In order to standardize the selection, collection and reporting of key results in research on maternal and newborn health during epidemic outbreaks, a study led by the IECS and carried out in collaboration with the World Health Organization (WHO) identified a minimum set of recommended core outcomes to be measured in research: the MNH-EPI-COS, which includes 18 core outcomes and 11 complementary outcomes.
This minimum set of basic results or COS (for the acronym in English of Core Outcome Set) "seeks to guarantee that, in the context of epidemics, research and surveillance studies in this field measure and report consistent and comparable results," said the first two authors, Mag. Verónica Pingray and Dr. Karen Klein, from the IECS Maternal and Child Health Research Department.
According to the author team, the use of the MNH-EPI-COS will facilitate evidence synthesis and informed decision-making in health emergency situations.
To arrive at these results, a systematic review was conducted to identify maternal and newborn health outcomes reported in research conducted during outbreaks, epidemics, and pandemics. The findings then served as input for developing a four-stage modified Delphi consensus, involving two rounds of online surveys and two consensus meetings with a group of key stakeholders from the six WHO regions, from diverse disciplines and with proven expertise in the subject matter, as well as representatives of civil society.
The main results identified that should be evaluated in research are:
- Maternal: Pregnancy outcome (live birth, stillbirth, spontaneous or induced abortion); maternal death; suspected symptomatic maternal infection; confirmed maternal infection; severe maternal illness (related to the outbreak-associated disease); spontaneous or iatrogenic preterm delivery; and mode of delivery.
- Neonatal: Neonatal death (early or late); suspected symptomatic neonatal infection; confirmed neonatal infection; severe neonatal disease (related to the outbreak-associated disease); vertical transmission; low birth weight; premature birth; congenital anomalies; neonatal respiratory support; skin-to-skin contact within the first hour after birth; and breastfeeding within the first hour after birth.
In addition, 11 additional maternal and neonatal complementary outcomes were agreed upon that are important to measure in specific types of studies, in specific settings (depending on resource availability), or during specific disease outbreaks. These include antepartum and postpartum hemorrhage, symptoms of depression and/or anxiety, sepsis, and birth asphyxia.