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Framing maternal morbidity: WHO scoping exercise.

Rachel C Vanderkruik1, Özge Tunçalp, Doris Chou

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Accurate maternal morbidity definitions are lacking, hindering maternal health improvements. This study highlights discrepancies in current definitions and expert opinions, emphasizing the need for a standardized approach to maternal morbidity measurement.

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Area of Science:

  • Public Health
  • Reproductive Health
  • Global Health

Background:

  • Current maternal morbidity estimations lack validated methodologies, limiting their effectiveness in improving maternal health.
  • A clear definition of maternal morbidity is essential for developing tools to measure and monitor maternal health outcomes.
  • The World Health Organization's Department of Reproductive Health and Research (WHO/RHR) conducted a scoping exercise to address this definitional gap.

Purpose of the Study:

  • To identify and analyze existing definitions and conditions of maternal morbidity.
  • To explore discrepancies and similarities in maternal morbidity definitions across studies.
  • To gather expert opinions on key elements for a standardized maternal morbidity definition.

Main Methods:

  • Conducted a comprehensive literature review on maternal morbidity definitions and classifications.
  • Developed and distributed an electronic questionnaire to 130 international maternal health experts.
  • Analyzed questionnaire responses to identify areas of consensus and divergence regarding maternal morbidity.

Main Results:

  • Maternal morbidities are inconsistently categorized by cause, complication type, and timeline.
  • Key areas requiring consensus include time frame, severity, identification, classification, and demographics.
  • Expert respondents indicated varied postpartum time frames (6 weeks to over a year) and supported a continuum of severity with mixed-methods case identification.

Conclusions:

  • Significant discrepancies exist in both the literature and expert opinions regarding maternal morbidity definitions.
  • A concrete, standardized definition of maternal morbidity is crucial for consistent measurement and monitoring globally.
  • Establishing a consensus definition will facilitate improved maternal health strategies and interventions.