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Are current measures of neonatal birth trauma valid indicators of quality of care?

Journal of Perinatology volume 35, pages 903–906 (2015)Cite this article

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Neonatal birth traumas are an important cause of morbidity and mortality, and the rates of these events are frequently used as a measure of the quality of obstetric care. The objectives of this clinical report are to review the limitations of using the current definition of birth trauma as an indicator of quality of care and to propose changes to make it a more accurate measure of quality of care.

The reported incidence of birth trauma is highly variable from study to study, with several large population-based studies reporting an incidence ranging between 24 and 37 per 1000 births.1, 2, 3 Although the majority of birth traumas occur in infants with risk factors, some occur in the absence of identifiable risk factors, making the latter challenging to predict and avoid. Because parents often assume birth traumas are preventable, their occurrence can lead to anger, frustration and sometimes litigation. Studies have shown that Obstetrician–gynecologists are the most frequently sued physicians in the United States and shoulder dystocia-related nerve injuries constitute the second highest category of payouts in obstetric malpractice suits.4, 5 It has also been reported that many different factors other than the medical error have a role in parents’ decision to sue the providers.6, 7, 8 The objectives of our report are to review the limitations of the current measures of birth trauma as indicators of quality of care and to propose a new framework to evaluate neonatal birth trauma to provide a more reliable measure of quality of care.

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Authors and Affiliations

  1. Division of Neonatal-Perinatal Medicine, University of Illinois, Peoria, IL, USA

    P Kumar

  2. Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

    L-A Papile

  3. Division of Neonatal-Perinatal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA

    K Watterberg

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  1. P Kumar
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  2. L-A Papile
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  3. K Watterberg
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Correspondence to P Kumar.

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Supplementary Information accompanies the paper on the Journal of Perinatology website .

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Kumar, P., Papile, LA. & Watterberg, K. Are current measures of neonatal birth trauma valid indicators of quality of care?. J Perinatol 35, 903–906 (2015). https://doi.org/10.1038/jp.2015.71

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