.4

110

O91.2

ICD-10 Finland

Nonpurulent mastitis associated with childbirth

98.5

50.3

O26.88

ICD-10 Finland

Other specified pregnancy-related conditions

35.6

49.7

MBA30

NOMESCO Finland

Manual removal of placenta from delivered uterus

17.0

49.2

MAC96

NOMESCO Finland

Other induction or advancement of labour

30.0

47.8

SPAT1357

SPAT

Monitoring of problem during pregnancy

50.9

47.7

O99.2

ICD-10 Finland

Endocrine, nutritional and metabolic diseases complicating pregnancy, childbirth and the puerperium

38.2

47.5

O68.2

ICD-10 Finland

Labour and delivery complicated by fetal heart rate anomaly with meconium in amniotic fluid

67.9

46.6

O20.0

ICD-10 Finland

Threatened abortion

9.8

44.9

O42.0

ICD-10 Finland

Premature rupture of membranes, onset of labour within 24 hours

21.6

43.1

Z32.0

ICD-10 Finland

Pregnancy, not (yet) confirmed

7.0

42.9

114

139

O99.0

ICD-10 Finland

Anaemia complicating pregnancy, childbirth and the puerperium

63.1

42.9

LX1AE

NOMESCO Finland

Gynecological ultrasound examination as part of clinical examination

2.5

41.8

377

1356

O03.9

ICD-10 Finland

Spontaneous abortion, Complete or unspecified, without complication

5.0

41.2

143

245

O71.4

ICD-10 Finland

Obstetric high vaginal laceration

35.2

40.2

O47

ICD-10 Finland

False labour

67.9

40.1

O72.2

ICD-10 Finland

Delayed and secondary postpartum haemorrhage

32.7

39.6

Z36.9

ICD-10 Finland

Antenatal screening, unspecified

29.1

39.2

W05

ICPC

Pregnancy vomiting/nausea

20.0

37.8

O64.8

ICD-10 Finland

Obstructed labour due to other malposition and malpresentation

62.2

36.4

O46.9

ICD-10 Finland

Antepartum haemorrhage, unspecified

18.6

35.7

WZB00

SPAT

0.3

35.6

1940

MBA03

NOMESCO Finland

Curettage of uterus after delivery or abortion

5.8

35.5

107

155

O62.2

ICD-10 Finland

Other uterine inertia

71.3

35.5

Z39.0

ICD-10 Finland

Care and examination immediately after delivery

42.4

35.0

WX306

NOMESCO Finland

Lumbar epidural anesthesy

4.3

34.9

138

271

O66.0

ICD-10 Finland

Obstructed labour due to shoulder dystocia

161.2

34.8

O69.1

ICD-10 Finland

Labour and delivery complicated by cord around neck, with compression

110.3

34.6

WX602

NOMESCO Finland

Repeated or continuing anesthesia shots throug a catheter

3.4

34.2

181

458

MA5AE

SPAT

295.5

33.2

MA3AE

SPAT

152.8

32.9

O21

ICD-10 Finland

Excessive vomiting in pregnancy

16.9

32.8

O36.9

ICD-10 Finland

Maternal care for fetal problem, unspecified

33.9

32.7

SPAT1246

SPAT

Screening of depression or other psychiatric problem

3.2

32.7

193

528

O63.0

ICD-10 Finland

Prolonged first stage (of labour)

9.8

32.3

O41.8

ICD-10 Finland

Other specified disorders of amniotic fluid and membranes

+∞

30.8

OAA10

SPAT

5.0

30.7

105

177

MBC33

NOMESCO Finland

Repair of complete rupture of perineum

61.2

30.0

Z39

ICD-10 Finland

Postpartum care and examination

59.5

29.1

O26.6

ICD-10 Finland

Liver disorders in pregnancy, childbirth and the puerperium

22.8

29.0

MAE03

NOMESCO Finland

Mid-cavity or high vacuum delivery

93.5

29.0

65000

ICD-8 Finland

Delivery without mention of complication, Occipital presentation

+∞

28.9

OAB30

SPAT

26.1

28.1

MBA96

NOMESCO Finland

Other removal of retained products of conception after delivery or abortion

7.7

27.8

O35.8

ICD-10 Finland

Maternal care for other (suspected) fetal abnormality and damage

9.3

27.4

O86.0

ICD-10 Finland

Infection of obstetric surgical wound

25.4

27.3

OAA70

SPAT

9.7

27.1

SPAT1249

SPAT

Treatment-related counselling outside office

1.7

27.1

954

5625

N81.6

ICD-10 Finland

Rectocele

5.7

27.1

120

O24.9

ICD-10 Finland

Diabetes mellitus in pregnancy, unspecified

13.5

27.0

8811

FHL

Cesarean section

0.3

27.0

1552

N61

ICD-10 Finland

Inflammatory disorders of breast

4.9

26.6

161

SPAT1190

SPAT

Insertion or removal of intrauterine contraceptive device

2.4

26.5

250

908

O86.1

ICD-10 Finland

Other infection of genital tract following delivery

123.5

26.3

MAC02

NOMESCO Finland

Rupture of aminiotic membrane for advancement of labor

123.5

26.3

O03.4

ICD-10 Finland

Spontaneous abortion, Incomplete, without complication

6.1

25.4

100

W94

ICPC

Puerperal mastitis

63.9

25.3

TMW99

NOMESCO Finland

Other minor surgical procedure in obstetrics

82.4

25.3

O99.6

ICD-10 Finland

Diseases of the digestive system complicating pregnancy, childbirth and the puerperium

35.0

25.1

O60

ICD-10 Finland

Preterm labour and delivery

6.2

24.8

SPAT1391

SPAT

Counselling and guidance related to family situation

8.2

24.8

O28.8

ICD-10 Finland

Other abnormal findings on antenatal screening of mother

31.2

24.4

O21.0

ICD-10 Finland

Mild hyperemesis gravidarum

24.8

24.4

Z87.5

ICD-10 Finland

Personal history of complications of pregnancy, childbirth and the puerperium

34.0

24.2

G02BA03

ATC

plastic IUD with progestogen

2.1

24.1

323

1375

O81.0

ICD-10 Finland

Low forceps delivery

+∞

24.1

O14.9

ICD-10 Finland

Pre-eclampsia, unspecified

18.5

23.6

SPAT1393

SPAT

Guidance to support interaction between parent and child

30.2

23.6

SPAT1381

SPAT

Extensive health check-up at 4 months of age

59.8

23.5

O14.0

ICD-10 Finland

Mild to moderate pre-eclampsia

10.8

23.5

O90.1

ICD-10 Finland

Disruption of perineal obstetric wound

+∞

23.1

O40

ICD-10 Finland

Polyhydramnios

19.8

22.9

W27

ICPC

Fear of complications of pregnancy

19.8

22.9

R3110

NOMESCO Finland

Psychosocial training

10.2

22.8

LC2BE

NOMESCO Finland

Transvaginal ultrasound examination of uterus, parametria and lower abdomen

1.6

22.6

792

4599

MBA04

NOMESCO Finland

Curettage of uterus after delivery

106.9

22.5

O85

ICD-10 Finland

Puerperal sepsis

31.9

22.4

O02.0

ICD-10 Finland

Blighted ovum and nonhydatidiform mole

4.2

22.3

177

O68.1

ICD-10 Finland

Labour and delivery complicated by meconium in amniotic fluid

39.8

22.0

SPAT1382

SPAT

Extensive health check-up at 18 months of age

102.7

21.6

O42.1

ICD-10 Finland

Premature rupture of membranes, onset of labour after 24 hours

12.9

21.2

O41.1

ICD-10 Finland

Infection of amniotic sac and membranes

15.6

21.2

MBA00

NOMESCO Finland

Vacuum aspiration from uterus after delivery or abortion

5.1

20.5

112

O70.0

ICD-10 Finland

First degree perineal laceration during delivery

32.9

20.5

O68.3

ICD-10 Finland

Labour and delivery complicated by biochemical evidence of fetal stress

16.5

20.4

N81.1

ICD-10 Finland

Cystocele

5.6

20.2

Z35.5

ICD-10 Finland

Supervision of elderly primigravida

18.8

20.1

O26.7

ICD-10 Finland

Subluxation of symphysis (pubis) in pregnancy, childbirth and the puerperium

23.9

19.6

G03AC03

ATC

levonorgestrel; systemic

2.1

19.4

239

979

MA4AT

NOMESCO Finland

Chorion biopsy with ultrasound guidance

10.8

19.1

G03DA04

ATC

progesterone; systemic, rectal, vaginal

2.5

18.8

156

528

103

Kela drug reimbursment

Diabetes, insulin-treated

0.4

18.7

1621

112

Kela drug reimbursment

Severe psychotic and other severe mental disorders

0.3

18.4

1026

FM1QE

NOMESCO Finland

Extensive ultrasound of fetal heart

20.9

18.3

215

Kela drug reimbursment

Diabetes, non-insulin-treated

0.4

18.2

1608

N97.9

ICD-10 Finland

Female infertility, unspecified

2.3

18.0

180

670

O03.1

ICD-10 Finland

Spontaneous abortion, Incomplete, complicated by delayed or excessive haemorrhage

5.9

18.0

O10.0

ICD-10 Finland

Pre-existing essential hypertension complicating pregnancy, childbirth and the puerperium

7.7

18.0

O70.21

ICD-10 Finland

III degree perineal tear involving less than one half of external anal sphincter thickness torn during childbirth

164.0

18.0

Z36.4

ICD-10 Finland

Antenatal screening for fetal growth retardation using ultrasound and other physical methods

29.4

17.9

O62.0

ICD-10 Finland

Primary inadequate contractions

17.0

17.7

O70.2

ICD-10 Finland

Third degree perineal laceration during delivery

32.8

17.6

R10.3

ICD-10 Finland

Pain localized to other parts of lower abdomen

1.6

17.4

624

3592

O82.11

ICD-10 Finland

Childbirth with an emergency caesarean section in an emergency

155.7

17.0

G03GA05

ATC

follitropin alfa; parenteral

3.1

17.0

266

MBA40

NOMESCO Finland

Pharmacological evacuation of uterus after abortion

5.7

16.6

XMA00

NOMESCO Finland

24.6

16.5

SPAT1128

SPAT

Instruction of pelvic floor / sphincter exercises

9.3

16.4

O80.9

ICD-10 Finland

Single spontaneous delivery, unspecified

+∞

16.4

G03GA01

ATC

chorionic gonadotrophin; parenteral

2.5

16.3

134

451

O68.9

ICD-10 Finland

Labour and delivery complicated by fetal stress, unspecified

27.0

16.2

MBC20

NOMESCO Finland

Repair of obstetric laceration of vulva

54.6

16.1

W18

ICPC

Post-partum symptom/complaint other

77.9

16.1

WX740

NOMESCO Finland

Nitrogen oxide therapy

21.9

15.9

OAB42

SPAT

0.4

15.9

1146

MAB20

NOMESCO Finland

Failed external version

30.1

15.9

G03GB02

ATC

clomifene; oral

2.7

15.8

115

361

Z30.1

ICD-10 Finland

Insertion of (intrauterine) contraceptive device

1.7

15.8

419

2223

ZXE00

NOMESCO Finland

One hour or less

1.5

15.6

676

4044

O73.0

ICD-10 Finland

Retained placenta without haemorrhage

11.9

15.4

O99.5

ICD-10 Finland

Diseases of the respiratory system complicating pregnancy, childbirth and the puerperium

17.1

15.4

Z35

ICD-10 Finland

Supervision of high-risk pregnancy

13.9

15.3

N81.2

ICD-10 Finland

Incomplete uterovaginal prolapse

5.0

15.3

A02BC01

ATC

omeprazole; systemic

1.7

15.1

398

2103

O86.8

ICD-10 Finland

Other specified puerperal infections

139.2

15.1

Z35.7

ICD-10 Finland

Supervision of high-risk pregnancy due to social problems

73.8

15.1

ZYC02

SPAT

0.2

14.8

690

Z86.4

ICD-10 Finland

Personal history of psychoactive substance abuse

32.8

14.8

O26.9

ICD-10 Finland

Pregnancy-related condition, unspecified

32.8

14.8

OAA41

SPAT

5.0

14.5

WYA50

NOMESCO Finland

Student oral health check consistent with decree to assess need for oral health guidance and services

0.4

14.5

1446

O70.22

ICD-10 Finland

III degree perineal tear involving one half or more of external anal sphincter thickness torn during childbirth

+∞

14.4

Z76.0

ICD-10 Finland

Issue of repeat prescription

0.6

14.4

179

2476

O92.7

ICD-10 Finland

Other and unspecified disorders of lactation

49.1

14.3

Z32

ICD-10 Finland

Pregnancy examination and test

9.5

14.3

HMAK

NOMESCO Finland

1.8

14.0

275

1333

O30.0

ICD-10 Finland

Twin pregnancy

7.4

14.0

SPAT1308

SPAT

Sexual health counselling

1.5

13.9

738

4588

O99.4

ICD-10 Finland

Diseases of the circulatory system complicating pregnancy, childbirth and the puerperium

36.8

13.6

205

Kela drug reimbursment

Chronic hypertension

0.4

13.6

940

Z35.1

ICD-10 Finland

Supervision of pregnancy with history of abortive outcome

19.1

13.5

MAB10

NOMESCO Finland

External version

46.4

13.4

J01DA01

ATC

[U] cefalexin; systemic

1.4

13.3

1247

8597

E11.9

ICD-10 Finland

Type 2 diabetes mellitus, without complications

0.4

13.3

1030

Z35.4

ICD-10 Finland

Supervision of pregnancy with grand multiparity

122.7

13.3

O75.2

ICD-10 Finland

Pyrexia during labour, not elsewhere classified

122.7

13.3

N39.3

ICD-10 Finland

Stress incontinence

2.8

13.1

246

O00.9

ICD-10 Finland

Ectopic pregnancy, unspecified

5.2

13.0

W03

ICPC

Antepartum bleeding

13.5

13.0

O99.1

ICD-10 Finland

Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating pregnancy, childbirth and the puerperium

13.5

13.0

F29

ICD-10 Finland

Unspecified nonorganic psychosis

0.2

12.9

566

O30.00

ICD-10 Finland

Twin pregnancy with separate amniotic and chorionic sacs

15.7

12.6

R2110

NOMESCO Finland

Giving the first information

2.0

12.6

170

721

O84.8

ICD-10 Finland

Other multiple delivery

+∞

12.5

O20.8

ICD-10 Finland

Other haemorrhage in early pregnancy

24.6

12.5

O86.4

ICD-10 Finland

Pyrexia of unknown origin following delivery

61.4

12.4

O24

ICD-10 Finland

Diabetes mellitus in pregnancy

114.5

12.3

O61.8

ICD-10 Finland

Other failed induction of labour

114.5

12.3

N05AH02

ATC

clozapine; systemic

0.0

12.3

279

O36.3

ICD-10 Finland

Maternal care for signs of fetal hypoxia

14.3

12.2

LEF03

NOMESCO Finland

Posterior colporrpahy with sutures for primary rectocele

5.8

12.2

SPAT1187

SPAT

General ultrasound examination in early pregnancy

11.1

12.0

N71.0

ICD-10 Finland

Acute inflammatory disease of uterus

2.6

11.9

294

T90

ICPC

Diabetes non-insulin dependent

0.4

11.9

1185

N97.0

ICD-10 Finland

Female infertility associated with anovulation

2.8

11.9

227

OAB39

SPAT

0.4

11.7

933

6542B

ICD-9 Finland

Abnormality of organs and soft tissues of pelvis, Previous Caesarean delivery[CICATRIX UTERI POSTOPERATIVA, SYNNYTYKSEN AIKANA]

0.1

11.7

289

O04.9

ICD-10 Finland

Medical abortion, complete or unspecified, without complication

1.7

11.7

252

1252

O75.3

ICD-10 Finland

Other infection during labour

+∞

11.5

O24.0

ICD-10 Finland

Diabetes mellitus in pregnancy: Pre-existing diabetes mellitus, insulin-dependent

4.4

11.5

MAA96

NOMESCO Finland

Other intrauterine operation on pregnant uterus or fetus

106.3

11.4

LA2AE

NOMESCO Finland

Ultrasound examination of ovarian cyst

3.2

11.2

152

O73.1

ICD-10 Finland

Retained portions of placenta and membranes, without haemorrhage

14.1

11.1

O66.9

ICD-10 Finland

Obstructed labour, unspecified

30.7

11.0

TLW00

NOMESCO Finland

Insemination

3.4

11.0

132

LEF13

NOMESCO Finland

Colpoperineoplasty and vaginal hysterectomy

7.4

10.9

N06AB03

ATC

fluoxetine; oral

0.5

10.8

123

1752

V252A

ICD-9 Finland

Contraceptive management, Sterilisation

0.1

10.8

273

O67.9

ICD-10 Finland

Intrapartum haemorrhage, unspecified

38.1

10.8

XMA20

NOMESCO Finland

Early examination of pregnancy

13.0

10.7

Z36.1

ICD-10 Finland

Antenatal screening for raised alphafetoprotein level

98.0

10.5

O12.1

ICD-10 Finland

Gestational proteinuria

24.5

10.5

N05AX12

ATC

aripiprazole; systemic

0.3

10.4

691

XLA10

NOMESCO Finland

2.1

10.4

121

485

O35.9

ICD-10 Finland

Maternal care for (suspected) fetal abnormality and damage, unspecified

13.4

10.3

N05AX08

ATC

risperidone; systemic

0.4

10.1

782

IHZ05

SPAT

0.3

10.0

670

N05AH04

ATC

quetiapine; oral

0.6

10.0

230

2768

F20.9

ICD-10 Finland

Schizophrenia, unspecified

0.1

10.0

252

C10AA01

ATC

simvastatin; oral

0.5

10.0

100

1475

P01AB01

ATC

metronidazole; oral, rectal

1.4

9.9

752

4919

SPAT1192

SPAT

Gynaecological examination

1.5

9.9

415

2433

N05AH03

ATC

olanzapine; systemic

0.4

9.7

856

O32.2

ICD-10 Finland

Maternal care for transverse and oblique lie

22.9

9.6

MAF00

NOMESCO Finland

Outlet forceps cephalic delivery

89.8

9.5

WZA10

SPAT

0.2

9.5

339

WX320

NOMESCO Finland

Spinalanesthesy

1.7

9.5

228

1169

R10.4

ICD-10 Finland

Other and unspecified abdominal pain

1.4

9.3

753

4964

D25.9

ICD-10 Finland

Leiomyoma of uterus, unspecified

0.5

9.3

1211

LCH11

NOMESCO Finland

Pharmacologic abortion

1.9

9.2

141

628

LEF00

NOMESCO Finland

Anterior colporraphy with sutures for primary cystocele

6.3

9.2

O75.7

ICD-10 Finland

Vaginal delivery following previous caesarean section

19.1

9.2

O28.3

ICD-10 Finland

Abnormal ultrasonic finding on antenatal screening of mother

19.1

9.2

C03CA01

ATC

furosemide; systemic

0.5

9.1

998

SPAT1263

SPAT

Sampling

1.3

9.1

863

5822

SPAT1383

SPAT

Extensive health check-up at 4 years of age

32.7

9.0

O41.9

ICD-10 Finland

Disorder of amniotic fluid and membranes, unspecified

32.7

9.0

G01AA10

ATC

clindamycin; vaginal

1.5

9.0

323

1831

E10.7

ICD-10 Finland

Type 1 diabetes mellitus, With multiple complications

0.0

8.9

211

L02BG04

ATC

letrozole; oral

2.0

8.8

117

495

FM1NE

NOMESCO Finland

Ultrasound examination of fetal heart

11.9

8.8

G01AF05

ATC

econazole; vaginal

1.8

8.8

161

764

A10AE04

ATC

insulin glargine; parenteral

0.4

8.7

618

N06AX12

ATC

bupropion; oral

0.5

8.7

1158

IHZ02

SPAT

0.2

8.7

370

O80.1

ICD-10 Finland

Spontaneous breech delivery

+∞

8.7

OAA48

SPAT

4.7

8.6

O21.1

ICD-10 Finland

Hyperemesis gravidarum with metabolic disturbance

81.6

8.6

N05AA02

ATC

levomepromazine; systemic

0.2

8.6

393

N05CD07

ATC

temazepam; oral

0.4

8.6

671

KAY20

NOMESCO Finland

0.5

8.5

1020

TQW30

NOMESCO Finland

Acupuncture

12.3

8.4

F33.9

ICD-10 Finland

Recurrent depressive disorder, unspecified

0.4

8.4

701

O61.0

ICD-10 Finland

Failed medical induction of labour

9.3

8.3

LCA30

NOMESCO Finland

Transfer of oocyte or embryo to uterus in assisted fertilisation

3.9

8.3

P72

ICPC

Schizophrenia

0.0

8.2

196

MAE20

NOMESCO Finland

Failed vacuum delivery

30.0

8.2

MBC00

NOMESCO Finland

Repair of obstetric laceration of cervix uteri

30.0

8.2

N03AX16

ATC

pregabalin; oral

0.6

8.0

181

2193

MBA05

NOMESCO Finland

Curettage of uterus after abortion

5.5

8.0

EB1SA

NOMESCO Finland

Dental X-ray, bite-wing X-ray on one side of the mouth

1.3

8.0

1326

9610

ZXD00

NOMESCO Finland

Emergency procedure

3.0

8.0

122

I10

ICD-10 Finland

Essential (primary) hypertension

0.7

8.0

289

3204

G03GA06

ATC

follitropin beta; parenteral

2.3

8.0

257

SFA20

NOMESCO Finland

Filling on two surfaces of tooth

1.3

7.9

1207

8645

O12.0

ICD-10 Finland

Gestational oedema

15.2

7.9

A10BK03

ATC

empagliflozin; oral

0.2

7.9

361

F20.00

ICD-10 Finland

Paranoid schizophrenia continuous

0.1

7.9

211

OAB36

SPAT

0.3

7.8

374

SPAT1303

SPAT

Counselling and guidance related to growth and development

3.6

7.8

C03EA01

ATC

hydrochlorothiazide and potassium-sparing agents; oral

0.4

7.8

768

SPAT1273

SPAT

Structured assessment of psychoactive substance / tobacco use

1.9

7.7

114

502

MBA20

NOMESCO Finland

Expression of placenta

+∞

7.7

O81.5

ICD-10 Finland

Delivery by combination of forceps and vacuum extractor

+∞

7.7

SAD01

NOMESCO Finland

Assessment of need for oral health care, standard

1.5

7.3

277

1585

W82

ICPC

Abortion spontaneous

6.2

7.3

O03.6

ICD-10 Finland

Spontaneous abortion, Complete or unspecified, complicated by delayed or excessive haemorrhage

7.3

O44.0

ICD-10 Finland

Placenta praevia specified as without haemorrhage

27.2

7.3

O99.8

ICD-10 Finland

Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium

27.2

7.3

LAA10

NOMESCO Finland

Percutaneous or transvaginal puncture and recovery of oocyte

2.4

7.2

208

25000

ICD-8 Finland

Diabetes mellitus, Sine complicatione

0.0

7.2

174

O34.3

ICD-10 Finland

Maternal care for cervical incompetence

18.0

7.2

N02BE01

ATC

paracetamol; systemic, rectal

1.3

7.2

1660

12486

6531B

ICD-9 Finland

Disproportion, Generally contracted pelvis[PELVIS ANGUSTA,SYNNYTYKSEN AIKANA]

0.0

7.1

147

H01CA02

ATC

nafarelin; nasal

2.0

7.1

337

MAW96

NOMESCO Finland

Other operation in pregnancy or at delivery

9.5

7.0

O90.8

ICD-10 Finland

Other complications of the puerperium, not elsewhere classified

36.7

7.0

O69.2

ICD-10 Finland

Labour and delivery complicated by other cord entanglement, with compression

36.7

7.0

A28

ICPC

Limited function/disability NOS

0.4

7.0

510

A10AA02

ATC

0.2

7.0

264

A10AB01

ATC

insulin (human); parenteral (insulins and analog. for injection, fast-acting)

0.3

6.9

378

C09CA01

ATC

losartan; oral

0.6

6.9

1215

WZC00

SPAT

0.5

6.9

844

N06AX11

ATC

mirtazapine; oral

0.7

6.8

394

4073

C03DA01

ATC

spironolactone; oral

0.4

6.8

481

65400

ICD-8 Finland

Occipital presentation

0.0

6.8

138

O64.3

ICD-10 Finland

Obstructed labour due to brow presentation

20.4

6.8

O46.8

ICD-10 Finland

Other antepartum haemorrhage

20.4

6.8

O23.1

ICD-10 Finland

Infections of bladder in pregnancy

20.4

6.8

Z36.2

ICD-10 Finland

Other antenatal screening based on amniocentesis

65.3

6.8

-48

ICPC

Clarification/discussion RFE/demand

1.8

6.8

108

489

O35.5

ICD-10 Finland

Maternal care for (suspected) damage to fetus by drugs

15.0

6.8

O21.8

ICD-10 Finland

Other vomiting complicating pregnancy

+∞

6.7

O86.3

ICD-10 Finland

Other genitourinary tract infections following delivery

+∞

6.7

C10AA05

ATC

atorvastatin; oral

0.6

6.7

125

1578

SPAT1388

SPAT

Extensive health check-up based on individual need

6.9

6.7

Z30.5

ICD-10 Finland

Surveillance of (intrauterine) contraceptive device

1.6

6.6

191

1029

M54.5

ICD-10 Finland

Low back pain

1.3

6.6

587

3886

WW500

NOMESCO Finland

Blood transfusion

2.6

6.6

137

346

Kela drug reimbursment

Dulaglutide, exenatide, liraglutide, lixisenatide and semaglutide (adults)

0.2

6.5

300

J01CA08

ATC

pivmecillinam; oral

1.3

6.5

1003

7128

285

Kela drug reimbursment

Dulaglutide, exenatide, liraglutide, lixisenatide and semaglutide (adults)

0.3

6.5

325

KAY40

NOMESCO Finland

0.6

6.4

1181

W19

ICPC

Lactation symptom/complaint

12.8

6.4

F34.1

ICD-10 Finland

Dysthymia

0.4

6.4

530

SPAT1315

SPAT

Periodic health check-up of children and adolescents

1.5

6.4

220

1235

N05CF01

ATC

zopiclone; oral

0.7

6.4

265

2882

A10AA01

ATC

0.2

6.4

247

SPAT1250

SPAT

Comprehensive monitoring of chronic illness

0.6

6.3

110

1413

8221

FHL

Sterilization of the laparotomy pathway

0.1

6.3

154

F20.30

ICD-10 Finland

Undifferentiated schizophrenia continuous

0.1

6.3

155

W01

ICPC

Question of pregnancy

2.6

6.3

138

SPAT1392

SPAT

Counselling and guidance related to couple relationship

3.2

6.3

O64.1

ICD-10 Finland

Obstructed labour due to breech presentation

4.3

6.3

WX600

NOMESCO Finland

Single shot through catheter

3.8

6.2

IGY99

SPAT

0.2

6.2

242

QXA70

SPAT

0.2

6.2

242

F33.2

ICD-10 Finland

Recurrent depressive disorder, current episode severe without psychotic symptoms

0.5

6.2

774

XF400

NOMESCO Finland

ECG with 12 standard connections

0.5

6.2

967

2500B

ICD-9 Finland

Diabetes mellitus without mention of complication[DIABETES MELLITUS SINE COMPLICATIONE ,TYYPPI I]

0.1

6.2

175

SPAT1283

SPAT

Restricted health certificate

1.3

6.2

669

4542

O99.7

ICD-10 Finland

Diseases of the skin and subcutaneous tissue complicating pregnancy, childbirth and the puerperium

32.6

6.1

NE1AG

NOMESCO Finland

MRI pelvimetry with high intensity magnet

32.6

6.1

C09AA02

ATC

enalapril; systemic

0.5

6.1

770

GD1AA

NOMESCO Finland

Thorax X-ray examination

0.7

6.1

326

3411

OAB44

SPAT

0.5

6.1

810

NAME	O15_DELIV_FORCEP_VAC
CONTROL_EXCLUDE	O15_DELIVERY
CONTROL_PRECONDITIONS
CONTROL_CONDITIONS
SEX	2
INCLUDE
PRE_CONDITIONS
CONDITIONS
OUTPAT_ICD
OUTPAT_OPER
HD_MAINONLY
HD_ICD_10_ATC
HD_ICD_10	O81
HD_ICD_9	$!$	The FinnGen clinical team has checked and no code can be used for this rule.
HD_ICD_8	$!$	The FinnGen clinical team has checked and no code can be used for this rule.
HD_ICD_10_EXCL
HD_ICD_9_EXCL
HD_ICD_8_EXCL
COD_MAINONLY
COD_ICD_10	O81
COD_ICD_9	$!$	The FinnGen clinical team has checked and no code can be used for this rule.
COD_ICD_8	$!$	The FinnGen clinical team has checked and no code can be used for this rule.
COD_ICD_10_EXCL
COD_ICD_9_EXCL
COD_ICD_8_EXCL
OPER_NOM
OPER_HL
OPER_HP1
OPER_HP2
KELA_REIMB
KELA_REIMB_ICD
KELA_ATC_NEEDOTHER
KELA_ATC
KELA_VNRO_NEEDOTHER
KELA_VNRO
CANC_TOPO
CANC_TOPO_EXCL
CANC_MORPH
CANC_MORPH_EXCL
CANC_BEHAV

Parameter	HR [95% CI]	p-value
O15_DELIV_FORCEP_VAC	0.456 [0.39, 0.54]	< 0.001
Birth year	0.993 [0.98, 1.0]	0.14

N-year risk	Females	Males
1	0.046%	No data
5	0.27%	No data
10	0.672%	No data
15	1.263%	No data
20	2.267%	No data

Single delivery by forceps and vacuum extractor

Endpoint definition

Endpoint definition steps

FinnGen

Phenotype data

1. Apply sex-specific rule

2. Check conditions

3. Check pre-conditions, main-only, mode, registry filters

4. Check minimum number of events

5. Include endpoints

6. Filter based on genotype QC (FinnGen only)

Similar endpoints

Case counts by codes

Summary Statistics

-FinRegistry-

Key figures

-FinnGen-

Key figures

-FinRegistry-

Age distribution of first events

-FinnGen-

Age distribution of first events

-FinRegistry-

Year distribution of first events

-FinnGen-

Year distribution of first events

-FinRegistry-

Cumulative Incidence Function

-FinnGen-

Cumulative Incidence Function

CodeWAS (R11)

Matched cohort

Mortality – FinRegistry

Association

Females

Males

Mortality risk

Relationships between endpoints