The Conceptualization of Pregnancy-Associated Maternal Morbidity in Research Studies: A Scoping Review [ID: 1376717

Abstract

INTRODUCTION: This study aimed to review the clinical literature to understand how maternal morbidity has been conceptualized. METHODS: We conducted a scoping review wherein we searched four databases until May 2022 for studies on maternal morbidity. We screened abstracts in duplicate and extracted data on the study scope, terms used to describe maternal morbidity, and conditions included. Results were presented descriptively. RESULTS: We identified 8,178 titles, of which 589 studies from 1986 to 2022 were included in the final analysis. Included studies used 73 terms to describe maternal morbidity. While 217 (37%) studies described maternal morbidity in the context of the general pregnant population, others described more specific contexts, for example, hypertensive disorders of pregnancy (43 studies, 7%), obesity (38 studies, 6%), and gestational and pregestational diabetes (31 studies, 5%). In terms of component outcomes, 156 (26%) studies utilized the World Health Organization criteria for maternal near miss and potentially life-threatening conditions or the Centers for Disease Control and Prevention criteria for severe maternal morbidity, while others included between one and 45 outcomes, the most frequent of which were intensive care unit admission, preeclampsia, eclampsia, hemorrhage, uterine rupture, hysterectomy, and blood transfusion. Notably, 36 (6%) studies included fetal or neonatal outcomes when describing maternal morbidity. CONCLUSION: Although maternal morbidity is reported in a large number of pregnancy studies, there is no consistency in what outcomes are included in its definition. There is need for a standardized definition of maternal morbidity that embodies the perspectives of persons with lived experience of pregnancy.