Quantifying severe maternal morbidity: a Scottish population study

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Healthcare Quality Improvement

Background:

• Severe maternal morbidity is a critical indicator of healthcare quality.
• Quantifying severe maternal morbidity is essential for improving maternal outcomes.
• Maternal mortality rates are low in developed countries, necessitating focus on morbidity.

Purpose of the Study:

• To quantify the incidence of severe maternal morbidity in Scotland.
• To assess the feasibility of establishing a national system for reporting maternal morbidity.
• To explore the utility of severe maternal morbidity as a quality measure for maternity services.

Main Methods:

• A prospective observational study was conducted across all 22 consultant-led maternity units in Scotland.
• Standardized definitions for 13 categories of severe maternal morbidity were developed and applied.
• Data on reported cases, incident categories, and dates were collected monthly and analyzed centrally.

Main Results:

• The incidence of severe maternal morbidity was 3.8 per 1000 deliveries (196 women out of 51,165).
• Major obstetric hemorrhage was the most frequent event, accounting for 50% of cases.
• Only 33% of identified patients required intensive care unit admission; four maternal deaths were recorded.

Conclusions:

• Defined categories of severe maternal morbidity can serve as a valuable measure of maternity service quality.
• Establishing a national reporting system for severe maternal morbidity is feasible.
• This approach is particularly relevant for developed nations with low maternal mortality rates.