Should European perinatal indicators be revisited?

Santos, João Vasco; Correia, Cláudia; Cabral, Filipe; Bernardes, João; Costa‐Pereira, Altamiro

doi:10.1016/j.ejogrb.2013.05.017

Cited by 6 publications

(2 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Feasibility and the need to focus on the most measurable data as opposed to what might be the most effective/interesting information was an issue which emerged from the literature [ 41 , 58 - 60 ], raising the question as to whether normal birth is not being measured due to the difficulties involved in generating consensus and effective tools and indicators for monitoring this mode of birth. At the same time, Chappell et al [ 59 ] made a persuasive case for the development of ‘aspirational’ indicators related to normal or unassisted birth through wider consultation and representation, challenging the argument that certain indicators are problematic to collect.…”

Section: Discussionmentioning

confidence: 99%

Assessing the performance of maternity care in Europe: a critical exploration of tools and indicators

Escuriet

White

Beeckman

et al. 2015

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundThis paper critically reviews published tools and indicators currently used to measure maternity care performance within Europe, focusing particularly on whether and how current approaches enable systematic appraisal of processes of minimal (or non-) intervention in support of physiological or “normal birth”. The work formed part of COST Actions IS0907: “Childbirth Cultures, Concerns, and Consequences: Creating a dynamic EU framework for optimal maternity care” (2011-2014) and IS1405: Building Intrapartum Research Through Health - an interdisciplinary whole system approach to understanding and contextualising physiological labour and birth (BIRTH) (2014-). The Actions included the sharing of country experiences with the aim of promoting salutogenic approaches to maternity care.MethodsA structured literature search was conducted of material published between 2005 and 2013, incorporating research databases, published documents in english in peer-reviewed international journals and indicator databases which measured aspects of health care at a national and pan-national level. Given its emergence from two COST Actions the work, inevitably, focused on Europe, but findings may be relevant to other countries and regions.ResultsA total of 388 indicators were identified, as well as seven tools specifically designed for capturing aspects of maternity care. Intrapartum care was the most frequently measured feature, through the application of process and outcome indicators. Postnatal and neonatal care of mother and baby were the least appraised areas. An over-riding focus on the quantification of technical intervention and adverse or undesirable outcomes was identified. Vaginal birth (no instruments) was occasionally cited as an indicator; besides this measurement few of the 388 indicators were found to be assessing non-intervention or “good” or positive outcomes more generally.ConclusionsThe tools and indicators identified largely enable measurement of technical interventions and undesirable health (or pathological medical) outcomes. A physiological birth generally necessitates few, or no, interventions, yet most of the indicators presently applied fail to capture (a) this phenomenon, and (b) the relationship between different forms and processes of care, mode of birth and good or positive outcomes. A need was identified for indicators which capture non-intervention, reflecting the reality that most births are low-risk, requiring few, if any, technical medical procedures.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-1151-2) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Assessing the performance of maternity care in Europe: a critical exploration of tools and indicators

Escuriet

White

Beeckman

et al. 2015

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…In neonatology, preterm birth is traditionally classified by gestational age in weeks and birth weight of the infant. These two markers are well-established core indicators for monitoring and evaluating perinatal health under routine health statistics (1,2). However, both indicators remain descriptive and non-functional, and do not allow for functional conclusions regarding the individual biological maturity and outcome of a preterm infant.…”

Section: Introductionmentioning

confidence: 99%

Cord blood telomere shortening associates with increased gestational age and birth weight in preterm neonates

et al. 2021

View full text Add to dashboard Cite

Preterm birth is considered to be associated with premature cellular aging. To address this question, two hallmarks of aging were analyzed in cord blood cells, namely telomere length and age-associated DNA methylation. Cord blood samples from 35 preterm and 11 full-term neonates were enrolled in the present study. Furthermore, quantitative telomere fluorescence in situ hybridization and flow cytometry (flow-FISH) were applied to demonstrate that telomere shortening was strongly associated with advanced gestational age and increased birth weight (R 2 =0.267 for granulocytes and R 2 =0.307 for lymphocytes). The estimated rate of telomere attrition in newborns during gestation ranged from 126 base pairs (bp)/week and 186 bp/week for granulocytes and lymphocytes, respectively. In addition, neonates with longer telomeres at birth were characterized by increased weight gain during the first year of their life compared with that noted to neonates with shorter telomeres. By contrast, the epigenetic aging signature (EAS) revealed a negative correlation between epigenetic age and premature birth of unclear basis (R 2 =0.26). Pending prospective validation in a larger patient cohort, the present study suggested that telomere length may be a novel biomarker alone or in combination with traditional indicators for the prediction of weight development in preterm neonates.

show abstract

Building a European perinatal health information system: plurality, innovation and realism

Zeitlin

Mohangoo²,

Macfarlane³

et al. 2013

European Journal of Obstetrics & Gynecology and Reproductiv

View full text Add to dashboard Cite

Should European perinatal indicators be revisited?

Cited by 6 publications

References 16 publications

Assessing the performance of maternity care in Europe: a critical exploration of tools and indicators

Assessing the performance of maternity care in Europe: a critical exploration of tools and indicators

Cord blood telomere shortening associates with increased gestational age and birth weight in preterm neonates

Building a European perinatal health information system: plurality, innovation and realism

Contact Info

Product

Resources

About