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Am J Perinatol
DOI: 10.1055/a-2517-2501
Short Communication

The Relationship between Various Measures of Perinatal Quality

Authors

  • Nansi S. Boghossian

    1   Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

  • Lucy T. Greenberg

    2   Vermont Oxford Network, Burlington, Vermont

  • Jeffrey S. Buzas

    3   Department of Mathematics and Statistics, University of Vermont, Burlington, Vermont

  • Ciaran S. Phibbs

    4   Health Economics Resource Center and Center for Implementation to Innovation, Veterans Affairs Palo Alto Health Care System, Menlo Park, California
    5   Departments of Pediatrics and Health Policy, Stanford University School of Medicine, Stanford, California

  • Molly Passarella

    6   Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

  • Jeannette Rogowski

    7   Department of Health Policy and Administration, The Pennsylvania State University, State College, Pennsylvania

  • George R. Saade

    8   Department of Obstetrics & Gynecology, Eastern Virginia Medical School, Norfolk, Virginia

  • Scott A. Lorch

    6   Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    9   Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania

Funding This study was supported by the National Institute on Minority Health and Health Disparities (grant no.: R01MD016012) and the National Institute for Child Health and Human Development (grant nos: R01HD084819 and R01HD099197).
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Abstract

Objective This study aimed to examine the correlations between pairs of maternal, infant, and maternal–infant dyad quality measures to provide a comprehensive assessment of perinatal care.

Study Design In a retrospective cohort study using birth and fetal death certificates linked to hospital discharge data from Michigan, Oregon, Pennsylvania, and South Carolina (2016–2018), we examined correlations between pairs of maternal, infant, and maternal–infant dyad quality measures. Maternal quality measures included nulliparous term singleton vertex (NTSV) cesarean birth, nontransfusion severe maternal morbidity (SMM), and a composite maternal outcome. Infant quality was assessed with a composite outcome measure, whereas the dyad measure combined maternal and infant outcomes.

Results Among 955,904 dyads across 266 hospitals, 25.9% had NTSV, 0.7% had nontransfusion SMM, 12.3% had the composite infant measure, and 19.3% had the dyad measure. The correlation between nontransfusion SMM and the dyad measure was 0.12, whereas the correlation between the composite infant measure and the dyad measure was 0.86, which was higher than the correlation between the composite maternal measure and the dyad measure (0.47).

Conclusion We observed minimal correlations among these perinatal quality measures, especially when aggregated beyond individual outcomes.

Key Points

  • There are minimal correlations among different perinatal quality measures.

  • Quality is multifaceted, and hospitals vary in the level of quality they achieve.

  • Assessing hospital care for pregnant patients and infants requires multiple quality measures.

Keywords

perinatal quality - NTSV - unexpected newborn complications - severe maternal morbidity

Supplementary Material



Publikationsverlauf

Eingereicht: 02. August 2024

Angenommen: 15. Januar 2025

Accepted Manuscript online:
16. Januar 2025

Artikel online veröffentlicht:
10. Februar 2025

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