Standardized Outcomes Set for Critical Pregnancy Research
An international consensus has established a Core Outcome Set featuring 10 standardized outcomes for research involving critically ill pregnant patients. The new framework, published in an open-access journal, is designed to improve the quality and consistency of research in maternal health by standardizing how results are measured.
- The consensus was the result of the "Core Outcome Set for Research on Critically Ill Obstetric Patients" (COSCO) study, which involved 68 participants from 16 countries, including 11 patients with lived experience of critical illness during pregnancy. - This international group reached its conclusions through a multi-step process that included a systematic review of existing literature, qualitative interviews, and a two-round online Delphi survey to rank 23 potential outcomes. - The 10 core outcomes include maternal mortality, cardiac arrest, severe maternal organ dysfunction, length of ICU and hospital stay, hospital or ICU readmission, new medical conditions at discharge, permanent infertility, perinatal loss, severe neonatal morbidity, and gestational age/preterm birth. - The framework was needed because previous research on critical illness in pregnancy—an event affecting 0.7 to 13.5 per 1,000 deliveries—used inconsistent outcomes, making it difficult to compare studies and inform evidence-based decisions. - In addition to the 10 outcomes, the panel also established seven reporting checklist items, such as specifying the location and mode of birth, to further standardize data collection in future studies. - In Virginia, recent legislation aims to expand the role of midwives to address maternal care shortages; House Bill 1904 allows certified nurse midwives to provide 24-hour on-call nursery care, while House Bill 1923 establishes insurance reimbursement parity for all licensed midwives. - Integrating midwives into health systems is associated with improved birth outcomes, including lower rates of C-sections and preterm births; standardized research data can further strengthen the evidence base for different models of maternal care. - Virginia is projected to face a significant shortage of healthcare workers, including an estimated 1,622 additional primary care physicians needed by 2030, which recent legislative changes expanding midwifery practice hope to address.
