Core outcome sets for research within the area of maternity care

Overview of completed and ongoing studies

Reading time approx. 61 minutes Published: Publication type:

SBU Policy support

identifies and presents available scientific evidence to support policy and decision making, including the development of national guidelines, at other government agencies. In consultation with professional experts, SBU staff generates supporting documentation to address the various questions that have been posed.

Published: Report no: 309 Registration no: SBU 2019/290 ISBN: 978-91-88437-51-8 https://www.sbu.se/309e

Background

When research is synthesised in systematic reviews it becomes clear that studies often overlook outcomes of importance to patients and that different outcomes as well as different methods or timepoints are used when assessing outcomes. This detracts from the potential to synthesise the results of different studies and as a result, the scientific evidence to support many treatment procedures is weakened. It is important that clinical studies use outcomes which are meaningful when patients and healthcare personnel are to make a decision, for example about type of treatment.

A core outcome set (COS) is an agreed standardised set of outcomes that should be assessed and reported, as a minimum, in all clinical trials in specific areas of health or health care (Figure 1). The outcomes to be included in different COS are selected by a consensus process in which healthcare personnel, researchers and patients should be included [1]. The aim with developing and implementing COS is that the results from various studies can be more readily comparable and collated, so that the basis for decisions, for patients and healthcare personnel, is therefore strengthened.

Figure 1 Schematic illustration showing the intended use of COS.

Schematic illustration of 3 research studies that explores 6–8 outomes each, whereas 4 are mutual (Core Outcome Set)

The main target groups for the report are researchers and research funders. The findings may also be of interest to professional associations, organizations and units involved in maternity/obstetric care. The project has been commissioned by the Swedish government, as part of its efforts for the promotion of women’s health.

Aim

The aim is to inventory, compile and analyse existing and ongoing studies which prioritize core outcomes within the field of maternity care (so-called Core Outcome Set (COS)). The report also highlights fields of potential interest for production of new COS, based on the opinions of patients, researchers and healthcare personnel.

Method

In order to identify completed and ongoing COS in the field of maternity care, a search of the literature was conducted (Appendix 1), followed by a summary of studies in the field.

We have also investigated how well the identified COS studies fulfil the proposed reporting criteria, using a checklist modified after Core Outcome Set–STAndards for Reporting (COS-STAR) (Appendix 2) [2]. In order to gain an indication of topics for which there may be a demand for new COS, an open questionnaire was posted on SBU´s website. This allowed relevant interested parties (primarily patients and their relatives, healthcare personnel and researchers) to nominate fields within maternal health which they considered warranted a COS.

The protocol is registered in Prospero and the COMET initiative database.

Inclusion criteria

Population

  • Pregnant women
  • Women giving birth (labour and delivery) 
  • Women who suffer an injury or other complication related to childbirth
  • Women or men suffering from psychiatric disorder during pregnancy or during or after childbirth

Intervention

No restriction.

Control

Not applicable.

Outcome

A list of outcomes included in the COS.

Study design

Ongoing or finalized original studies were outcomes were prioritized using some form of consensus method.

Language

English and Scandinavian languages.

Search period

Final search, June 2019.

Databases searched

MEDLINE, Embase, PsycINFO, Academic Search Elite, CINAHL with Full Text, SocINDEX with Full Text and the Core Outcome Measures in Effectiveness Trials (COMET) Initiative database.

Client/patient involvement

Yes

Results

This report identified 19 completed studies which prioritized outcomes, Table 1, Table 2 and Table 3.

Table 4.2 Discription of the included finished COS studies.
NA = Not applicable; IQR = Interquartile range; TTTS = Twin – twin transfusion syndrome
Ref
First author
Year
Population

Intervention

Setting
Stakeholders represented in the workgroupConsensus criteria for an outcome to be included in the final COSMethod used

Participants receiving the first survey, % of participants answering all surveys, participants at consensus meeting
[10]
Meher
2018
Postpartum haemorrhage

Two core outcomes sets presented one for prevention and one for treatment

Clinical trials
Healthcare professionals and women’s representatives from 36 nations

Sweden not represented
At least 70% of participants in each stakeholder group to score the outcome as critically important and <15% to score the outcome as not important A two-round Delphi survey and face-to-face consensus meeting

Prevention: 205, 74%, 36

Treatment: 197, 73%, 36
[19]
Nijagal
2018
Women and infants

The care that they receive during pregnancy and the postpartum period
Consumer representatives and international experts in various fields of perinatal and neonatal care, research and patient advocacy from 8 nations. One person from Sweden included Outcome domains thought to be “critical” (scored between 7 and 9) by at least 70% of the respondents were included in the set A series of nine tele­conferences, incorporating a modified Delphi process

21, 73%, NA
[16]
Bunch
2018
Women in maternity care

Monitor the quality of maternity care
Service designers, providers and users from England ≥70% of participants rated the metric 7–9 (high importance) and <15% rated it as 1–3 (low importance) A two-round Delphi survey and face-to-face consensus meeting

101, 71%, 19
[8]
Egan
2017
Women with pregestational diabetes

Prepregnancy care

Clinical trials
Clinicians’ patient’s policy makers, researchers in the area advocates on behalf of those with diabetes and others from 24 nations. Do not specify which nations that were represented. At least 70% of participants to score the outcome as critically important (7–9) and <15% to score the outcome as not important (1–3) A three-round Delphi survey and face-to-face consensus meeting

151, 67%, 14
[14]
Van ʼt Hooft
2016
Pregnant women

Interventions to Prevent Preterm Birth

Clinical trials
Parents, midwives, obstetricians, neonatologists, and re-searcher from 25 nations. Do not specify which nations that were represented Core outcomes required at least 70% of participants in each stakeholder group to score the outcome as “critical” and less than 15% of participants in each stakeholder group to score the outcome as limited importance A two-round Delphi survey and face-to-face consensus meeting

228, 76%, 29
[6]
Devane
2007
Models of maternity care

Clinical trials
Healthcare professionals and women’s representatives from 28 nations

Four participants from Sweden
Outcomes with both a mean value greater than the overall group mean for all outcomes combined and rated 4 or more on a 5-point Likert-type scale for importance of inclusion in a minimum data set of outcome measures by at least 70% of respondents A three-round Delphi survey

320, 48%, NA
[3]
Al Wattar
2016
Epilepsy in pregnancy

Clinical trials
Healthcare professionals, and patient representatives with lived experience of epilepsy from UK We included outcomes that scored ≥4 by >70% of participants, and outcomes that scored ≤2 by <15% of participants (used a 5-point scale) A modified three-round Delphi survey and consultation meeting

99 participants finished first survey, 49%, 15
[7]
Dos Santos
2018
Pregnant women

Induction of labour

Clinical trials
Midwives, obstetricians, neonatologists, and women’s representatives

Number of nations not clearly stated
≥70% participants rated outcomes as critical and <15% rated outcomes as limited importance A two-round Delphi survey and face-to-face consensus meeting

159, 45%, 20
[5]
Briscoe
2019
Caesarean deliveries with infectious morbidity outcome

Clinical trials
Systematic review authors

Number of nations not clearly stated
Consensus of the panel was defined by the majority of respondents A two-round Delphi survey

41, 34%, NA
[18]
Fong
2014
Late-onset preeclampsia

Management

Maternal and neonatal composite outcomes for trials
Practising senior clinicians and clinical academics from the United Kingdom We selected the outcomes that had a median score of 4 or more and indicated consensus (IQR ≤2) for evaluation in the third stage. (5-point scale) A two-round Delphi survey

44, 90% maternal outcomes

75% neonatal outcomes, NA
[15]
Bennett
2012
Gestational Diabetes Mellitus

Medication and delivery management

Clinical trial
Clinical experts

Number of nations not clearly stated
Appearing in the top 3 list of two or more of the nine national stakeholders Regarding prioritization of outcomes, one- survey

20, NA, NA
[20]
Rogozinska
2016
Pregnancy

Diet and lifestyle

Composite outcomes for individual patient data (IPD) meta-analysis
Researchers from the International Weight Management in Pregnancy collaborative network from 11 nations. Sweden not represented Considered to be critically important by the Delphi panel (score >7), of equal importance, similar rates of occurrence, independent of each other, and evidence of the same trend in effect of the intervention A two-round Delphi survey

26, 96%, NA
[21]
Saldanha
2013
Gestational diabetes mellitus

Antenatal drug treatment
Clinicians, primary researchers, research funders, insurers, and patients or patient representatives from 1 nation Not specified Prioritization of research questions using the Delphi method for some including prioritization of outcomes. Does not specified how many rounds for outcomes

9 participants
[17]
Fiala
2018
Pregnancy

First trimester medical termination
Group of European experts, included clinicians, researchers and members of the pharmaceutical industry

Number of nations not clearly stated
Not specified Face-to-face consensus meeting

Number of participants not clearly stated
[4]
Bogdanet
2019
Women with gestational diabetes treated with insulin and/or oral glucose-lowering agents

Follow-up at 1 year and beyond

Clinical trails
Patients, clinicians, researchers, policy makers and others from 33 nations. Participants from Sweden included At least 70% of participants to score the outcome as critically important (7–9) and <15% to score the outcome as not important (1–3) A three-round Delphi survey and face-to-face consensus meeting

835, 20%, 20
[11]
Mehra
2012
Pregnancy weight management clinical trails (Only available as a conference abstract) 20 Consultants from 2 nations Not enough information provided A two-round Delphi survey

20 participants
[13]
Townsed
2019
Selective fetal growth restriction in twins management clinical trails Clinicians, obstetricians, fetal medicine specialists, neonatologists, and midwives), researchers, and parents or patients from 23 nations. Do not specify which nations that were represented Consensus was defined as any outcome achieving a median score of eight after the third round. All outcomes meeting this criterion were taken forwards as potential core outcomes for discussion A three-round Delphi survey and face-to-face consensus meeting using the modified nominal group technique

102 participants completed first survey, 86%, 19
[12]
Perry
2019
Twin – twin transfusion syndrome (TTTS) treatments Healthcare professionals, researchers and patients or relatives of patients who had experienced TTTS from 29 nations. Do not specify which nations that were represented Defined a priori using the 15% / 70% definition of the COMET Initiative A three-round Delphi survey and face-to-face consensus meeting using the modified nominal group technique

103 participants completed first survey, 85%, 16
[99]
Healy
2019
Fetal growth restriction prevention and treatment Healthcare providers, researchers/academics, members of the public from 36 nations. Do not specify which nations that were represented At least 70% of participants to score the outcome as critically important (7–9) and <15% to score the outcome as not important (1–3) A three-round Delphi survey and face-to-face consensus meeting

238, 45%, not specified

 

Table 4.3 Outomes that are included in the identified studies and how ell the studies fulfilled the report demands that are.
BP =Blood presure; BMI = Body Mass Index; COS = Core Outcome Set; COS-STAR = Core Outcome Set–STAndards for Reporting; GDM = Gestational diabetes mellitus; HbA1c = Hemoglobin A1c (Långtidsblodsockret); MToP = Medical termination of pregnancy; ITU/HDU = Intensive care units (/ high dependency units
Ref
First author
Year of publication

Subject
Final COSCompliance with COS-STAR

Comments
[10]
Meher
2018

Prevention and treatment of postpartum haemorrhage
Prevention of postpartum haemorrhage:
  • Blood loss
  • Shock
  • Maternal death
  • Use of additional uterotonics
  • Blood transfusion
  • Transfer for higher level of care
  • Women’s sense of wellbeing
  • Acceptability and satisfaction with the intervention
  • Breastfeeding
  • Adverse effects

Treatment of postpartum haemorrhage:
  • Blood loss
  • Shock
  • Coagulopathy
  • Hysterectomy
  • Organ dysfunction
  • Maternal death
  • Blood transfusion
  • Use of additional haemostatic intervention
  • Transfer for higher level of care
  • Women’s sense of wellbeing
  • Acceptability and satisfaction with the intervention
  • Breastfeeding
  • Adverse effects
Good compliance with COS-STAR

Not able to access protocol
[19]
Nijagal
2018

Care for women and infants during pregnancy and the postpartum period
  • Maternal death
  • Still birth
  • Neonatal death
  • Maternal need for intensive care
  • Maternal length of stay
  • Late maternal complication
  • Transfusion
  • Spontaneous preterm birth
  • Iatrogenic preterm birth
  • Oxygen dependence
  • Neonate length of stay
  • Birth injury
  • Health related quality of life
  • Incontinence
  • Pain with intercourse
  • Success with breast­feeding
  • Confidence with breast­feeding
  • Mother-infant attachment
  • Confidence with role as a mother
  • Postpartum Depression
  • Satisfaction with the results of care
  • Confidence as an active participant in healthcare decisions
  • Confidence in healthcare providers
  • Birth Experience
Some details form COS-STAR not reported

No reference to a protocol given

Only 2 consumers and 19 clinical expertise in the working group

A very large number of outcomes included in the final COS
[16]
Bunch
2018

Monitor the quality of maternity care
  • Smoking rate at booking
  • Rate of birth without intervention
  • Caesarean section delivery rate in Robson group 1 women
  • Caesarean section delivery rate in Robson group 2 women
  • Caesarean section delivery rate in Robson group 5 women
  • Third-and fourth-degree tear rate among women delivering vaginally
  • Rate of postpartum haemorrhage of ≥1500 ml
  • Rate of successful vaginal birth after a single previous caesarean section
  • Smoking rate at delivery
  • Proportion of babies born at term with an Apgar score <7 at 5 minutes
  • Proportion of babies born at term admitted to the neonatal intensive care unit
  • Proportion of babies re admitted to hospital at <30 days of age
  • Breast­feeding initiation rate
  • Breast­feeding rate at 6–8 weeks
Some details form COS-STAR not reported

No reference to a protocol given

Patients are included in the panel but not represented at the final meeting
[8]
Egan
2017

Prepregnancy care for women with pre­gestational diabetes
  • Healthcare professional review prior to conception
  • Smoking status at first antenatal visit
  • Use of folic acid preconception
  • Thyroid function at first antenatal visit
  • Use of potentially teratogenic medications at conception
  • Gestational age at first antenatal visit
  • BMI at first antenatal visit
  • BP at first antenatal visit
  • First trimester HbA1c
  • Perinatal mortality
  • Miscarriage
  • Congenital malformation
  • Preterm birth
  • Large for gestational age
  • Small for gestational age
  • Gestational weight gain
  • Severe maternal hypoglycaemia in first trimester
Good compliance with COS-STAR

Does not specify the number of non-responders from the first survey

Only a few patient representatives present in the workshop
[14]
van ʼt Hooft
2016

Interventions to Prevent Preterm Birth
Related to pregnant women:
  • Maternal mortality
  • Maternal infection or inflammation
  • Prelabor rupture of membranes
  • Harm to mother from intervention

Related to offspring:
  • Gestational age at birth
  • Off-spring mortality
  • Birth weight
  • Early neuro­developmental morbidity
  • Late neuro­developmental morbidity
  • Gastro­intestinal morbidity, infection
  • Respiratory morbidity
  • Harm to offspring from intervention
Good compliance with COS-STAR

Only a few patient representatives present in the workshop
[6]
Devane
2007

Models of maternity care
  • Maternal death
  • Mode of birth
  • Neonatal death
  • Stillbirth
  • Type of labour onset
  • Neonatal admission to special care and/or intensive care unit
  • Birth injury to infant
  • Ruptured uterus
  • Postpartum haemorrhage
  • Mother requires admission to intensive care
  • Maternal postnatal readmission to hospital
  • Method of infant feeding
  • Vaginal birth after previous caesarean section
  • Gestational age at birth
  • Postnatal depression
  • Place of birth
  • Neonatal resuscitation required
  • Normal (i.e., physiological) birth without intervention
  • Oxytocin augmentation of labour
  • Anal sphincter damage
  • Hypoxic ischemic encephalopathy (a condition of injury to the brain)
  • Intrapartum hypertensive disorders of pregnancy
  • Hypertensive disorders of pregnancy
  • Puerperal psychosis
  • Maternal fecal incontinence
  • Neonatal readmission to hospital
  • Apgar score at 5 min
  • Trial of labour after previous caesarean delivery
  • Breastfeeding at 3 months
  • Maternal satisfaction (postnatal)
  • Infant birthweight
  • Neonatal fitting/seizures
  • Infant requiring intubation
  • Congenital anomaly (chromosomal, genetic, and/or structural)
  • Use of pharmacological analgesia/anesthesia
  • Maternal satisfaction (antenatal)
  • Postnatal hypertensive disorders of pregnancy
  • Maternal satisfaction (intrapartum)
  • Caesarean section wound infection
  • Pulmonary embolism
  • Intrauterine growth restriction
  • Preterm labour
  • Meconium aspiration
  • Intrapartum haemorrhage
  • Neonatal infection
  • Shoulder dystocia
  • HELLP = hemolysis, elevated liver enzymes, and low platelets
  • Birth asphyxia
  • Breastfeeding at discharge
Some details form COS-STAR not reported

No reference to a protocol given

The PICO for the COS is not clearly stated

Very broad area for the COS development and a very large number of outcomes included in the final COS
[3]
Al Wattar
2016

Epilepsy in pregnancy
Maternal
  • Seizure control in pregnancy
  • Postpartum seizure control
  • Status epilepticus
  • Maternal mortality
  • Drowning
  • Sudden unexpected death in epilepsy
  • Postnatal depression
  • Maternal quality of life
  • Maternal anti-epileptic drug toxicity
  • Compliance with anti-epileptic drug intake

Offspring outcomes
  • Major congenital abnormalities
  • Minor congenital abnormalities
  • Fetal anticonvulsant syndrome
  • Neurodevelopment
  • Autism spectrum disorder
  • Neonatal clinical complications
  • Admission to neonatal intensive care unit
  • Anthropometric measurements, including birthweight
  • Neonatal withdrawal symptoms
  • Neonatal haemorrhagic disease

Obstetric outcomes
  • Live birth
  • Stillbirth
  • Miscarriage
  • Ectopic pregnancy
  • Termination of pregnancy
  • Maternal admission to high dependency or intensive care unit
  • Breastfeeding
  • Mode of delivery
  • Preterm birth
  • Pre-eclampsia
  • Eclampsia
Good compliance with COS-STAR

Patients participated in a separate survey which consisted of only one round

Only persons from UK represented

A very large number of outcomes included in the final COS
[7]
Dos Santos
2018

Induction of labour
Short-term maternal outcomes
  • Cardiorespiratory arrest
  • Damage to internal organs
  • Death
  • Haemorrhage
  • Hysterectomy
  • Infection
  • Intensive care admission
  • Length of hospital stay
  • Mode of delivery
  • Need for more than one induction agent
  • Oxytocin augmentation
  • Postnatal depression
  • Pulmonary embolus
  • Satisfaction with care
  • Stroke
  • Time from induction to delivery
  • Uterine hyper­stimulation
  • Uterine scar dehiscence/rupture

Short-term offspring outcomes
  • Admission to the neonatal unit
  • Birth trauma
  • Death
  • Hypoxic ischaemic encephalo­pathy/need for therapeutic hypothermia
  • Meconium aspiration syndrome
  • Need for respiratory support
  • Infection
  • Seizures

Long-term maternal outcomes
  • Operative pelvic floor repair

Long-term offspring outcomes
  • Disability including neuro­developmental delay
Good compliance with COS-STAR

Only a few patient representatives present in the workshop

A very large number of outcomes included in the final COS
[5]
Briscoe
2019

Cesarean deliveries with infectious morbidity outcome
  • Endometritis (primary outcome)
  • Maternal mortality
  • Wound infection
  • Wound complications
  • Febrile morbidity
  • Neonatal morbidity
Significant details from COS-STAR not reported

No reference to a protocol given

Only includes authors of systematic reviews in the process
[18]
Fong
2014

Composite outcomes regarding management late-onset preeclampsia
The maternal composite outcome included
  • Maternal death
  • Eclampsia
  • Stroke or reversible ischaemic neurological deficit
  • Pulmonary oedema
  • Major obstetric haemorrhage
  • Need for positive inotropic support
  • Haemolysis
  • Elevated liver enzymes and low platelets syndrome and placental abruption

The neonatal composite outcome included
  • Neonatal death
  • Respiratory distress syndrome
  • Needing ventilator support and neurological outcomes as cystic periventricular leukomalacia and grade III/IV intraventricular haemorrhage.
Significant details from COS-STAR not reported

Aim is not a conventional COS development but a development of a composite outcome

No reference to a protocol given

No patients included in the process
[15]
Bennett
2012

Medication and delivery management for Gestational Diabetes Mellitus
  • Hypertensive disorders of pregnancy
  • Medication adherence
  • Large for gestational age and macrosomia
  • Gestational weight gain
  • Neonatal hypoglycemia
  • Neonatal intensive care unit admission
  • Chronic disease incidence in offspring
  • Postpartum incident type 2 diabetes mellitus or glucose intolerance/impaired fasting glucose mangaement
  • Cesarean delivery
  • Birth trauma
  • Neonatal intensive care unit admission
  • Patient-reported outcomes (e.g., patient preference, quality of life)
  • Complications of cesarean delivery (e.g., wound infection, wound dehiscence)
  • Vaginal delivery (spontaneous, operative)
  • Hypoxia/anoxia
  • Respiratory distress syndrome
Significant details from COS-STAR not reported

The aim is to article is to prioritize research need. For some of the research questions the outcomes to measure were also prioritized

No patients included, but two members that served as proxy for the patient/consumer perspective
[20]
Rogozinska
2016

Composite outcomes for diet and lifestyle interventions in pregnancy
The maternal composite outcome included
  • Pre-eclampsia/pregnancy induced hypertension
  • Gestational diabetes mellitus (GDM)
  • Elective or emergency caesarean section
  • Preterm delivery

The neonatal composite outcome included
  • Intrauterine death
  • Small for gestational age
  • Large for gestational age
  • Admission to a neonatal intensive care unit
Significant details from COS-STAR not reported

Aim is not a conventional COS development but a development of a composite outcome

No reference to a protocol given

Only researchers included in the process
[21]
Saldanha
2013

Antenatal drug treatment for gestational diabetes mellitus
Oral agents compared with insulin:
  • Chronic diseases (e.g., obesity and type 2 diabetes) in the offspring
  • Hypertensive disorders of pregnancy (e.g., GDM and pre-eclampsia) in the mother
  • Large for gestational age
  • Macrosomia in the neonate

Selective cesarean delivery or the choice of timing of induction:
  • Cesarean delivery (primary cesarean and repeat cesarean)
  • Indication for cesarean delivery in the mother
  • Birth trauma (e.g., bone fractures and cerebral palsy)
  • Neonatal intensive care unit admission
Significant details from COS-STAR not reported

The aim is to article is to prioritize research need. For some of the research questions the outcomes to measure were also prioritized

No reference to a protocol given
[17]
Fiala
2018

First trimester medical termination
  • Success
  • Failure (ongoing pregnancy)
  • Need for additional treatment (medical or surgical) to complete MToP (missed abortion, incomplete abortion)
  • Complications
  • The woman’s request for additional treatment (medical or surgical)
Significant details from COS-STAR not reported

The aim is to article is to standardize the definition of the outcomes

No reference to a protocol given

No Delphi survey
[4]
Bogdanet
2019

Follow-up at 1 year and beyond for women with gestational diabetes treated with insulin and/or oral glucose-lowering agents
  • Assessment of glycaemic status
  • Diagnosis of type 2 diabetes since the index pregnancy
  • Number of pregnancies since the index pregnancy
  • Number of pregnancies with a diagnosis of GDM since the index pregnancy
  • Diagnosis of prediabetes since the index pregnancy
  • BMI
  • Post-pregnancy weight retention
  • Resting blood pressure
  • Breastfeeding
Good compliance with COS-STAR
[11]
Mehra
2012

Weight management interventions in pregnancy
Top 5 clinically important outcomes:
  • Gestational diabetes
  • Preeclampsia
  • Gestational hyper­tension
  • Maternal admission to ITU/HDU
  • Venous thrombo­embolism
Not able to check compliance with COS-STAR

Conference abstract. Lot of information missing
[13]
Townsed
2019

Mamagement of selective fetal growth restriction in twins
  • Live birth
  • Gestational age at birth
  • Birth weight
  • Inter-twin birthweight discordance
  • Death of surviving twin after death of co-twin
  • Loss during pregnancy or before final hospital discharge (miscarriage, stillbirth, termination of the pregnancy, neonatal death, perinatal death)
  • Parental stress
  • Procedure-related adverse outcome (failure of procedure, procedure to delivery interval, placenta abruption, life threatening haemorrhage, sepsis, maternal death)
  • Length of stay in hospital (neonatal)
  • Neurological abnormalities on postnatal imaging
  • Childhood disability
Good compliance with COS-STAR

Does not specify the number of non-responders from the first survey
[12]
Perry
2019

Twin – twin transfusion syndrome
  • Live birth
  • Pregnancy loss (including miscarriage, stillbirth, termination of pregnancy and neonatal mortality)
  • Subsequent death of a cotwin following single-twin demise at the time of treatment
  • Recurrence of TTTS
  • Twin anemia – poly­cythemia­sequence and amniotic band syndrome
  • Gestational age at delivery
  • Birthweight
  • Brain injury syndromes
  • Ischemic limb injury
  • Maternal mortality
  • Admission to Level-2 or -3 care setting
  • One aspirational outcome
  • Neuro­development at 18–24 months of age
Good compliance with COS-STAR

Does not specify the number of non-responders from the first survey
[9]
Healy
2019

Prevention and treatment of fetal growth restriction
  • Pree­clampsia
  • Eclampsia
  • Maternal death
  • Mode of birth
  • Fetal still­birth/live­birth
  • Gestational age at birth
  • Preterm birth (delivery at <37 weeks gestation)
  • Extremely preterm birth (delivery at<28 weeks gestation)
  • Birthweight
  • Birthweight <10th percentile
  • Birthweight <3rd percentile
  • Need for mechanical ventilation
  • Bronch­opulmonary dysplasia/chronic lung disease
  • Necrotizing entero­colitis
  • Neonatal seizures
  • Hypoxic ischemic ence­phalo­pathy
  • Neonatal death
  • Childhood cognitive impairment
  • Motor impairment
  • Cerebral palsy
  • Hearing Impairment
  • Visual Impairment
Good compliance with COS-STAR

A very large number of outcomes included in the final COS

 

Table 4.4 Number of outcomes that have been identified in the area and number of outcome in the final COS.
GDM = Gestational diabetes mellitus; IQR = Interquartile range; NA = Not applicable; SR = Systematic Review
Ref
First author
Number of outcomes in first roundNumber of outcomes added by participantsNumber of outcomes in final COS
[10]
Meher
Prevention: 161 combined into 35

Treatment: 97 combined into 31
Prevention: 16

Treatment: 18
Prevention: 9

Treatment: 12
[19]
Nijagal
Not specified Not specified 24
[16]
Bunch
125 19 14
[8]
Egan
86 27 17
[14]
Van ʼt Hooft
86 grouped into 29 2 13
[6]
Devane
263 73 48
[3]
Al Wattar
70 grouped into 48 Not enough information provided 31
[7]
Dos Santos
93 reduced to 77 by combining different outcomes after first survey round 4 28
[5]
Briscoe
511

Outcomes were grouped into 20 primary outcome groups
4 6
[18]
Fong
21 maternal and 24 neonatal outcomes 8 Maternal composite outcome: 7

Neonatal composite outcome: 3
[15]
Bennett
>20 NA Medication management of GDM: 8

Delivery management for women with GDM: 8
[20]
Rogozinska
Maternal: 36

Fetal and neonatal: 27
Maternal: 2

Fetal and neonatal: 2
Maternal: 6 (condensed to 4)

Fetal and neonatal: 4
[21]
Saldanha
Not enough information provided Not enough information provided Maternal: 17

Neonatal offspring: 13
[17]
Fiala
NA NA NA
[4]
Bogdanet
121 10 9
[11]
Mehra
Not enough information provided Not enough information provided Not enough information provided
[13]
Townsed
96 identified in SR, 56 included in the first round 7 11
[12]
Perry
71 21 12
[9]
Healy
103 Not enough information provided 22

Among these, the main aim for 12 was to develop a COS for future research [3-14]. In the remaining seven studies, outcomes were also prioritized, but the main aim of the studies somewhat varied [15-21]. The primary aim of two articles was to prioritize future research questions, and this included prioritizing the outcomes to be assessed [15,21]. Two other articles investigated which outcomes should be prioritized in a composite outcome while other studies considered which outcomes should be assessed in clinical follow-up of patients [16-20]. Of the 19 studies identified, nine met the reporting criteria for COS-studies well [3,4,7-10,12-14]. In addition to these studies, 39 COS-studies in progress were identified: for ten of these, protocols were published (Appendix 4) [22-31].

Most of the COS-studies identified (both completed and ongoing) focused on physical conditions and complications during pregnancy. There was also several COS for different preventive measures during pregnancy.

The result show that COS exist or are under development for many of the specified conditions highlighted by SBU’s open questionnaire, for example gestational diabetes, preeclampsia, maternal birth injuries, miscarriage and stillbirth. The results disclose however a lack of existing COS or COS under development, for mental health problems or mental illness during or after pregnancy.

Of 2543 records through database searching included 58 studies: 19 finished and 39 ongoing studies. Flow chart

Discussion

In the research fields of women’s health and neonatal health, an international network, called CoRe Outcomes in Women’s and Newborn health (CROWN), has been established [32]. It is led by journal editors, and aims to address the widespread, unwarranted variation in reporting of outcomes, which makes comparison between and combination of results across studies difficult, if not impossible. As a result, there is currently considerable activity in the development of various COS in the field of maternity care.

It is however important to point out that there remain many important subfields within obstetrics/childbirth where there are no COS. This applies for example to vaginal delivery and caesarean section, topics nominated in SBU:s questionnaire, primarily by healthcare personnel and researchers. Other fields which completely lack existing COS or COS under development are mental health issues or illness during pregnancy and after childbirth.

COS is a relatively new concept in the world of research. This is the first time SBU has presented an overview of completed and ongoing COS. The aim is that this report shall contribute to dissemination of knowledge about what a COS is, which COS are established within maternal health and which are under development. Moreover, the report can contribute to increasing the potential for Swedish researchers to apply existing COS and to participate in development of COS developed by international actors. As an HTA-organisation, SBU supports the use of COS: in the long term, COS can contribute to scientific evidence of higher certainty. For a COS to be implemented effectively, SBU believes that it is important to discuss how broad the field, for which the COS applies, should be, and how many outcomes can be included in a practically applicable COS. Moreover, it is important to continue to work with various instruments in order to appraise the methodology of established COS and the representativity of the stakeholders who participated in the consensus process.

Project Group

Experts

  • Maria Jonsson, Associate professor and senior consultant at the Department of Obstetrics and Gynecology, Uppsala university hospital, Sweden.
  • Alkistis Skalkidou, Professor of Obstetrics and Gynecology, Dept. of Women’s and Children’s Health, Uppsala University and senior consultant at the Gynecologic Department, Uppsala university hospital
  • Frida Trönnberg, Patient representative

SBU

  • Marie Österberg (Project Manager)
  • Christel Hellberg (Project Manager)
  • Ann-Kristine Jonsson (Information Specialist)
  • Sara Fundell (Project Administrator)

External reviewers

  • Eva Uustal, PhD, Senior consultant Department of Obstetrics and Gynecology
  • Ann Josefsson, Professor, Senior consultant in Obstetrics and Gynecology
  • Sverker Svensjö, PhD, Senior Consultant, Surgery

References

  1. Williamson PR, Altman DG, Bagley H, Barnes KL, Blazeby JM, Brookes ST, et al. The COMET Handbook: version 1.0. Trials 2017;18:280.
  2. Kirkham JJ, Gorst S, Altman DG, Blazeby JM, Clarke M, Devane D, et al. Core Outcome Set–STAndards for Reporting: The COS-STAR Statement. PLOS Medicine 2016;13:e1002148.
  3. Al Wattar BH, Tamilselvan K, Khan R, Kelso A, Sinha A, Pirie AM, et al. Development of a core outcome set for epilepsy in pregnancy (E-CORE): a national multi-stakeholder modified Delphi consensus study. Bjog 2017;124:661-667.
  4. Bogdanet D, Reddin C, Macken E, Griffin TP, Fhelelboom N, Biesty L, et al. Follow-up at 1 year and beyond of women with gestational diabetes treated with insulin and/or oral glucose-lowering agents: a core outcome set using a Delphi survey. Diabetologia 2019.
  5. Briscoe KE, Haas DM. Developing a Core Outcome Set for Cesarean Delivery Maternal Infectious Morbidity Outcomes. Am J Perinatol 2019.
  6. Devane D, Begley CM, Clarke M, Horey D, Oboyle C. Evaluating maternity care: a core set of outcome measures. Birth (Berkeley, Calif.) 2007;34:164-172.
  7. Dos Santos F, Drymiotou S, Antequera Martin A, Mol BW, Gale C, Devane D, et al. Development of a core outcome set for trials on induction of labour: an international multistakeholder Delphi study. Bjog 2018;125:1673-1680.
  8. Egan AM, Galjaard S, Maresh MJA, Loeken MR, Napoli A, Anastasiou E, et al. A core outcome set for studies evaluating the effectiveness of prepregnancy care for women with pregestational diabetes. Diabetologia 2017;60:1190-1196.
  9. Healy P, Gordijn SJ, Ganzevoort W, Beune IM, Baschat A, Khalil A, et al. A Core Outcome Set for the prevention and treatment of fetal GROwth restriction: deVeloping Endpoints: the COSGROVE study. Am J Obstet Gynecol 2019;221:339.e1-339.e10.
  10. Meher S, Cuthbert A, Kirkham JJ, Williamson P, Abalos E, Aflaifel N, et al. Core outcome sets for prevention and treatment of postpartum haemorrhage: an international Delphi consensus study. BJOG: An International Journal Of Obstetrics And Gynaecology 2019;126:83-93.
  11. Mehra H, Thangaratinam S. Prioritisation of outcomes in the evaluation of weight management interventions in pregnancy: A DELPHI survey. Archives of Disease in Childhood: Fetal and Neonatal Edition 2012;97:A38.
  12. Perry H, Duffy JMN, Reed K, Baschat A, Deprest J, Hecher K, et al. Core outcome set for research studies evaluating treatments for twin-twin transfusion syndrome. Ultrasound Obstet Gynecol 2019;54:255-261.
  13. Townsend R, Duffy JMN, Sileo F, Perry H, Ganzevoort W, Reed K, et al. A core outcome set for studies investigating the management of selective fetal growth restriction in twins. Ultrasound Obstet Gynecol 2019.
  14. van ʼt Hooft J, Duffy JMN, Daly M, Williamson PR, Meher S, Thom E, et al. A Core Outcome Set for Evaluation of Interventions to Prevent Preterm Birth. Obstetrics And Gynecology 2016;127:49-58.
  15. Bennett WL, Robinson KA, Saldanha IJ, Wilson LM, Nicholson WK. High priority research needs for gestational diabetes mellitus. J Womens Health (Larchmt) 2012;21:925-32.
  16. Bunch KJ, Allin B, Jolly M, Hardie T, Knight M. Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process. BJOG: An International Journal Of Obstetrics And Gynaecology 2018;125:1612-1618.
  17. Fiala C, Cameron S, Bombas T, Parachini M, Agostini A, Lertxundi R, et al. Outcome of first trimester medical termination of pregnancy: definitions and management. European Journal of Contraception & Reproductive Health Care 2018;23:451-457.
  18. Fong F, Rogozinska E, Allotey J, Kempley S, Shah DK, Thangaratinam S. Development of maternal and neonatal composite outcomes for trials evaluating management of late-onset pre-eclampsia. Hypertens Pregnancy 2014;33:115-31.
  19. Nijagal MA, Wissig S, Stowell C, Olson E, Amer-Wahlin I, Bonsel G, et al. Standardized outcome measures for pregnancy and childbirth, an ICHOM proposal. BMC Health Services Research 2018;18:953-953.
  20. Rogozinska E, D'Amico MI, Khan KS, Cecatti JG, Teede H, Yeo S, et al. Development of composite outcomes for individual patient data (IPD) meta-analysis on the effects of diet and lifestyle in pregnancy: a Delphi survey. BJOG: An International Journal of Obstetrics & Gynaecology 2016;123:190-8.
  21. Saldanha IJ, Wilson LM, Bennett WL, Nicholson WK, Robinson KA. Development and pilot test of a process to identify research needs from a systematic review. Journal of Clinical Epidemiology 2013;66:538-45.
  22. Dadouch R, Faheim M, Juando-Prats C, Parsons J, D'Souza R. Development of a Core Outcome Set for Studies on Obesity in Pregnant Patients (COSSOPP): a study protocol. Trials 2018;19:655-655.
  23. Duffy JMN, van 't Hooft J, Gale C, Brown M, Grobman W, Fitzpatrick R, et al. A protocol for developing, disseminating, and implementing a core outcome set for pre-eclampsia. Pregnancy Hypertension 2016;6:274-278.
  24. Egan AM, Dunne FP, Biesty LM, Bogdanet D, Crowther C, Dempsey E, et al. Gestational diabetes prevention and treatment: a protocol for developing core outcome sets. BMJ Open 2019;9:e030574.
  25. Kelly LE, Jansson LM, Moulsdale W, Pereira J, Simpson S, Guttman A, et al. A core outcome set for neonatal abstinence syndrome: study protocol for a systematic review, parent interviews and a Delphi survey. Trials [Electronic Resource] 2016;17:536.
  26. Nielsen KK, O'Reilly S, Wu N, Dasgupta K, Maindal HT. Development of a core outcome set for diabetes after pregnancy prevention interventions (COS-DAP): a study protocol. Trials 2018;19:708-708.
  27. Prins JR, Holvast F, van 't Hooft J, Bos AF, Ganzevoort JW, Scherjon SA, et al. Development of a core outcome set for immunomodulation in pregnancy (COSIMPREG): a protocol for a systematic review and Delphi study. BMJ Open 2018;8:e021619.
  28. Smith P, Cooper N, Dhillon-Smith R, O'Toole E, Clark TJ, Coomarasamy A. Core Outcome Sets in Miscarriage Trials (COSMisT) study: a study protocol. BMJ Open 2017;7:e018535-e018535.
  29. Smith V, Daly D, Lundgren I, Eri T, Begley C, Gross MM, et al. Protocol for the development of a salutogenic intrapartum core outcome set (SIPCOS). BMC Medical Research Methodology 2017;17:61-61.
  30. Viau-Lapointe J, D’Souza R, Rose L, Lapinsky SE. Development of a Core Outcome Set for research on critically ill obstetric patients: A study protocol. Obstetric Medicine (1753-495X) 2018;11:132-136.
  31. Whitehouse KC, Kim CR, Ganatra B, Duffy JMN, Blum J, Brahmi D, et al. Standardizing abortion research outcomes (STAR): a protocol for developing, disseminating and implementing a core outcome set for medical and surgical abortion. Contraception 2017;95:437-441.
  32. The Core Outcomes in Women’s and Newborn health (CROWN). [cited 2020 Jan 30]. Available from: http://www.crown-initiative.org/.

Search strategies

Embase via Elsevier 26 June 2019

Title: Core outcomes sets (COS) in obstetric care
The search result, usually found at the end of the documentation, forms the list of abstracts.
/de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti:ab = Title or abstract; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search termsItems found
Intervention
1. 'core outcome set'/exp 59
2. "core outcome*":ti,ab or "core event*":ti,ab 1620
3. ((core or composite or harmonise* or harmonize* or minimal or prioriti* or standard or standards or standardise* or standardize* or set or sets) NEAR/2 outcome*):ti,ab 17358
4. 1-3 (or) 17425
Population
5. 'childbirth'/exp or 'obstetric anesthesia'/exp or 'obstetric procedure'/exp or 'obstetrics'/exp or 'pregnant woman'/exp or 'pregnancy'/exp 1056620
6. abortion:ti OR antenatal:ti OR antepartum:ti OR birth:ti OR caesarean:ti OR childbirth:ti OR delivery:ti OR fertilization:ti OR gestation:ti OR labor:ti OR labour:ti OR maternal:ti OR neonatal:ti OR obstretric*:ti OR perinatal:ti OR peripart*:ti OR postnatal:ti OR postpartum:ti OR pregnan*:ti OR puerperium:ti OR preterm:ti 810053
7. 5 OR 6 1398844
Combined sets
8. 4 AND 7 AND ([medline]/lim OR [pubmed-not-medline]/lim) 1918
9. 4 AND 7 AND [embase]/lim AND ([danish]/lim OR [english]/lim OR [norwegian]/lim OR [swedish]/lim) 979
10. 9 NOT 8 935

Medline (Ebsco) June 26 2019

Title: Core outcomes sets (COS) in obstetric care
The search result, usually found at the end of the documentation, forms the list of abstracts.
[MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [MeSH:NoExp] = Does not include terms found below this term in the MeSH hierarchy; [MAJR] = MeSH Major Topic; [TIAB] = Title or abstract; [TI] = Title; [AU] = Author; [OT] = Other term; [TW] = Text Word; Systematic[SB] = Filter for retrieving systematic reviews; * = Truncation
Search termsItems found
Intervention
1. ("core outcome*" or "core event*" or ((core or composite or harmoni#e* or minimal or prioriti* or standard or standards or standardi#e* or set or sets) adj2 outcome*)).mp. 10749
Population
2. exp Pregnancy Complications/ or exp Pregnancy/ or exp Obstetric Surgical Procedures/ or exp Anesthesia, Obstetrical/ or exp Analgesia, Obstetrical/ or exp Obstetrics/ or exp Pregnant Women/ or (abortion or antenatal or antepartum or birth or caesarean or caesarean or caesarean or childbirth or delivery or fertilization or gestation or labor or labour or maternal or neonatal or obstretric* or perinatal or peripart* or postnatal or postpartum or pregnan* or puerperium or preterm).ti 1199069
Combined sets/Limits
  1 and 2 Limiters - Language: Danish, English, Norwegian, Swedish 1028

PsycINFO, Academic Search Elite, CINAHL with Full Text, SocINDEX with Full Text via EBSCO 26 June 2019

Title: Core outcomes sets (COS) in obstetric care
The search result, usually found at the end of the documentation, forms the list of abstracts.
AB = Abstract; AU = Author; DE = Term from the thesaurus; MM = Major Concept; TI = Title; TX = All Text. Performs a keyword search of all the database's searchable fields; ZC = Methodology Index; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search termsItems found
Intervention
1. TI ( ("core outcome*" or "core event*" or ((core or composite or harmoni#e* or minimal or prioriti* or standard or standards or standardi#e* or set or sets) NEAR/2 outcome*)) ) OR AB ( ("core outcome*" or "core event*" or ((core or composite or harmoni#e* or minimal or prioriti* or standard or standards or standardi#e* or set or sets) NEAR/2 outcome*)) ) 1414
Population
2. TI ( (abortion or antenatal or antepartum or birth or caesarean or caesarean or caesarean or childbirth or delivery or fertilization or gestation or labor or labour or maternal or neonatal or obstretric* or perinatal or peripart* or postnatal or postpartum or pregnan* or puerperium or preterm) ) OR AB ( (abortion or antenatal or antepartum or birth or caesarean or caesarean or caesarean or childbirth or delivery or fertilization or gestation or labor or labour or maternal or neonatal or obstretric* or perinatal or peripart* or postnatal or postpartum or pregnan* or puerperium or preterm) ) OR SU ( (abortion or antenatal or antepartum or birth or caesarean or caesarean or caesarean or childbirth or delivery or fertilization or gestation or labor or labour or maternal or neonatal or obstretric* or perinatal or peripart* or postnatal or postpartum or pregnan* or puerperium or preterm) ) 2019640
Combined sets
  1 and 2 110

Comet initiative database

Date of Search,"10/06/2019", updated ,"27/01/2020"

Search Options,"search{Health Area - Disease Category{:Anaesthesia & pain control:Gynaecology:Pregnancy & childbirth:Urology:}}",

Checklist modified after Core Outcome Set–STAndards for Reporting (COS-STAR)

Article: ___________________

 ItemQuestionYesNoUnclear
Title and abstract 1a Does the title contain information that the paper reports the development of a COS?      
1b Does the abstract contain the key information, such as a list of the recommended outcomes in the COS?      
Introduction 2a Is a background and explanation of the rationale for developing the COS provided?      
2b Are a clear objective presented?      
3a Is the health condition(s) and population(s) covered by the COS sufficiently described?      
3b Is the intervention(s) covered by the COS sufficiently described?      
3c Is the setting(s) in which the COS is to be applied sufficiently described?      
Methods 4 Do the authors provide information about were the COS development protocol can be accessed      
5 Is the rationale for which stakeholder groups that are involved and the eligibility criteria for participants described?      
6a Are the information sources used to identify an initial list of outcomes provided?      
6b Is it described, with reasons, how outcomes were dropped/combined if this was done?      
7 Is a description for how the consensus process was undertaken provided?      
8 Is a description for how outcomes were scored and summarised, provided?      
9a Is a description of the consensus definition provided?      
9b Is a description of the procedure for determining how outcomes were included or excluded from consideration during the consensus process provided      
10 Is a statement regarding the ethics and consent issues for the study provided?      
Results 11 Are any motivated deviations from the protocol and their eventual impact on the results described?      
12 Are numbers and relevant characteristics of the people involved at all stages of COS development presented?      
13a Are all outcomes considered at the start of the consensus process listed?      
13b Are any new outcomes introduced or any outcomes dropped during the consensus process and the reasons for doing so described?      
14 Is a list of the outcomes in the final core outcome set provided?      
Discussion 15 Are limitations with the COS development process discussed?      
16 Is an interpretation of the final COS in the context of other evidence, and implications for future research given?      
Other information 17 Are sources of funding and role of funders given?      
18 Are any conflicts of interest within the study team and how these were managed presented?      
Representation (Not included in COS-STAR) 19 Are researchers as well as health care providers and patients included in the development process?      

Appendix 3 Excluded studies

Studies considered not relevant
StudyReason for exclusion
A Core Outcome Set for Very Preterm Birth?, http://www.comet-initiative.org/studies/details/256 Not a Core Outcome Set
Allin B, Bradnock T, Kenny S, Walker G, Knight M. NETS1HD: study protocol for development of a core outcome set for use in determining the overall success of Hirschsprung's disease treatment. Trials 2016;17:1-7. Outside prespecified population
Allin B, Ross A, Marven S, Hall NJ, Knight M, J Hall N. Development of a core outcome set for use in determining the overall success of gastroschisis treatment. Trials 2016;17:1-7. Outside prespecified population
An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for reporting outcomes of surgical procedures for pelvic organ prolapse, http://www.comet-initiative.org/studies/details/525 Not a Core Outcome Set
Bakhbakhi D, Burden C, Fraser A, Hinton L, Duffy J, Redshaw M, et al. Development of a core outcome set and identification of outcome measurement tools for interventions after stillbirth. J Evid Based Med 2019;12:10. Duplication with a published protocol/registration in the COMET initiative database/or finished COS article
Bakhbakhi D, Duffy JMN, Hinton L, Burden C, Main B, Downe S, et al. Development of a core outcome set for interventions after stillbirth. Int J Gynaecol Obstet 2018;143:235. Duplication with a published protocol/registration in the COMET initiative database/or finished COS article
Bannatyne AJ, Hughes R, Stapleton P, Watt B, MacKenzie-Shalders K. Signs and symptoms of disordered eating in pregnancy: a Delphi consensus study. BMC Pregnancy Childbirth 2018;18:262-262. Not a Core Outcome Set
Bunch K, Allin B, Knight M. Authors' reply re: Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process. BJOG 2019;126:130-130. Not a Core Outcome Set
Butler MM, Brosnan MC, Drennan J, Feeney P, Gavigan O, Kington M, et al. Evaluating midwifery-led antenatal care: using a programme logic model to identify relevant outcomes. Midwifery 2014;30:e34-41. Not a Core Outcome Set
Clayton AH, Dennerstein L, Fisher WA, Kingsberg SA, Perelman MA, Pyke RE. Standards for clinical trials in sexual dysfunction in women: research designs and outcomes assessment. J Sex Med 2010;7:541-60. Outside prespecified population
Dadouch R, Faheim M, Juando-Prats C, Parsons J, D'Souza R. Development of a core outcome set for studies on obesity in pregnant patients (COSSOPP): A study protocol. J Evid Based Med 2019;12:19. Duplication with a published protocol/registration in the COMET initiative database/or finished COS article
Dadouch R, Rosen C, Parsons J, D'Souza R. Obesity in pregnancy patient-reported outcomes: A qualitative study. J Evid Based Med 2019;12:18-9. Not a Core Outcome Set
D'Souza R, Hall C, Siu S, Sermer M, Silversides C. Patient-reported outcomes in pregnancy and heart disease: A qualitative study. J Evid Based Med 2019;12:20. Not a Core Outcome Set
D'Souza R, Thurman R, Sermer M, Siu S, Duffy J, Silversides C. Developing a core outcome set for pregnant women with cardiac disease. J Evid Based Med 2017;10:24-5. Duplication with a published protocol/registration in the COMET initiative database/or finished COS article
D'Souza RD, Thomas H, Wuebbolt D, Nguyen V, Sermer M, Krahn M, et al. Preferences of pregnant women with cardiac disease for combined maternal-fetal health states. J Evid Based Med 2017;10:22-3. Not a Core Outcome Set
Duffy J, Rolph R, Gale C, Hirsch M, Khan KS, Ziebland S, et al. Core outcome sets in women's and newborn health: a systematic review. BJOG 2017;124:1481-9. Not a Core Outcome Set
Duffy J, Thompson T, Hinton L, Salinas M, McManus RJ, Ziebland S. What outcomes should researchers select, collect and report in pre-eclampsia research? A qualitative study exploring the views of women with lived experience of pre-eclampsia. BJOG 2019;126:637-46. Not a Core Outcome Set
Egan AM, Smith V, Devane D, Dunne FP. Effectiveness of prepregnancy care for women with pregestational diabetes mellitus: protocol for a systematic review of the literature and identification of a core outcomes set using a Delphi survey. Trials 2015;16:356-356. Protocol for a completed COS
Einerson BD, Einerson BD. Getting it right: core outcome sets in quality improvement research. BJOG 2018;125:1619-1619. Not a Core Outcome Set
Fong F, Rogozinska E, Allotey J, Kempley S, Shah D, Thangaratinam S. Identification of clinically important components of maternal and neonatal composite outcomes to assess the effect of timing of delivery in women with mild to moderate pre-eclampsia at 34 to 37 weeks. Arch Dis Child Fetal Neonatal Ed 2013;98. Duplication with a published protocol/registration in the COMET initiative database/or finished COS article
Hooft J, van 't Hooft J. A core outcome set for evaluation of interventions to prevent preterm birth: summary for CROWN. BJOG 2016;123:666-666. Not a Core Outcome Set
Kelly LE, Jansson LM, Moulsdale W, Pereira J, Simpson S, Guttman A, et al. A core outcome set for neonatal abstinence syndrome: study protocol for a systematic review, parent interviews and a Delphi survey. Trials [Electronic Resource] 2016;17:536. Outside prespecified population
Khan K. The Core Outcomes in Women's Health (CROWN) Initiative: Journal Editors Invite Researchers to Develop Core Outcomes in Women's Health. Gynecologic And Obstetric Investigation 2015;80:1-2. Not a Core Outcome Set
Khan K. The CROWN Initiative: journal editors invite researchers to develop core outcomes in women's health. BJOG 2016;123:103-4. Not a Core Outcome Set
Khan K. The CROWN Initiative: journal editors invite researchers to develop core outcomes in women's health. Hypertens Pregnancy 2014;33:261-4. Not a Core Outcome Set
Khan K. The CROWN Initiative: journal editors invite researchers to develop core outcomes in women's health. Journal Of Perinatal Medicine 2014;42:543-4. Not a Core Outcome Set
Khan K. The CROWN initiative: journal editors invite researchers to develop core outcomes in women's health. Obstetrics And Gynecology 2014;124:487-8. Not a Core Outcome Set
Killeen S, O'Brien E, Geraghty A, McAuliffe F. Maternal nutrition in pregnancy: A protocol for the development of a core outcome set. Obes Facts 2019;12:222. Duplication with a published protocol/registration in the COMET initiative database/or finished COS article
Killeen SL, O'Brien EC, Geraghty AA, McAuliffe F. A protocol for the development of a core outcome set for research on maternal nutrition during pregnancy. BJOG 2019;126:46. Duplication with a published protocol/registration in the COMET initiative database/or finished COS article
Kuo J, Petrie KJ, Alsweiler JM. Prioritising long-term outcomes for babies born preterm: The hip survey. J Paediatr Child Health 2019;55:83. Outside prespecified population
Lakhanpaul M, Irish C, Jarvis R, Edbrooke-Childs J, Deighton J, Franklin M, et al. A shared outcome perinatal mental health value scorecard to support health visitors to improve outcomes for children 0-5 years and their families. Arch Dis Child 2016;101:A91. Outside prespecified population
Lumsden MA. Will the development of a core outcome set on prevention and treatment of postpartum haemorrhage add value to research or clinical care? BJOG 2019;126:95-95. Not a Core Outcome Set
Malinowski AK, Daru J, D'Souza R, Shehata N. Constructing a core outcome set for iron deficiency and iron deficiency anemia in pregnancy and postpartum. J Evid Based Med 2017;10:37. Duplication with a published protocol/registration in the COMET initiative database/or finished COS article
Malinowski AK, Shehata N, D'Souza R. Constructing a core outcome set for immune thrombocytopenia in pregnancy. J Evid Based Med 2017;10:38. Duplication with a published protocol/registration in the COMET initiative database/or finished COS article
Malinowski AK, Shehata N, D'Souza R. Constructing a core outcome set for venous thromboembolism in pregnancy. J Evid Based Med 2017;10:37-8. Duplication with a published protocol/registration in the COMET initiative database/or finished COS article
Mann S, Pratt S, Gluck P, Nielsen P, Risser D, Greenberg P, et al. Assessing quality obstetrical care: development of standardized measures Jt Comm J Qual Patient Saf 2006;32:497-505. Not a Core Outcome Set
Mawer G. Core outcomes for studies of pregnancy with epilepsy. BJOG 2017;124:668-668. Not a Core Outcome Set
Medley N, Alfirevic Z, Caldwell DM, Dias S, Dowswell T, Keeney E, et al. Outcomes reported in trials of methods for the induction of labour. Trials 2015;16. Not a Core Outcome Set
Metabolic follow-up at one year and beyond of women with gestational diabetes treated with insulin and/or oral hypoglycaemic agents, study protocol for the identification of a core outcomes set using a Delphi survey. Protocol for a completed COS
Myatt L, Redman CW, Staff AC, Hansson S, Wilson ML, Laivuori H, et al. Strategy for standardization of preeclampsia research study design. Hypertension 2014;63:1293-301. Not a Core Outcome Set
Nguyen V, Wuebbolt D, Thomas H, Shehata N, Krahn M, D'Souza R. Iron deficiency anemia in pregnancy and treatment options: A patient-preference study. J Evid Based Med 2017;10:24. Not a Core Outcome Set
Outcomes Important to Patients Public and Practitioners (OMIPPP): Breastfeeding, http://www.comet-initiative.org/studies/details/662 Not a Core Outcome Set
Patient Preferences and Experiences in Hyperemesis Gravidarum Treatment: A Qualitative Study, http://www.comet-initiative.org/studies/details/1334 Not a Core Outcome Set
Perry H, Duffy JMN, Umadia O, Khalil A. Outcome reporting across randomized trials and observational studies evaluating treatments for twin-twin transfusion syndrome: systematic review. Ultrasound Obstet Gynecol 2018;52:577-85. Not a Core Outcome Set
Petersen R, Nijagal M, Wissig S, Stowell C, Franx A. Defining an international standard set of outcomes measures for maternity care: Consensus of the international consortium of health outcomes measurement pregnancy & childbirth working group. Aust N Z J Obstet Gynaecol 2016;56:51-2. Duplication with a published protocol/registration in the COMET initiative database/or finished COS article
Progressing towards core outcomes for maternal and perinatal clinical trials and reviews. J Paediatr Child Health 2017;53:91-91. Not a Core Outcome Set
Rahn DD, Abed H, Sung VW, Matteson KA, Rogers RG, Morrill MY, et al. Systematic review highlights difficulty interpreting diverse clinical outcomes in abnormal uterine bleeding trials. J Clin Epidemiol 2011;64:293-300. Outside prespecified population
Ricciardi P, Haydar A. Re: Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process: The Robson 10-groups classification system - all groups are needed. BJOG 2019;126:129-30. Not a Core Outcome Set
Rogers J, Spink M, Magrill A, Burgess K, Agius M. Evaluation of a Specialised Counselling Service for Perinatal Bereavement. Psychiatr Danub 2015;27:S482-S5. Not a Core Outcome Set
Rosen C, Dadouch R, Parsons J, D'Souza R. The comparison of outcomes reported by healthcare professionals and patients on the management of obesity in pregnancy. J Evid Based Med 2019;12:9. Not a Core Outcome Set
Rysavy MA, Marlow N, Doyle LW, Tyson JE, Serenius F, Iams JD, et al. Reporting Outcomes of Extremely Preterm Births. Pediatrics 2016;138. Not a Core Outcome Set
Say RE, Thomson RG, Robson SC. Making high quality decisions in pregnancy: How should interventions which aim to improve decision quality be evaluated? Arch Dis Child Fetal Neonatal Ed Edition 2012;97:A114-A5. Not a Core Outcome Set
Schaap T, Bloemenkamp K, Deneux-Tharaux C, Knight M, Langhoff-Roos J, Sullivan E, et al. Defining definitions: a Delphi study to develop a core outcome set for conditions of severe maternal morbidity. BJOG 2019;126:394-401. Not a Core Outcome Set
Signs and symptoms of disordered eating in pregnancy: a Delphi consensus study, http://www.comet-initiative.org/studies/details/1339 Not a Core Outcome Set
Slavin V, Gamble J, Creedy DK, Fenwick J. “Coming of Age”: assessing the feasibility of using a core set of value-based health outcomes for pregnancy and childbirth. Women Birth 2018;31:S29-S30. Not a Core Outcome Set
Smith CA, Betts D. The practice of acupuncture and moxibustion to promote cephalic version for women with a breech presentation: implications for clinical practice and research. Complement Ther Med 2014;22:75-80. Not a Core Outcome Set
Son M. Core outcome set for induction of labour trials: what's the expectation? BJOG 2018;125:1681-1681. Not a Core Outcome Set
Spink M, Magrill A, Burgess K, Rogers J, Agius M. Petals: An Assessment of the Outcomes of a Service for Bereavement during Childbirth. Psychiatr Danub 2014;26:211-21. Not a Core Outcome Set
Standards for clinical trials in sexual dysfunction in women: research designs and outcomes assessment, http://www.comet-initiative.org/studies/details/411 Outside prespecified population
Stevens G, Donnelly KZ, Theiler RN, Washburn H, Woodhams EJ, Lindahl V, et al. (Family) planning ahead: User-centered design of the birth control after pregnancy patient decision aid and protocol for delivery and evaluation. Contraception 2017;96:289. Outside prespecified population
Strategy for standardization of preeclampsia research study design, http://www.comet-initiative.org/studies/details/610 Not a Core Outcome Set
The core outcomes in women's health (CROWN) initiative. Eur J Obstet Gynecol Reprod Biol 2014;180:A1-A2. Not a Core Outcome Set
The practice of acupuncture and moxibustion to promote cephalic version for women with a breech presentation: implications for clinical practice and research, http://www.comet-initiative.org/studies/details/728 Not a Core Outcome Set
Toozs-Hobson P, Freeman R, Barber M, Maher C, Haylen B, Athanasiou S, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for reporting outcomes of surgical procedures for pelvic organ prolapse. Neurourol Urodyn 2012;31:415-21. Not a Core Outcome Set
van der Aa JE, Tancredi A, Goverde AJ, Velebil P, Feyereisl J, Benedetto C, et al. What European gynaecologists need to master: Consensus on medical expertise outcomes of pan-European postgraduate training in obstetrics & gynaecology. Eur J Obstet Gynecol Reprod Biol 2017;216:143-52. Not a Core Outcome Set
van 't Hooft J, Alfirevic Z, Asztalos EV, Biggio JR, Dugoff L, Hoffman M, et al. CROWN initiative and preterm birth prevention: researchers and editors commit to implement core outcome sets. BJOG 2018;125:8-11. Not a Core Outcome Set
van 't Hooft J. A core outcome set for evaluation of interventions to prevent preterm birth: summary for CROWN. BJOG 2016;123:107-107. Not a Core Outcome Set
van 't Hooft J. A core outcome set for evaluation of interventions to prevent preterm birth: summary for CROWN. BJOG 2016;123:666-666. Not a Core Outcome Set
van Vliet R, Bink M, Polman J, Suntharan A, Grooten I, Zwolsman SE, et al. Patient Preferences and Experiences in Hyperemesis Gravidarum Treatment: A Qualitative Study. J Pregnancy 2018;2018:5378502. Not a Core Outcome Set
Van't Hooft J, Duffy JMN, Saade GR, Alfirevic Z, Meher S, Mol BWJ, et al. Core outcomes set for studies on primary prevention of preterm birth. Trials 2015;16. Duplication with a published protocol/registration in the COMET initiative database/or finished COS article
Van't Hooft J, Khan KS. P-hacking can be avoided with core outcome sets: preterm birth research is ready to take this leap. BJOG 2017;124:1017-1017. Not a Core Outcome Set
Webbe J, Brunton G, Afonso E, Latour JM, Gale C. The importance of core outcome sets and developing one for neonatal care. Infant 2017;13:70-2. Outside prespecified population
Webbe J, Brunton G, Ali S, Duffy JM, Modi N, Gale C. Developing, implementing and disseminating a core outcome set for neonatal medicine. BMJ Paediatr Open 2017;1:e000048. Outside prespecified population
Webbe J, Brunton G, Ali S, Wann L, Modi N, Gale C. Using existing data sources to extract parent and patient outcomes for a neonatal core outcome set. J Evid Based Med 2017;10:10-11. Outside prespecified population
What outcomes should researchers select, collect and report in pre-eclampsia research? A qualitative study exploring the views of women with lived experience of pre-eclampsia, http://www.comet-initiative.org/studies/details/1327 Not a Core Outcome Set
Whitehouse KC, Kim CR, Ganatra B, Duffy JMN, Blum J, Brahmi D, et al. Standardizing abortion research outcomes (STAR): a protocol for developing, disseminating and implementing a core outcome set for medical and surgical abortion. Contraception 2017;95:437-41. Protocol for a completed COS
Wiegers TA, Keirse MJ, Berghs GA, van der Zee J. An approach to measuring quality of midwifery care. J Clin Epidemiol 1996;49:319-25. Not a Core Outcome Set
Williamson P. Core outcome sets will improve the quality of obstetrics research. BJOG 2014;121:1196. Not a Core Outcome Set

Appendix 4 Ongoing studies

Ongoing COS studies
Reference
First author
Year
PopulationStakeholders to be included in the workgroupMethodsCompliance with COS-STAR
[57]
(registered in COMET database)
Prevention and treatment of obstetric anal sphincter injuries

COS for clinical trials or clinical research and COS for practice
  • Clinical experts
  • Consumers (patients)
  • Epidemiologists
  • Journal Editors
  • Patient/support group representatives
  • Systematic review to identify outcome measures
  • International survey of stakeholders to review identified outcomes and other outcomes identified by stakeholders
  • Delphi methodology to achieve a consensus
Not enough information
[18]
Egan
2007
Published protocol
Two core outcome sets:

Intervention for prevention of gestational diabetes mellitus and intervention for treatment of gestational diabetes mellitus

COS for clinical trials or clinical research and COS for practice
  • Clinical experts
  • Researchers
  • Service users
  • Systematic review to identify outcome measures
  • A three-round, web-based, e‑Delphi survey
  • Consensus face-to-face meeting
Yes
[46]
(registered in COMET database)
Interventions for overweight women before pregnancy and in the first trimester of pregnancy

COS for clinical trials or clinical research COS for practice
  • Clinical experts
  • Consumers (patients)
  • Economists
  • Epidemiologists
  • Families
  • Researchers
  • Service providers Statisticians
  • Systematic review to identify outcome measures
  • A Delphi process until reduction of the list of identified outcomes to ten or less or on completion of the second round
  • Consensus face-to-face meeting
Not enough information
[13]
(registered in COMET database)
Interventions for hyperemesis gravidarum

COS for clinical trials or clinical research
  • Clinical experts
  • Consumers (caregivers)
  • Consumers (patients)
  • Journal editors
  • Patient/support group representatives
  • Researchers
  • Systematic review to identify outcome measures
  • Two round Delphi survey to achieve a consensus
  • If no consensus has been reached even after additional Delphi rounds, a final consensus meeting will be organized
Not enough information
[40]
(registered in COMET database)
Therapeutic interventions for pregnant women with cardiac disease

COS for clinical trials or clinical research, COS for practice
  • Clinical experts
  • Consumers (patients)
  • Guideline developers
  • Journal editors
  • Researchers
  • Service providers
  • Statisticians
  • Systematic review to identify outcome measures
  • Two round Delphi survey to achieve a consensus
  • Consensus face-to-face meeting
  • Recommendations for outcome measures (measure­ment/how)
Not enough information
[41]
(registered in COMET database)
Identification, assessment and management of iron deficiency and iron deficiency anaemia in pregnancy and postpartum

COS for clinical trials or clinical research
  • Clinical experts
  • Consumers (patients)
  • Researchers
  • Systematic review to identify outcome measures
  • Two round Delphi survey to achieve a consensus
Not enough information
[42]
(registered in COMET database)
Identification, assessment and management of venous thrombo­embolism in pregnancy

COS for clinical trials or clinical research
  • Clinical experts
  • Consumers (patients)
  • Researchers
  • Systematic review to identify outcome measures
  • Two round Delphi survey to achieve a consensus
Not enough information
[33]
(registered in COMET database)
The evolution and management of immune thrombo­cytopenia in pregnancy

COS for clinical trials or clinical research
  • Clinical experts
  • Researchers
  • Systematic review to identify outcome measures
  • Two round Delphi survey to achieve a consensus
Not enough information
[24]
(registered in COMET database)
Research in multiple pregnancies, irrespective of chorionicity

COS for clinical trials or clinical research
  • Clinical experts
  • Consumers (patients)
  • Families
  • Patient/support group representatives
  • Researchers
  • Systematic review to identify outcome measures
  • Delphi survey
  • Consensus face-to-face meeting
Not enough information
[34]
(registered in COMET database)
Diagnostic and therapeutic management pregnancies complicated by cancer

COS for clinical trials or clinical research and COS for practice
  • Clinical experts
  • Consumers (caregivers)
  • Consumers (patients)
  • Patient/ support group representatives
  • Systematic review to identify outcome measures
  • Delphi survey
  • If necessary, consensus meeting
Not enough information
[35]
(registered in COMET database)
Antenatal diagnosis and management pregnant women with vasa previa

COS for clinical trials or clinical research COS for practice
  • Charities
  • Clinical experts
  • Conference participants
  • Consumers (caregivers)
  • Consumers (patients)
  • Epidemiologists
  • Families
  • Methodologists
  • Patient/support group representatives
  • Policy makers
  • Researchers
  • Systematic review to identify outcome measures
  • Qualitative patient interviews to identify potential core outcomes
  • Delphi survey
  • If necessary, consensus face-to-face meeting
  • Determining How Core Outcomes Should be Measured
Not enough information
[36]
(registered in COMET database)
Screening, diagnosing, and managing of invasive placentation

COS for clinical trials or clinical research
  • Clinical experts
  • Consumers (caregivers)
  • Consumers (patients)
  • Journal editors
  • Policy makers
  • Researchers
  • Service providers
  • Service users
  • Systematic review to identify outcome measures
  • Focus Groups to identify important outcomes from the perspectives of patients
  • Delphi survey
  • Consensus face-to-face meeting
Not enough information
[25]
(registered in COMET database)
Management, treatment and frequency of surveillance of twin anaemia poly­cythaemia sequence

COS for clinical trials or clinical research COS for practice
  • Charities
  • Clinical experts
  • Epidemiologists
  • Families
  • Patient/support group representatives
  • Researchers
  • Systematic review to identify outcome measures
  • Delphi survey
  • Consensus face-to-face meeting
Not enough information
[37]
(registered in COMET database)
Fetal Interventions of myelom­eningocele (spina bifida)

COS for clinical trials or clinical research COS for practice
  • Clinical experts
  • Consumers (caregivers)
  • Consumers (patients)
  • Families
  • Patient/ support group representatives
  • Researchers
  • Systematic review to identify outcome measures
  • Delphi survey
  • Consensus face-to-face meeting
Not enough information
[39]
(registered in COMET database)
Management of sickle cell disease in pregnancy

COS for clinical trials or clinical research
  • Clinical experts
  • Consumers (patients)
  • Methodologists
  • Patient/ support group representatives
  • Pharmaceutical industry representatives
  • Researchers
  • Service providers
  • Service users
  • Systematic review to identify outcome measures
  • Delphi survey
  • Consensus face-to-face meeting
Not enough information
[44]
(registered in COMET database)
Maternal nutrition during pregnancy

COS for clinical trials or clinical research COS for practice
  • Clinical experts
  • Consumers (patients)
  • Researchers
  • Systematic review to identify outcome measures
  • Delphi survey
  • Steering group meeting
Not enough information
[38]
(registered in COMET database)
Prenatal interventions for congenital diaphragmatic hernia

COS for clinical trials or clinical research
  • Clinical experts
  • Patient/support group representatives
  • Researchers
  • Systematic review to identify outcome measures
  • Delphi survey
  • Consensus face-to-face meeting
  • Determining how core outcomes should be measured
Not enough information
[63]
(registered in COMET database)
Treatment of female pelvic floor disorders (urinary incontinence, pelvic organ prolapse, childbirth perineal trauma and pelvic pain syndromes)

COS for clinical trials or clinical research COS for practice
  • Charities
  • Clinical experts
  • Consumers (caregivers)
  • Consumers (patients)
  • Governmental agencies
  • Patient/ support group representatives
  • Pharmaceutical industry representatives
  • Policy makers
  • Researchers
  • Service commissioners
  • Service providers
  • Service users
  • Systematic review to identify outcome measures
  • Qualitative patient interviews to identify potential core outcomes
  • Delphi survey
  • Consensus face-to-face meeting
  • Determining how core outcomes should be measured
Not enough information
[64]
(registered in COMET database)
Treatment of rectovaginal fistula

COS for clinical trials or clinical research COS for practice
  • Charities
  • Clinical experts
  • Conference participants
  • Consumers (caregivers)
  • Consumers (patients)
  • Patient/support group representatives
  • Researchers
  • Systematic review to identify outcome measures
  • Qualitative patient interviews to identify potential core outcomes
  • Delphi survey
  • Consensus face-to-face meeting
Not enough information
[56]
(registered in COMET database)
Interventions for assessment of fetal wellbeing in labour

COS for clinical trials or clinical research
  • Clinical experts
  • Service users
  • Systematic review to identify outcome measures
  • Delphi survey
  • Consensus face-to-face meeting
Not enough information
[50]
(registered in COMET database)
Interventions for prevention of stillbirth and care after stillbirth

COS for clinical trials or clinical research
Unknown
  • Systematic review to identify outcome measures
  • Qualitative patient interviews to identify potential core outcomes
  • Delphi survey
  • Consensus face-to-face meeting
Not enough information
[51]
(registered in COMET database)
Interventions for the detection and management of reduced fetal movements

COS for clinical trials or clinical research
  • Clinical experts
  • Researchers
  • Service users
  • Systematic review to identify outcome measures
  • Delphi survey
  • Consensus face-to-face meeting
Not enough information
[52]
(registered in COMET database)
Interventions to prevent stillbirth

COS for clinical trials or clinical research COS for practice
  • Clinical experts
  • Consumers (patients)
  • Researchers
  • Systematic review to identify outcome measures
  • Qualitative patient interviews to identify potential core outcomes
  • Delphi survey
  • Determining how core outcomes should be measured
Not enough information
[54]
(registered in COMET database)
Examining outcomes resulting from operative vaginal birth

COS for clinical trials or clinical research COS for practice
  • Charities
  • Clinical experts
  • Families
  • Journal editors
  • Patient/ support group representatives
  • Researchers
  • Service commissioners
  • Service providers
  • Service users
  • Statisticians
  • Systematic review to identify outcome measures
  • Qualitative patient interviews to identify potential core outcomes
  • Delphi survey
  • Consensus face-to-face meeting
Not enough information
[66]
(registered in COMET database)
Intervention to support women and infants to breastfeed

COS for clinical trials or clinical research
  • Clinical experts
  • Consumers (caregivers)
  • Researchers
  • Systematic review to identify outcome measures
  • Delphi survey
Not enough information
[69]
(registered in COMET database)
Maternal and fetal Composite Adverse

Obstetric Outcomes

COS for clinical trials or clinical research
  • Clinical experts
  • Conference participants
  • Consumers (caregivers)
  • Consumers (patients)
  • Epidemiologists
  • Families
  • Policy makers
  • Researchers
  • Service providers
  • Service users
  • Statisticians
  • Systematic review to identify outcome measures
  • Qualitative patient interviews to identify potential core outcomes
  • Delphi survey
  • Consensus face-to-face meeting
  • Determining how core outcomes should be measured
Not enough information
[19]
Nielsen
Published protocol
Interventions to prevent diabetes after pregnancy for women with previous GDM

COS for clinical trials
  • Clinical experts
  • Conference participants
  • Consumers (patients)
  • Epidemiologists
  • Families
  • Methodologists
  • Researchers
  • Systematic review to identify outcome measures
  • Semi-structured discussion meeting will inform the Delphi survey development
  • Two-round Delphi survey
  • Consensus face-to-face meeting
Yes
[47]
Danouch
Published protocol
Antenatal and peripartum intervention for obesity

COS for clinical trials
  • Clinical experts
  • Conference participants
  • Consumers (caregivers)
  • Consumers (patients)
  • Epidemiologists
  • Families
  • Guideline developers
  • Policy makers
  • Researchers
  • Service providers
  • Service users
  • Statisticians
  • Trialists
  • Systematic review to identify outcome measures
  • Qualitative patient interviews to identify potential core outcomes
  • Two-round Delphi survey
  • Consensus face-to-face meeting
  • Determining how core outcomes should be measured
Yes
[65]
Smith
Published protocol
What constitutes positive health and wellbeing (saluto­genesis) in maternity care

COS for clinical trials and measuring in daily intrapartum clinical care
  • Clinical experts
  • Consumers (patients)
  • Researchers
  • Service users
  • Three-round Delphi survey
Yes
[21]
Duffy
Published protocol
Therapeutic interventions for pre-eclampsia

COS for clinical trials or clinical research
  • Academic research representatives
  • Carer organisation/support­group representatives
  • Charities
  • Clinical experts
  • Consumers (patients)
  • Correlative science experts
  • Governmental agencies
  • Individuals with a known interest
  • Patient/support group representatives
  • Pharmaceutical industry representatives
  • Service commissioners
  • Service providers
  • Study investigators
  • Trialists
  • Systematic review to identify outcome measures
  • Qualitative patient interviews to identify potential core outcomes
  • Two-three-round Delphi survey
  • Determining how core outcomes should be measured
Yes
[60]
Smith
Published protocol
Prevention and treatment of miscarriage

COS for clinical trials
  • Clinical experts
  • Consumers (patients)
  • Families
  • Patient/ support group representatives
  • Systematic review to identify outcome measures
  • Qualitative patient interviews to identify potential core outcomes
  • Three-round Delphi survey
  • Consensus face-to-face meeting
Yes
[62]
Whitehouse
Published protocol
Medical and surgical abortion

COS for clinical trials
  • Clinical experts
  • Consumers (patients)
  • Epidemiologists
  • Governmental agencies
  • Service providers
  • Systematic review to identify outcome measures
  • Qualitative patient interviews to identify potential core outcomes
  • Two-round Delphi survey
  • Consensus face-to-face meeting
Yes
[31]
Viau-Lapointe
Published protocol
Research on critically ill obstetric patients

COS for clinical trials or clinical research

COS for practice
  • Clinical experts
  • Consumers (caregivers)
  • Consumers (patients)
  • Families
  • Journal editors
  • Researchers
  • Service providers
  • Systematic review to identify outcome measures
  • Qualitative patient interviews to identify potential core outcomes
  • Two-round Delphi survey
  • Virtual consensus meeting
Yes
[32]
Prins
Published protocol
Immune modulation interventions as preventive or therapeutic strategies for pregnancy complications

COS for clinical trials or clinical research

COS for practice
  • Clinical experts
  • Consumers (caregivers)
  • Consumers (patients)
  • Patient/support group representatives
  • Researchers
  • Systematic review to identify outcome measures
  • Three-round Delphi survey
  • Consensus face-to-face meeting
Yes
[28]
Kelly
Published protocol
Prevention and management strategies of neonatal abstinence syndrome

COS for clinical trials or clinical research

COS for practice
  • Clinical experts
  • Consumers (caregivers)
  • Epidemiologists
  • Methodologists
  • Researchers
  • Systematic review to identify outcome measures
  • Qualitative patient interviews to identify potential core outcomes
  • Three-round Delphi survey
  • Consensus face-to-face meeting
Yes
[29]
Viau-Lapointe
Conference abstract
Pregnant women requiring mechanical ventilation

COS for clinical trials
  • International group of patients and members of the public
  • Systematic review to identify outcome measures
  • Delphi survey
Not enough information

Conference abstract
[30]
Sankaran
Published protocol Conference abstract
Obstetric antiphospholipid antibody syndrome (OAPS), the need for low-molecular weight heparin (LMWH for pregnant women

COS for clinical trials
  • Clinicians (rheumatology, obstetrics, maternal-fetal medicine, fertility and haematologists) patients
  • Systematic review to identify outcome measures
  • Delphi survey
Not enough information

Conference abstract
[70]

(registered in COMET database)
Uniform

Definitions of maternal morbidity

Definition
  • Researchers
  • Delphi survey
  • Consensus meeting
Not enough information
[27]

(registered in COMET database)
Ectopic pregnancy

COS for clinical trials or clinical research
  • Clinical experts
  • Patient/ support group representatives
  • Researchers
  • Service providers
  • Systematic review to identify outcome measures
  • Delphi survey
  • Consensus face-to-face meeting
  • Recommendations for outcome measures (measure­ment/how)
Not enough information
Page published